Patient Access Specialist II - Oncology

American Addiction Centers • Chicago, IL

3d • $22 - $33 • Onsite

About The Position

Performs at a higher skill level than the Access Specialist I. Assumes responsibility as a preceptor/trainer and back up Registration Quality Associate as needed. May assume role of in-charge associate if designated by the manager, supervisor, or Lead Patient Access Rep. Must be proficient in all patient access areas, including, but not limited to, ONC registration and other outpatient service codes. Must be proficient in AMG copay collections per department standards. This role is responsible for interviewing, analyzing, and recording patient demographic and insurance information, which serves as the starting point of every patient's clinical and revenue cycle experience. This includes obtaining and recording pertinent demographic and insurance information necessary for accuracy in billing, coding, and patient discharge follow-up, using systems like Allegra, IDX, and Mosiaq. The specialist also verifies patient identity, applies patient identification bands, and contributes to the reduction of duplicate medical record numbers using BASEshield software. Maintaining patient confidentiality per HIPPA regulations is crucial. The role requires acquiring and maintaining knowledge of all Medicare, Medicaid, and commercial insurance payers' rules and regulations, including compliance with Medicare requirements such as MSP questionnaires, IMM issuance, medical necessity screening, and ABN issuance when appropriate. The specialist generates, assembles, processes, and scans all required documents for registration completion, obtains necessary signatures, performs direct admissions to the Cancer Center, and verifies accuracy of pre-registered accounts. They also verify physician/practitioner licensure and order completeness, contacting physicians for corrections as needed. Participation in achieving department KRA goals for courtesy and wait times, practicing AIM (acknowledge-introduce-manage) and patient flow management, is expected. The role also involves recognizing and facilitating communication for patients with hearing/sight loss or language barriers, securing interpreters or assistance as needed. Completion of all required department and medical center competencies, including annual CBTs, is mandatory. The role contributes to department and medical center KRAs related to Financial Advocacy and clean billing claims by identifying and obtaining needed authorizations, referrals, and service approvals. This includes screening physician orders against medical necessity criteria, following procedures to obtain additional diagnosis information, and initiating Medicare Advance Beneficiary Notices of Non-Coverage when appropriate. For self-pay patients, the specialist partners with Financial Counselors to determine appropriate charges and document in EMR. They request and accept payments, generate receipts, maintain records of payment transactions, and utilize automated systems for payment processing. Uninsured patients are referred to Financial Counselors as needed, and all outstanding registration alerts are resolved in AMP or other quality assurance systems, meeting or exceeding an accuracy percentage of 99.5%. The role provides point of entry reception service in all Patient Access departments to create high levels of patient satisfaction, minimize wait times, and assist with patient throughput. This involves interacting with patients using AIDET and Behaviors of Excellence, greeting patients and families promptly and courteously, and assisting with questions and directions. The financial clearance process begins by reviewing patient orders and confirming the reason for the visit verbally, communicating discrepancies to clinical partners, and obtaining orders from physicians if needed, ensuring complete narrative diagnosis and signatures. Effective partnership with ancillary units is required to facilitate patient arrival, with knowledge of testing requirements (e.g., fasting) to gauge appropriateness of arrival. Communication of patient arrival to departments or call areas for STAT processes is also necessary. Maintaining knowledge of hospital locations and services and providing clear directions is essential. Answering all incoming telephone calls according to established department procedure and directing or escorting patients to service locations, working in conjunction with Guest Services for escort service, are key duties. The specialist works as a team player to assist with patient flow management during peak times and collaborates with Cancer Center Clinical and Administrative staff, including physicians, to promote high-quality patient experiences.

Requirements

• High school diploma or equivalent.
• 4-7 years of hospital registration experience.
• Knowledge of third party payers, regulatory compliance, and industry standards.
• Knowledge of patient access systems which include Allegra, NEBO, Baseshield, Care Connection scheduling and Compass web payment.
• Medical terminology certification.
• Superior customer services skills as demonstrated by an annual average Press Ganey courtesy score of 4.5 or higher (5.0 scale.)
• Must meet or exceed an annual average registration accuracy level of 99.5%.
• Must meet or exceed annual department productivity average.
• Successful completion of a data entry assessment
• Excellent communication and customer service skills.
• Office equipment knowledge, including computer skills
• Must possess communication skills in order to perform complete patient interviews, type information into the appropriate fields, and to verbalize patient instructions.
• Ability to lift up to 35 pounds without assistance.

Nice To Haves

• Medical terminology preferred within the last five years.
• CHA certification within one year of employment.

