Patient Access Call Center Specialist - ARC

JPS Health Network•Azle, TX

20d•Onsite

About The Position

The Patient Access Call Center Specialist - ARC is responsible for inbound/outbound calls of appointment scheduling, specified elements of pre-registration, registration, and referrals management to ensure patient care is expedited and reimbursement is maximized for multiple clinic sites and the Access Resource Center, and payment collections where appropriate. This role delivers a high-quality patient experience through inbound and outbound call resolution within established protocols, appropriately mitigating issues and assisting patients with needs and/or questions in a timely manner using Acknowledge, Introduce, Duration, Explanation and Thank You (AIDET) principles. The specialist interviews and updates patient demographics and insurance information via phone, obtaining all necessary demographic, financial, and clinical information required for timely scheduling and registration. They coordinate and schedule appointments, select appropriate referrals, providers, visit types, and locations to expedite patient access to care, minimize no-shows, and maximize reimbursement. The role accurately identifies patients and registers JPS patients while maintaining regulatory and functional knowledge of all information required for timely and accurate reporting/billing. They provide awareness regarding notice of privacy practices, patient rights and responsibilities, and MyChart enrollment. Additionally, the specialist collects patient owed cost-sharing amounts in accordance with ARC Standard Operating Procedures and reconciles the case drawer at the end of the shift. They utilize critical thinking skills to determine if escalation is required and take ownership to ensure issues are handled effectively. The role maintains and coordinates high-level scheduling support for the Network, ensuring referrals and pre-authorizations are accurately obtained. They also coordinate diagnostic and ancillary scheduling and assist out-of-network patients with financial questions, escalating as needed. The specialist identifies existing Medical Record Numbers (MRNs) or creates new ones, avoiding duplicates and overlays. They maintain productivity levels with minimal errors and comply with attendance and punctuality procedures, potentially working beyond scheduled shifts. Attendance at mandatory educational, compliance, and safety programs is required, and they may assist in staff training.

Requirements

High School Diploma, GED, or equivalent.
1 plus years of practical experience with computer programs and/or applications.
Required to pass assigned training knowledge and application exit exam within 30 days of hire.

Nice To Haves

Associates degree in a related field of study from an accredited college or university.
Patient registration or Customer Service and call center experience.
Experience working in a healthcare setting.

Responsibilities

Deliver a high-quality patient experience through inbound and outbound call resolution within established protocols.
Appropriately mitigate issues and assist patients with needs and/or questions in a timely manner using Acknowledge, Introduce, Duration, Explanation and Thank You (AIDET) principles.
Interview and update patient demographics and insurance information via phone, obtaining all necessary demographic, financial, and clinical information required to facilitate timely scheduling and registration; collect payments where appropriate and perform elements of pre-registration.
Coordinate and schedule appointments, select appropriate referral, provider, visit type and location to expedite patient access to care, to minimize “no shows” and maximize reimbursement.
Accurately identify patient and register JPS patients while maintaining regulatory and functional knowledge of all information required to register patient types in database ensuring timely and accurate reporting/billing.
Provide awareness as needed related to notice of privacy practices, patient rights and responsibilities, MyChart enrollment, etc.
Collect patient owed cost sharing amounts (copays, deductibles, coinsurance, full costs [non-covered/self-pay]) in accordance with ARC Standard Operating Procedures.
Reconcile case drawer at end of shift.
Utilize critical thinking skills to determine if escalation is required to resolve individual patient situations and help identify trends requiring management intervention.
Take ownership and accountability to ensure issues presented on the call are handled effectively.
Maintain, coordinate and provide high level scheduling support for the Network utilizing the template format designed for each service area/physician and ensures referrals, pre-authorizations, pre-certifications have been accurately obtained as required by the patient’s payer.
Coordinate diagnostic and ancillary scheduling; schedule appointments, selecting appropriate referral, provider, visit type and location to expedite patient access to care.
Perform, organize, and streamline operational tasks to reduce the potential for errors.
Assist Out of Network patients with financial questions and escalate to the appropriate party.
Provide information regarding services and provide additional assistance as needed.
Identify existing Medical Record Number (MRN) or create new MRN, taking care to avoid duplicates and overlays in accordance with National Patient Safety Goals.
Maintain productivity levels, with minimal errors, as established by department and Network standards.
Provide the highest level of care to our patients by complying with JPS Health Network’s attendance and punctuality procedure.
May be required to work beyond normal scheduled shifts.
Attend all mandatory educational, compliance and safety program sessions.
Assist in staff training of peers, colleagues and management as applicable or requested.