Patient Access Specialist I - New England Neurological Associates Lawrence

Tufts Medicine•Lawrence, KS

5d•$20 - $25•Onsite

About The Position

The Patient Access Specialist I performs revenue cycle and patient access activities to facilitate patients’ procurement of clinical services. Responsibilities include collecting demographic and financial information, coordinating referrals, scheduling appointments, verifying insurance eligibility and benefits, and completing financial-clearance tasks. The role is entry level, routine, and closely supervised, with work generally performed in a hands-on administrative support environment. The specialist supports patients and families with insurance coverage, out-of-pocket costs, payment arrangements, and applications for eligible public assistance programs. The position also coordinates with clinical and administrative teams and maintains documentation related to patient accounts and services. The role is based at the New England Neurological Associates Lawrence, Massachusetts office and is scheduled for 40 hours per week, Monday through Friday, 8:00 a.m. to 4:30 p.m.

Requirements

High school diploma or equivalent.
Two years of related experience in insurance, managed care referral processes, a private physician’s office practice, or a hospital registration setting.
In-depth knowledge of medical terminology and its relationship to establishing certifiable disabilities.
Excellent interpersonal skills to interact effectively with patients, families, medical staff, QSS, other departments, and outside agencies.
Ability to learn, retain, and apply regulatory and procedural changes within the institution and at outside agencies.
Understanding of how health insurance benefits apply to hospital and professional charges.
Ability to handle stressful situations involving critically ill patients and sensitive financial issues.
Good written communication skills.
Excellent systems skills.
Ability to work in a complex systems environment and understand spreadsheets and other business technologies.
Ability to occasionally lift or move up to 25 pounds.
Ability to perform a largely sedentary role involving sitting most of the time, with some walking, standing, reaching, stair use, and operation of office equipment.
Ability to speak, hear, communicate, and exchange information frequently; see and read computer displays and print, including fine print, and distinguish letters, numbers, and symbols.
Ability to wear a gown and mask when interviewing patients on precautions and to use an appropriate approach in situations involving potentially violent patients.

Nice To Haves

Bachelor’s degree.
Three years of related experience in insurance, managed care referral processes, a private physician’s office practice, or a hospital registration setting.
MassHealth Certified Application Counselor.

Responsibilities

Coordinate incoming consultation referrals from physician practices, hospitals, nursing homes, and other healthcare facilities.
Compile clinical information needed for consultations, including physician notes, patient history, laboratory results, and imaging results.
Arrange and schedule consultation appointments, confirm demographic information, and verify insurance eligibility.
Verify insurance, check benefits, and obtain information about patient responsibility from payers.
Meet with patients and families during interdisciplinary introduction meetings to review insurance coverage and out-of-pocket costs.
Serve as a patient liaison for financial matters throughout treatment, including periodic follow-up on insurance and financial risk assessments.
Collect patient responsibility before services and establish payment plans when needed.
Complete, file, and follow Massachusetts Medicaid and other assistance applications through resolution, including disability and Health Safety Net applications.
Refer patients to programs that hospital staff cannot apply for directly, including Veteran's Services and EAEDC.
Coordinate with Social Work, Case Management, Billing, and Contracting to support patients and clinical providers.
Stay current on regulations and ensure applications are appropriate and complete so eligible benefits are obtained.
Document meeting minutes and actions taken on patient accounts.
Process medical record requests from patients, insurers, attorneys, and others; communicate applicable fees and ensure payment before releasing records.
Request and obtain insurance referrals from referring physicians or patients’ primary care physicians.
Send patients pre-visit paperwork with clear instructions.
Help patients maximize their insurance benefits.