Financial Access Specialist

Yale New Haven Health•Torrington, CT

About The Position

The Patient Financial Access Specialist - OP performs Patient Financial Access Facilitator functions and supports complex scheduling across multiple outpatient service areas. The specialist uses effective communication and technology to identify patients accurately, follow Red Flag procedures, and obtain or update demographic and financial information in multiple computer systems so visits can be processed promptly. The role serves as a liaison between physicians and patients for internal and external appointment and procedure scheduling. Working with patients, physicians, and nursing professionals, the specialist manages the sequencing of complex procedures, physician appointments, infusion or chemotherapy, and other multifaceted services. The specialist confirms that required instructions, preparations, and laboratory tests are completed before appointments and procedures; coordinates appointments; and manages patient and insurance demographics to support appropriate reimbursement. The specialist makes decisions about whether ordered exams meet Medical Necessity requirements and follows up with patients or physicians when a Waiver or ABN is required. The role also considers imaging and satellite locations across the system when aligning appointments with patient locations. Attention to detail, accuracy, and patient sensitivity are essential. The specialist represents YNHH service standards, performs statistical and quality-assurance functions, helps develop procedures, and participates in planning, implementing, and training staff on system improvements.

Requirements

High school diploma or GED.
Self-directed, well organized, and team oriented, with the ability and desire to educate and advocate for patients and families.
Ability to multitask and reprioritize in response to changes in volume.
Strong interpersonal skills and ability to build rapport with a wide range of people, including clinical staff.
Excellent investigative, critical-thinking, and problem-solving skills.
Intermediate computer skills and ability to adapt to different programs and systems.
Demonstrated proficiency in understanding registration work queues that affect workflow.
Ability to provide training or in-service sessions to staff in the department and hospital.
Effective written and oral communication skills, including the ability to communicate complex requirements across clinical and financial disciplines.
Attention to detail, accuracy, and patient sensitivity and compassion.

Nice To Haves

Associate degree.
Two to three years of work experience in a customer service environment, preferably in a hospital or physician office, with an emphasis on registration, scheduling, medical insurance, and eligibility requirements.

Responsibilities

Obtain required information from referring physicians and clinical providers and provide it to third-party payers to support reimbursement for outpatient services.
Accurately schedule patient follow-up physician appointments in the appropriate scheduling system using established guidelines and requirements.
Enter insurance information accurately and understand insurance options, eligibility, benefits, and copayment amounts; document findings in the appropriate system.
Coordinate and support patient appointment scheduling, including complex and time-sensitive appointment types in Epic.
Provide support and coverage in other outpatient service departments in collaboration with the Supervisor or Manager.
Optimize time spent on patient appointment scheduling.
Deliver service excellence and acknowledge and receive patients and visitors according to YNHHS Standards of Professional Behavior.
Work with clinical staff to maintain Epic templates for multiple locations and meet with clinical teams to plan and create scheduling templates for different disciplines.
Review and update training materials as needed and train other staff members.
Perform other duties as assigned by Management.
Follow up with patients or physician offices to confirm required instructions, preparations, laboratory tests, waivers, or ABNs.
Coordinate patient appointments and manage patient and insurance demographics to support appropriate reimbursement.
Evaluate whether ordered exams meet Medical Necessity requirements and align appointments with appropriate imaging or satellite locations.
Perform statistical and quality-assurance functions and participate in developing, planning, implementing, and training staff on system improvements.