Patient Access Specialist I - New England Neurological Associates, Lawrence

Tufts Medicine•Lawrence, KS

1d•$20 - $25•Onsite

About The Position

This entry-level position supports revenue cycle operations and patient access by coordinating administrative and financial-clearance activities that help patients obtain clinical services. The role coordinates incoming consultation referrals from physician practices, hospitals, and other healthcare facilities; manages benefits, referrals, and medical record requests; and serves as a patient contact for insurance and financial counseling. The specialist also reports information back to the multidisciplinary team. The position arranges consultation appointments, verifies demographic and insurance information, helps patients understand coverage and costs, collects pre-service patient responsibility, and assists with payment plans and applications for eligible assistance programs. It works closely with Social Work, Case Management, Billing, Contracting, clinical providers, patients, and outside agencies. The work is generally routine and closely supervised, with most time spent delivering administrative support services. The role is based at New England Neurological Associates in Lawrence, Massachusetts, and is scheduled for 40 hours weekly, Monday through Friday, 8:00 a.m. to 4:30 p.m. The work is largely sedentary, though it may involve walking, standing, reaching, stairs, and operating office equipment. Some patient interviews may require a gown and mask, and the role may involve situations in which patients are violent.

Requirements

High school diploma or equivalent.
Two years of related experience in insurance, managed care referral processes, 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 with patients, families, medical staff, QSS, facility departments, and outside agencies.
Ability to grasp, retain, and apply new regulations and procedural changes within the institution and 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 and/or move up to 25 pounds.
Ability to sit for most of the workday and perform related movements such as walking, standing, reaching, ascending or descending stairs, and operating office equipment.
Ability to speak, hear, communicate, and exchange information frequently.
Ability to see and read computer displays and print, including fine print, and distinguish letters, numbers, and symbols.

Nice To Haves

Bachelor’s degree.
Three years of related experience in insurance, managed care referral processes, 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 data needed for consultations, including physician notes, patient history, laboratory and imaging results, and other information from referring providers or facilities.
Arrange and schedule consultation appointments, confirm demographic information, and verify insurance eligibility.
Verify insurance, check benefits, and obtain information from payers about patient responsibility.
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 quarterly follow-up on insurance and financial risk assessments.
Collect patient responsibility before services and establish payment plans when necessary.
Complete, file, and follow Massachusetts Medicaid applications through resolution, including disability, Health Safety Net, and other programs.
Refer patients to programs that hospital staff cannot file 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 the hospital, professional groups, and patients receive eligible benefits.
Document meeting minutes and steps taken on accounts.
Process medical record requests from patients, insurers, attorneys, and others; communicate applicable fees and ensure payment is received before releasing records.
Request and obtain insurance referrals from referring physicians or patients’ primary care physicians.
Send pre-visit paperwork to patients with clear instructions.
Assist patients with maximizing insurance benefits.