Patient Access Specialist-Hospital Operator Service

Northwestern Memorial Healthcare•Sandwich, IL

5h•$18 - $28•Onsite

About The Position

The Patient Access Specialist reflects the mission, vision, and values of NMHC, adheres to the organizations Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. This role consistently practices Patients First philosophy and adheres to high standards of customer service, setting an example to peers, coworkers, etc. by fostering a team atmosphere. The specialist responds to questions and concerns, and forwards, directs, and notifies the Team Lead or Operations Coordinator of extraordinary issues as necessary. They maintain patient confidentiality per HIPAA regulations and provide exceptional customer service to patients, establishing a positive first impression of Northwestern Medicine. The role involves exceeding consumer requests and alerting management of issues or concerns that require escalation. The Patient Access Specialist correctly identifies and collects patient demographic information in accordance with organization standards, and interacts with various hospital departments and physicians offices to effectively schedule and direct patients through the NMHC systems in a patient/customer friendly manner. They reach out to patients to schedule appointments, perform medical necessity checks, and communicate options to patients if an appointment fails. The specialist informs patients of any issues with securing the financial account for their encounter, completes out-of-pocket estimations as requested, and provides training and education as needed. They manage their work schedule efficiently, completing tasks and assignments on time, and participate in Quality Assurance reviews to ensure the integrity of patient data information. The role utilizes effective service recovery skills to solve problems or service breakdowns, and uses departmental and hospital policies and procedures to complete assigned tasks. They avoid putting patients in financial or safety risk. Communication involves communicating information to the patient regarding questions about physician referrals, insurance referrals and consultations, and collecting authorization numbers in appropriate systems. The specialist provides a professional and constructive environment for communication across units/departments and resolves operational issues. They may attend intra/interdepartmental meetings which involve walking within the NM Campus. They communicate customer satisfaction issues to appropriate individuals and demonstrate teamwork by helping co-workers within and across departments. Effective communication with others, respecting diverse opinions and styles, and acknowledging the assistance and contributions of others is essential. The role involves interacting with internal customers to provide excellent support service to staff in departments which provide direct patient care and accommodating all levels of communication ability. Technology utilization includes multiple online order retrieval systems to verify or print patient orders, verifying insurance eligibility and benefit levels through online tools or over the phone, and completing accurate handoff instructions and notes to scheduling staff by noting appropriately in Epic. The specialist demonstrates the ability to use all computer applications efficiently and to the capacity needed for the position, runs real-time eligibility (RTE) on all patients to verify insurance and follows out-of-network policies, and sends quality Epic Messages/Telephone encounters that are descriptive and grammatically correct. Efficiency, Process Improvement, and Business Growth involve proactively preventing issues with patient visits by double checking test types, preps required, assuring no conflict with other tests, verifying time and location, communicating relevant information, verifying documenting order retrieval in notes for check-in person, ensuring no duplicate patient records. The specialist understands the minimum data set required for a complete registration, collects and verifies critical data and updates that information into the registration system. They understand departmental and individual quality metrics, proactively analyze account activity, identify problems, and initiate appropriate actions/resolutions. Evaluating procedures and suggesting improvements to enhance customer service and operational efficiency, and participating in departmental quality improvement activities are key. Providing ideas and suggestions for process improvements within the department, monitoring registration and scheduling, including insurance verification to ensure processing within prescribed quality standards, and adjusting processes as needed to meet standards are also part of the role. Efficient use of organizational and unit/department resources is expected. The specialist acts as a training resource for new staff and a resource for coworkers, sharing process and workflow information. They understand that the schedule may change to reflect shifting business needs and evolve and learn as healthcare policies change.

Requirements

High School diploma or equivalent.
2-3 years customer service or medical office experience.
Excellent interpersonal, verbal, and written communication skills.
Proficiency in computer data-entry/typing.
Excellent verbal and written communication skills.
Ability to read, write, and communicate effectively in English.
Basic Computer Skills.
Ability to type 40 wpm.
Ability to multi-task.
Customer service oriented.
Excellent organizational, time management, analytical, and problem solving skills.