Responsibilities

• Serves as an "in charge" associate when management personnel are not on site.
• Serves as a preceptor/trainer for new hires or low performers requiring mentoring for registration accuracy.
• May perform registration QA reviews for patient access associates or decentralized associates.
• Performs banking procedures, including cash balancing and daily deposits with the cashier for AMG and AIMMC physicians copays.
• Participates on the Peer Interview team for Patient Access departments or decentralized points of registration.
• Participates in pilot patient access projects and provides feedback on process improvements for registration.
• Accurately reviews physicians orders and schedules future appointments as ordered and documents.
• Assures patient receives printed copy of clinic visit summary.
• Demonstrates competency with all patient access functions, for AMG and AIMMC SCRO systems, and department policies in all assigned areas of Business Services.
• Interviews, analyzes, and records patient demographic and insurance information.
• Obtains and records pertinent demographic and insurance information necessary for accuracy in billing, coding and patient discharge follow-up, which includes Allegra, IDX, and Mosiaq.
• Verifies patient identity and applies patient identification band as required by the "We ID for Patient Safety" policy.
• Contributes to the reduction of Duplicate Medical Record numbers by using BASEshield software and collecting information categorized as "key identifiers."
• Maintains patient confidentiality throughout the registration process per HIPPA regulations.
• Acquires and maintains knowledge of all Medicare, Medicaid and commercial insurance payers rules and regulations.
• Complies with all Medicare requirements which include completion of the Medicare Secondary Payer questionnaire (MSP), issuing of the Important Message for Medicare (IMM), screening orders for Medical Necessity, and issuing of ABNs when appropriate.
• Generates, assembles, processes and scans all required documents for the completion of each registration, including face sheets, labels, advance directives, privacy notices, and consent forms.
• Obtains proper signatures on all required documents.
• Performs direct admissions to Cancer Center, as scheduled or converts accounts for other in house outpatient services as needed.
• Verifies accuracy of pre-registered accounts and updates registration as appropriate.
• Verifies physician/practitioner licensure and verifies that the order is complete with signatures and proper diagnosis information.
• Contacts physician for real time correction as needed.
• Participates in achieving department KRA goals (metrics as recorded by the Press Ganey Patient Satisfaction surveys) in terms of courtesy and wait times.
• Practices AIM (acknowledge-introduce-manage) and patient flow management toward achievement of department KRA goals.
• Recognizes and facilitates communication obstacles for patients with loss of hearing and/or sight, as well as those who have difficulty with the English language.
• Secures interpreter and/or other necessary assistance in order to facilitate customer comprehension throughout the registration process.
• Completes all required department and medical center competencies, including annual CBTs (computer based training.)
• Contributes to department and medical center KRAs related to Financial Advocacy and clean billing claims.
• Identifies and obtains needed authorizations, referrals and service approvals from physicians, insurance companies and/or medical management companies.
• Screens physician orders against medical necessity criteria using compliance checker software.
• Follows procedures to obtain additional diagnosis information from physicians and initiates the Medicare Advance Beneficiary Notice of Non-Coverage to patients as appropriate.
• For self pay patients: Partners with Financial Counselor on determining appropriate charges at the time of service and document appropriate in EMR.
• Requests and accepts payments, generates receipts for funds received, and maintains necessary records of payment transactions.
• Utilizes automated systems to process check, credit and debit card transactions.
• Documents in EMR per department standards.
• Refers uninsured patients to Financial Counselors as needed.
• Resolves all outstanding registration alerts in AMP or any other quality assurance system related to registration.
• Meets or exceeds an accuracy percentage for registration of 99.5%.
• Provides point of entry reception service in all Patient Access departments in order to create the highest levels of patient satisfaction, to minimize wait times, and to assist with patient throughput during the patient arrival process.
• Interacts with patients using AIDET and Behaviors of Excellence.
• Greets patients and families promptly and with courtesy, assisting with questions and directions.
• Begins financial clearance process by reviewing patient orders and confirming reason for patient visit verbally.
• Communicates discrepancies or questions to clinical partners.
• Obtain orders from physicians if needed.
• Ensure that complete narrative diagnosis and signatures are written on order.
• Partners effectively with ancillary units to facilitate patient arrival.
• Must be familiar with testing requirements (i.e. fasting) in order to gauge appropriateness of patient arrival.
• Communicates patient arrival to departments and call areas if STAT process is required.
• Maintains knowledge of hospital locations and services.
• Able to communicate with clear directions
• Answers all incoming telephone calls according to established department procedure.
• Directs or escorts patients to service location if required.
• Works in conjunction with Guest Services to provide escort service to patients.
• Works as a team player to assist with patient flow management during peak patient volume times.
• Collaborates with Cancer Center Clinical and Administrative staff, including physicians, to promote high quality patient experiences.

Benefits

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED