Patient Access Specialist (Full Time)

DESCRIPTION OF POSITION:

• Performs related processing duties for all patients being served by the hospital. As a member of the Radiation Oncology team the Patient Access Specialist is trained in performing a wide range of skilled administrative and clerical duties.

SUPERVISION: Reports directly to the Director of Radiation Oncology

RESPONSIBILITIES AND DUTIES:

• Employee documents and forwards applicable information to facility or in office.
• Employee familiar with different insurance companies and their requirements in terms of precertification and authorization for surgery, testing, and procedures.
• Verifies patient information is correct, demographics and insurance coverage.
• If changes are required, changes the information into the Practice Management system.
• Checks in the patient in the Practice Management system.
• 3 days prior to appointment, confirmation calls should be made to the patient.
• Patient should be called daily until patient or family member personally confirms.
• Scan and attach all paperwork received into EMR system and attach and send appropriately.
• Runs and reconciles receipts following established protocol.
• Scan and attach all paperwork received into EMR system and attach and send appropriately.
• Is trained to perform all checkout duties.
• Performs other job duties as assigned.
• Able to perform administrative duties (i.e. scheduling, registration, insurance authorization, answering phone, schedule testing, refer patients as ordered by physician or mid level provider etc…).
• Performs and safely operates all equipment according to the manufacturers’ instructions and protocols.
• Answers phone with correct salutation. Takes messages when appropriate.
• Greets each patient warmly and cheerfully.
• Employee is familiar with CPT coding and Medical Necessity of testing.
• Employee ensures criteria met prior to scheduling testing and/or procedures, including surgery.
• Employee is knowledgeable about insurance processing and is able to explain deductibles, co-insurance, co-payments, and how processing occurs.
• Updates and scans updated information and forms into appropriate Practice Management or EMR system.
• In the event a patient does not show for scheduled appointment, a “No Show” letter must be generated in the patient chart in the EMR system.
• Letter should be mailed to patient.
• Message in the EMR should be sent to the physician of the no show.
• Collects patient co-pay and prior balances, posting to account and giving receipt.
• Verification of insurance should be performed and noted on the careslip.
• Co-Pay/Balance Owed noted on the careslip.
• If patient does not leave required information, patient access specialist must call patient back in order to obtain.
• Records all messages into electronic EMR after completing request.
• Checks out the patient in the EMR system.
• Pulls all orders from checkout function.
• Schedules all return appointments.
• Schedules all testing after obtaining precertification per physician checkout orders.
• Completes and sends medical records request per physician orders.
• Completes all referrals through the EMR following correct protocol.
• Collect faxes and scan if testing.
• Other than testing, distribute into boxes if appropriate.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND WORK EXPERIENCE

• High school diploma or equivalent required.
• Knowledge and training in medical terminology, keyboarding, and computer skills required.
• Basic skills in Microsoft Office required.
• Previous experience preferred in the areas of scheduling, EPIC preferred, insurance verification and authorization.
• Broad range of administrative and technical skills in the context of the healthcare environment.
• Impacts activities in other work areas on a frequent basis and contributes in multiple work areas.
• Demonstrates critical thought process and can work independently.
• Provides feedback to assist with decision making process.
• Works well with others.
• Documents detailed information in patient chart.
• Requires listening skills to maintain cooperative associations.

Physical Demands/Work Environment

• Work requires a variety of physical activities, including moving about within and outside of all hospital proper