Nice To Haves

Additional education.
Additional language skills.
Healthcare finance and/or healthcare insurance experience.
Knowledge and experience in a healthcare setting, especially patient scheduling and/or registration.

Responsibilities

Consistently practices Patients First philosophy and adheres to high standards of customer service.
Responds to questions and concerns.
Forwards, directs, and notifies Team Lead or Operations Coordinator of extraordinary issues as necessary.
Maintains patient confidentiality per HIPAA regulations.
Provides exceptional customer service to patients which establish a positive first impression of Northwestern Medicine.
Exceeds all consumer requests and alerts management of issues or concerns that require escalation.
Correctly identifies and collects patient demographic information in accordance with organization standards.
Interacts with various hospital departments and physicians offices to effectively schedule and direct patients through the NMHC systems in a patient/customer friendly manner.
Reaches out to patients to schedule an appointment as defined.
Performs medical necessity checks as necessary for scheduled services, communicates options to patient if appointment fails.
Informs patients of any issues with securing the financial account for their encounter.
Completes out-of-pocket estimations as requested by patients.
Provides training and education as needed.
Manages work schedule efficiently, completing tasks and assignments on time.
Completes other duties assigned by manager.
Cross-training between various departments will take place to ensure coverage.
Participates in Quality Assurance reviews to ensure integrity of patient data information.
Uses effective service recovery skills to solve problems or service breakdowns when they occur.
Utilizes department and hospital policies and procedures to complete assigned tasks.
Adheres to all department policies and compliance requirements.
Avoids putting patient in financial or safety risk.
Communicates information to the patient regarding questions about physician referrals, insurance referrals and consultations.
Collects authorization numbers in appropriate systems as applicable.
Provides professional and constructive environment for communication across units/departments and resolves operational issues.
May attend intra/interdepartmental meetings which involve walking within NM Campus.
Communicates customer satisfaction issues to appropriate individuals.
Demonstrates teamwork by helping co-workers within and across departments.
Communicates effectively with others, respects diverse opinions and styles, and acknowledges the assistance and contributions of others.
Interacts with internal customers to provide excellent support service to staff in departments which provide direct patient care.
Accommodates all levels of communication ability.
Utilizes multiple online order retrieval systems to verify or print the patients order.
Verifies insurance eligibility and benefit levels through the use of online tools (NDAS, ASF, etc.) or over the phone as necessary.
Completes accurate handoff instructions and notes to scheduling staff, by noting appropriately in Epic.
Demonstrates ability to use all computer applications efficiently and to the capacity needed in this position.
Runs real time eligibility (RTE) on all patients to verify insurance and follows out of network policies as applicable.
Sends quality Epic Messages/Telephone encounters that are descriptive and grammatically correct.
Proactive in preventing issues with patient visit by double checking type of test, preps required, assuring no conflict with other tests, verifying time and location, communicating relevant information, verifying documenting order retrieval in notes for check-in person, ensures there are no duplicate patient records.
Understands minimum data set required for a complete registration, collects and verifies critical data and updates that information into registration system.
Understands departmental and individual quality metrics.
Proactively analyzes account activity, identifies problems, and initiates appropriate actions/resolutions.
Evaluates procedures and suggests improvements to enhance customer service and operational efficiency.
Participates in departmental quality improvement activities.
Provides ideas and suggestions for process improvements within the department.
Monitors registration and scheduling, including insurance verification to ensure processing within prescribed quality standards.
Adjusts processes as needed to meet standards.
Uses organizational and unit/department resources efficiently.
Acts as a training resource for new staff and a resource for coworkers, sharing process and workflow information.
Understands that schedule may change to reflect shifting business needs.
Evolves and learns as healthcare policies change.