Access Specialist (Therapy Services)

Nemours Children's Health•Wilmington, DE

27d•Onsite

About The Position

Nemours Children's Health is seeking an Access Specialist to join its Therapy Services team in Wilmington, Delaware. The Therapy Access Specialist communicates with patients and providers by telephone to schedule therapy appointments accurately, promptly, and courteously according to established guidelines. The role obtains and enters accurate demographic and insurance information for encounters, discusses financial obligations with patient families, and collects payment when appropriate. It also monitors registration and insurance-related items in patient work queues to support timely claim filing. The specialist collaborates with program managers and supervisors to meet patients’ access needs and provides superior service to internal and external customers while representing Nemours professionally and demonstrating its service commitment and organizational values. The position handles appointment scheduling and follow-up calls, insurance verification and authorization, registration and billing documentation in the Electronic Medical Record (EMR), communication of appointment updates and barriers, and escalation of urgent diagnoses or appointments. It informs callers about financial responsibility and authorization requirements, refers families to Financial Advocates when they need assistance, explains appointment preparation requirements, and documents pertinent account information for clinic, registration, authorization, family financial, and billing departments.

Requirements

High school diploma.
At least three years of experience.
Customer service experience.

Nice To Haves

Call center experience.
Front-end healthcare experience.
NAHAM Certification (CHAA).

Responsibilities

Promptly answer incoming calls to schedule patient appointments and make outbound follow-up calls when needed.
Provide smooth transitions for internal and external customers through excellent customer service and effective communication.
Process and document information required for insurance verification, registration, and billing in the Electronic Medical Record (EMR) system.
Schedule appointments according to established division guidelines and communicate updates and barriers promptly.
Prioritize urgent diagnoses and appointments and use escalation processes when necessary.
Verify insurance eligibility and authorizations using available resource tools.
Use the Managed Care Manual to verify participating insurances and their requirements.
Inform callers of financial responsibility due at the time of service, offer advance collection during scheduling, and ensure accurate daily cash reconciliation.
Explain applicable authorization requirements to callers when appointments are made.
Refer patients to Financial Advocates when financial assistance is needed.
Educate callers about appointment preparation and requirements for a productive visit.
Accurately document pertinent information in patient accounts for clinic, registration, authorization, family financial, and billing departments.