Access Specialist I-AR

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General Description of the Job Class

Performs various appointment and access-related duties to include, but not limited to, scheduling, canceling, rescheduling, general appointment information, and directions.

Coordinate services across multiple DUHS and PDC clinical locations, departments, and providers.

Service oriented tasks are transactional, and productivity based.

Professionally and effectively, communicate verbally and in writing with patients, referring providers, colleagues, and Duke Providers.

Actively identify, listen, and understand the needs of the caller.

Own calls through the resolution of requests.

Proactively resolve conflict, utilizing emotional intelligence and positive language based on Duke Health Access Services values.

Understand and effectively utilize appropriate medical terminology.

Proactively offer alternative providers or locations when appropriate.

Utilizes multiple technology applications and systems to perform scheduling tasks to include but not limited to: EPIC, Cadence, Op-time, Template changes, On Base and Telephony Systems such as Finesse, TeleOpti, and ZOOM.

Duties and Responsibilities of this Level

Scheduling an appointment

• Identify the caller and relationship to the patient, using compliance- based scheduling guidelines.
• Identify the patient using 2 identifiers in accordance with compliance guidelines.
• Register the patient by entering, verifying and/or updating demographic and guarantor information including emergency contacts.
• Gather special needs information and coordinate the provision of necessary support services, i.e., disabilities, language services, other special needs.
• Translate a patient's request using clinical terminology and specialty-specific guidelines that are recognized by our information systems and approved by our clinical leadership.
• Use scheduling questionnaires, scheduling guidelines and other scheduling-related resources to conduct an advanced appointment search.
• Determine the appropriate provider, appointment template, and slot while respecting provider, referring provider, and patient preferences.
• Coordinate and, where appropriate, schedule necessary tests and studies associated with a clinic visit.
• Understand and respond appropriately to scheduling-related warning messages to ensure provider template guidelines are adhered to and the patient is scheduled with the right provider in the right time slot.
• Complete the appointment by resolving all registration and scheduling warning messages, confirming referring provider, the location of the visit, directions and additional scheduling instructions as specified by specialty.

Revenue Cycle:

• Collect or verify insurance information.
• Initiate an eligibility check for new insurance entries.
• Communicate sensitive, health care related financial obligations of the patients when a non-contacted insurance, self-pay or Out-of-County Medicaid, Veterans Administration, or Worker's Compensation coverage is realized.
• Follow workflows to include creating a referral for a financial review and trace the progress of the referral until the patient requires an appointment to be scheduled.
• Identify who is responsible for the payment for the bill and enter the information in the guarantor section.
• Notify patient of financial responsibility for the visit to include the payment that will be required at the time of the visit.
• Working from a worklist:
• Analyze work lists and prioritize by Emergent, Urgent, and Routine request.
• Work lists include faxed referral request from strategic partners, medical practices, and programs.
• Referral request submitted by internal Duke Providers for new patient appointments.
• Patients needing an appointment rescheduled due to a change in the provider's schedule.
• Patients needing a future appointment when provider schedules are not yet published.
• Patients needing a sooner appointment.
• Use all available resources to contact the patient, including phone numbers, MyChart account, and email while following compliance guidelines.
• Provide detailed information about the reason for the call. Be prepared for questions, remain attentive, and resolve complex tasks.
• If the patient is ready to schedule, make the appointment and/or coordinate any related tests or labs, following approved scheduling algorithms.

Quality and Performance Measures:

• Achieve call quality standards job results, recognizing calls are recorded and scored.
• Meet quality and performance expectations.
• Adhere to published daily work schedules and percentage of availability scores.
• Achieve service measures such as lower percentage of abandoned calls, call duration and calls lost.
• Support other services and functions within the Duke Health Access Services.

Required Qualifications at this Level

Education

A high school diploma or equivalent is required. College or completion of post-secondary education is preferred.

Experience

A minimum of 2 years of customer service experience or 1 year of relevant healthcare and/or call center experience.