Patient Access Representative Specialist

Core Job Summary:
The Patient Access Specialist (On-Site) is responsible for coordinating a wide range of complex duties that support front end revenue cycle and clinic functions for hospital and clinic operations that impact the patient experience. Serves as functional expert for department peers and oversees team adherence with established policies and procedures.

Core Responsibilities:

1. Obtains, confirms, and enters demographic, financial, and clinical information necessary for financial clearance of scheduled patient accounts.
2. Contacts patients’ families or physicians’ offices to obtain missing insurance information.
3. Verifies insurance and confirms insurance eligibility of patient coverage benefits, notifying patient and referring physician in the event of failed eligibility.
4. Collaborates with scheduling departments to identify add-on patients.
5. Obtains necessary authorizations, pre-certifications, and referrals.
6. Notifies patients of liabilities prior to date of service and collects funds.
7. Maintains appropriate records, files, and accurate documentation in the system of record.
8. Serves as a lead resource for lower-level Patient Services staff.
9. Recommends new approaches to management for enhancing performance and productivity.
10. Deploys critical thinking while responding to a variety of technical issues from patients, physicians and employees via phone, email, web messages, fax, or email.
11. Works independently and deals effectively with stress, due to heavy workload and the handling of complex patient inquiries.
12. Serves as a role model, facilitator, and coach in developing a culture of compassion and caring through building healthy relationships among staff, patients, and families.
13. Projects a professional appearance and pleasant demeanor creating a welcoming atmosphere.
14. Adheres to University and unit-level policies and procedures and safeguards University assets.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

CORE QUALIFICATIONS

High School Diploma or equivalent/relevant experience, certification or license
Minimum 3 years of relevant experience required


Knowledge, Skills and Abilities:

• Learning Agility: Ability to learn new procedures, technologies, and protocols, and adapt to changing priorities and work demands.

• Teamwork: Ability to work collaboratively with others and contribute to a team environment.

• Technical Proficiency: Skilled in using office software, technology, and relevant computer applications.

• Communication: Strong and clear written and verbal communication skills for interacting with colleagues and stakeholders.