Patient Access Specialist III

Hospital for Special Surgery•New York, NY

1d•$37 - $41

About The Position

The Patient Access Specialist III performs advanced patient access work across patient service, scheduling, registration, insurance verification, financial clearance, patient flow, and operational support. The role handles complex cases independently, applies advanced knowledge of departmental procedures and Epic workflows, and coordinates with clinical, administrative, payer, and revenue cycle partners to resolve barriers to patient care and service. The specialist also serves as a subject-matter resource and coach to PAS I and PAS II staff, supports onboarding and cross-training, and contributes to quality reviews, audits, process improvements, and special projects. The position is regular full-time and works a day shift.

Responsibilities

Provide courteous, compassionate, professional service to patients, families, visitors, physicians, staff, and other customers in person and by telephone.
Manage complex, sensitive, and 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 customer needs.
Protect patient privacy and handle sensitive information in accordance with confidentiality practices.
Serve as a resource to Patient Access staff on 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 records for missing, conflicting, or inaccurate information and determine appropriate resolutions.
Coordinate with clinical, administrative, and operational partners to address scheduling and registration barriers that could delay care or service.
Perform advanced insurance verification and financial clearance involving complex eligibility, benefits, coverage, coordination of benefits, payer, or financial circumstances.
Apply payer requirements, organizational policies, and available resources to resolve complex insurance and coverage questions and barriers.
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 issues with potential operational, financial, compliance, or patient-care impact and take appropriate action or escalate them.
Support complex patient flow and care coordination activities using advanced Patient Access knowledge and independent judgment.
Coordinate bed assignments for postoperative surgical patients and emergency admissions as assigned.
Troubleshoot access barriers, delays, competing operational needs, and patient flow issues with clinical and operational partners.
Identify recurring patient flow or access barriers and communicate trends and recommendations to leadership.
Provide day-to-day guidance and coaching to PAS I and PAS II staff on workflows, payer requirements, Epic functionality, registration requirements, and procedures.
Assist with onboarding and cross-training staff; demonstrate complex processes and share best practices.
Help staff evaluate complex situations, identify resources, and determine appropriate escalation pathways.
Provide functional support during high volume, staffing changes, system issues, and other operational challenges as assigned.
Meet productivity, accuracy, quality, confidentiality, compliance, and service expectations while performing advanced Patient Access responsibilities.
Conduct or assist with quality reviews and audits of Patient Access activities.
Identify recurring errors, delays, work queue issues, access barriers, and operational trends; assist in determining root causes.
Recommend workflow, training, and process improvements to enhance patient experience, efficiency, accuracy, compliance, or financial performance.
Assist with testing, implementation, and stabilization of new workflows, system changes, and 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.