Patient Access Specialist III

Hospital for Special Surgery • New York, NY

1d

About The Position

The Patient Access Specialist III performs advanced patient access work across patient service, scheduling, pre-registration, registration, insurance verification, financial clearance, patient flow, and care coordination. The role uses independent judgment to resolve complex situations, explain access and financial information, and coordinate with patients, payers, clinical teams, operational partners, and revenue cycle resources. The specialist is also a subject-matter resource for Patient Access staff, provides guidance and training, supports quality and compliance efforts, and contributes to operational improvements and special projects.

Responsibilities

• Provide courteous, compassionate, and professional service to patients, families, visitors, physicians, staff, and other customers in person and by telephone.
• Manage complex, sensitive, or escalated patient questions and concerns using advanced communication, problem-solving, and service-recovery skills.
• Explain complex registration, insurance, financial, and access information clearly and respectfully, adapting communication to the needs of the patient or customer.
• Protect patient privacy and handle sensitive information with discretion in accordance with confidentiality practices.
• Serve as a resource to Patient Access staff for complex patient access and service concerns; serve as a Greeter at Welcome kiosk locations when assigned and support patient navigation and service recovery.
• Perform complex scheduling, pre-registration, registration, and related Patient Access activities using Epic and departmental workflows.
• Investigate and resolve complex demographic, guarantor, registration, scheduling, documentation, and patient account discrepancies.
• Review complex patient records and registration information to identify missing, conflicting, or inaccurate information and determine appropriate resolution.
• Coordinate with clinical, administrative, and operational partners to resolve complex scheduling and registration barriers that could delay care or service.
• Serve as a subject-matter resource to PAS I and PAS II staff regarding complex registration and scheduling processes.
• Perform advanced insurance verification and financial clearance involving complex eligibility, benefits, coverage, coordination of benefits, payer, or financial circumstances.
• Analyze insurance and coverage information and apply payer requirements, organizational policies, and available resources to determine appropriate resolutions.
• Investigate access discrepancies and barriers and coordinate resolution with payers, clinical departments, revenue cycle partners, and other appropriate resources.
• Resolve complex work queue encounters and follow-up items requiring investigation, interpretation, coordination, or advanced knowledge.
• Communicate complex insurance and financial responsibility information to patients and internal partners; identify and appropriately address or escalate issues with potential operational, financial, compliance, or patient-care impact.
• Support complex patient flow and care coordination activities requiring advanced Patient Access knowledge and independent judgment.
• Coordinate bed assignments for postoperative surgical patients and emergency admissions as assigned.
• Troubleshoot complex access barriers, delays, competing operational needs, and patient flow issues with clinical and operational partners.
• Identify recurring patient flow or access barriers, communicate trends and recommendations to leadership, and escalate operational or patient flow concerns to management in a timely manner.
• Provide day-to-day guidance and coaching to PAS I and PAS II staff on complex workflows, payer requirements, Epic functionality, registration requirements, and departmental procedures.
• Assist with onboarding and cross-training staff, demonstrate complex processes, share best practices, and reinforce departmental standards and competency development.
• Provide functional support during high-volume periods, staffing changes, system issues, or other operational challenges as assigned.
• Meet established productivity, accuracy, quality, confidentiality, compliance, and service expectations while performing advanced Patient Access responsibilities.
• Apply departmental policies, standard work, documentation requirements, and escalation pathways to complex situations using independent judgment.
• Conduct or assist with quality reviews and audits to identify accuracy, compliance, documentation, and workflow issues.
• Identify recurring errors, delays, work queue issues, access barriers, and other operational trends; assist with determining root causes and recommend improvements.
• Assist with testing, implementation, and stabilization of new workflows, system changes, or Patient Access initiatives as assigned.
• Collaborate with department leadership on special projects and strategic initiatives requiring advanced Patient Access knowledge.
• Maintain current knowledge of departmental procedures, payer requirements, Epic workflows, and other changes affecting Patient Access operations.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed