Patient Access Specialist

Overview

Patient Access Specialist, Business Office

Full Time, 80 Hours Per Pay Period, Day Shift

Covenant Health Overview:

Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year.

Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times. 

Position Summary:

The Patient Access Specialist coordinates the verification, scheduling, and pre-registration of all outpatient diagnostic procedures, as defined under the Centralized Scheduling Department’s purview. Responsibilities include the accurate collection and entry of required financial and demographic patient information, scheduling queue management, verification of benefits, scheduling, and payment collection. 

Responsibilities

• Collects patient payment of financial responsibility over the phone, provides receipt of payment to patient, and documents payment as outlined in the department’s workflow
• Recommends to the Supervisor modifications to existing policies and procedures that support Covenant Health’s values and are intended to increase efficiency and promote data integrity
• Notifies the Supervisor/Financial Counselor of any potential self-pay patient, worker’s compensation patient, or non-covered procedures
• Schedules diagnostic procedures utilizing the eCare (Cerner) scheduling system
• Verifies all orders are completed and signed
• Verifies insurance benefits and verifies pre-certification from third-party payers
• Has extensive knowledge of insurance plan and pre-certification requirements
• Accurately documents relevant demographic, clinical, and financial information required for scheduling, pre-registration, and insurance verification using eCare (Cerner), TransUnion, and STAR
• Attempts to collect payment of financial responsibility for all patients to improve overall collections and cash flow
• Reports pertinent procedural changes/updates to appropriate leadership
• Professionally interacts with patients, providers, office staff, and hospital department staff members
• Demonstrates ability to keep up with regulatory and insurance requirements, ensuring that changes are incorporated into daily job functions
• Ensures the scheduling process is handled in a professional and courteous manner
• Schedules on average 25 appointments per day
• Clearly communicates all necessary information to patients, e.g. clinical preps as outlined in the eCare scheduling guidelines, ABNs, financial responsibility, etc.
• Recognizes situations that necessitate managerial intervention and seeks out appropriate resources
• Promotes good public relations for the department and the organization
• Attends monthly staff meetings and participates in discussions regarding work performance and departmental/hospital updates
• Displays competence in the use of all IT Systems related to insurance verification, scheduling, patient registration, and scheduling
• Monitors appointment schedules daily for cancellations, reschedules, stats, or other changes; communicates with all departments impacted
• Shows initiative to cross-train in all duties related to departmental functions
• Activates manual systems for computer network downtime, printing schedules in advance when necessary
• Notifies leadership of unscheduled downtime occurrences
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.

Qualifications

Minimum Education:          

None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED.  Preference may be given to individuals possessing a Bachelor’s degree in a directly-related field from an accredited college or university.

Minimum Experience:         

Experience in hospital setting or financial area required. 

Licensure Requirement:      

None