Central Scheduling - Patient Access Associate III - 40hrs

Connecticut Children's Medical Center•Hartford, CT

About The Position

Under limited supervision, the Patient Access Associate III independently coordinates and performs multiple complex functions within the Patient Access department. The role uses considerable judgment to interpret departmental policies and resolve routine to complex inquiries and patient account problems. The associate identifies process-improvement opportunities, proposes and implements solutions, represents the department at meetings, and serves as a primary resource to team members for training and problem resolution. The associate performs all duties in a manner that supports teamwork and reflects the mission, behaviors, core values, philosophy, and standards of CT Children’s Medical Center. Responsibilities span administrative support, quality assurance and training, patient registration, appointment scheduling, front-office check-in and check-out, financial clearance, financial counseling support, and financial responsibility. The associate audits registration records and account follow-up, trains staff, maintains spreadsheets and databases, coordinates with clinical, financial, insurance, and utilization-review teams, and works to resolve outstanding registration, authorization, and payment issues. The position also may coordinate daily departmental activities, delegate work, and serve as a first-level resource to staff and leadership.

Requirements

High school diploma, GED, or higher education that requires completion of high school.
Healthcare experience.
Two to four years of directly related experience.
CHAA (Certified Healthcare Access Associate) certification required within one year.
Advanced knowledge of Microsoft Word and Excel.
Knowledge of ADT systems and insurance verification systems; knowledge of EPIC is preferred.
Knowledge of managed care, referrals, pre-certification and authorization, denials, patient accounts, and DSS.
Computer, typing, and data-entry skills.
Excellent verbal and written communication skills.
Excellent organizational skills and ability to provide feedback to staff.
Ability to work in a fast-paced, high-volume environment and alongside multiple disciplines.
Ability to coordinate workflows, anticipate workload needs, and reassign or balance workloads.
Ability to provide ongoing staff guidance and training, delegate effectively, and conduct crucial conversations independently.
Ability to demonstrate age-related awareness and cultural sensitivity when working with patients and families.

Nice To Haves

Bachelor’s or associate degree.
One year of directly related experience at CT Children’s.
EPIC experience.

Responsibilities

Provide receptionist, secretarial, or Health Unit Coordinator support and other administrative activities according to department protocols.
Respond compassionately and professionally to patients and families while protecting privacy and confidentiality in accordance with HIPAA policies.
Create staffing assignments and schedules, delegate work, train staff, and provide quality assurance.
Identify process-improvement opportunities and trends, implement solutions, and provide follow-up education to team members.
Audit complete registration data, documentation, patient or guarantor interactions, collection efforts, and referrals; ensure outstanding issues are resolved in a timely manner.
Conduct weekly reviews for new employees and at least monthly reviews for current employees; ensure employee cash drawers are closed according to standard process.
Create and maintain spreadsheets and databases, and liaise with Patient Accounting to resolve denials and account problems.
Collect and enter accurate demographic, guarantor, and financial information for emergency, inpatient, outpatient, and physician-practice visits; verify insurance and billing information and use correct payer plan codes.
Generate required visit forms, obtain patient or guardian signatures for assignment, authorization, consent, privacy, and other required forms, and complete pre-registration and registration according to procedure.
Update patient information in ADT systems, address questions or issues before departure, collect patient liability and co-payments, and document incomplete information, insurance verification, and patient or guarantor interactions clearly.
Follow up on open items, work assigned registration queues, ensure account accuracy, and provide feedback to front-end users about registration completeness and accuracy.
Schedule routine and complex appointments in person or by telephone, coordinate appointments with other hospital areas, create provider appointments, and build and maintain scheduling templates.
Work with DCF to obtain appropriate signatures and legal-guardian information.
Arrive patients in the ADT system, verify demographic and insurance information at arrival, collect patient financial liability, and enter patient charges into the billing system according to protocol.
Independently complete check-out, including scheduling or rescheduling future appointments; answer and triage departmental telephone calls; and perform other front-office duties as needed.
Manage financial-clearance work queues and communicate with insurers, clinical and office staff, and other departments about benefits, referrals, authorizations, eligibility, and clinical documentation.
Review charts and submit documentation to insurers; coordinate referrals, authorizations, admission notifications, and benefit verification with third-party payers.
Refer patients and families to Financial Counseling for eligibility or financial issues; notify RN-, APRN-, and MD-level staff of denials requiring action; coordinate admission status with Utilization Review; and escalate authorization barriers to management.
Work with insurance representatives to resolve outstanding authorization issues and track issues that delay or result in authorization denials.
Support financial counselors by reviewing account work queues, communicating with insurers and departments, and responding to patient and family account inquiries.
Interview patients or families to verify insurance and financial information, explain financial policies, complete financial evaluation forms, and assist with DSS and Financial Assistance processes.
Assess guarantor ability to pay non-covered charges and potential eligibility for financial assistance, establish payment arrangements, identify reasons for non-payment, and follow up to resolve them.
Verify insurance plans using available methods, investigate coverage, facilitate certification, maximize payment from commercial and managed-care plans, and follow up with team members to resolve outstanding financial issues.
Apply knowledge of age-related needs from neonates through adolescents and demonstrate cultural sensitivity in patient and family interactions.
Support the organization’s mission, values, goals, and standards through consistent behavior.
Coordinate daily departmental activities, delegate assignments, and serve as a first-level resource to staff and leadership when required.
Participate actively in at least one hospital committee and share departmental or organizational initiatives with team members.