Patient Access Specialist Sr

INTEGRIS Health•Oklahoma City, OK

8d•Onsite

About The Position

The Patient Access Specialist Sr. provides patient access services for assigned ancillary, diagnostic, surgical, and emergency services to support efficient operations, timely reimbursement, and positive patient and employee experiences. The role serves as a liaison between INTEGRIS Health and patients, providers, and payers for pre-care account resolution, explaining coverage eligibility and benefits, financial liability, and billing practices and policies. The position handles complex registration and access transactions, including scheduling, demographic verification, point-of-service payments, consent documentation, document imaging, insurance verification, eligibility, patient responsibility calculations, and authorization requirements. The specialist responds to patient and payer inquiries, resolves complex account and access issues, documents account activity, and supports financial clearance. As a senior resource, the role provides systems expertise, staff guidance and training, monitors assignments and productivity, and coordinates process and quality improvement efforts. The specialist also maintains compliance with applicable performance standards, federal and state regulations, policies, procedures, and third-party contracts. This is a full-time day-shift position with a Monday–Friday schedule and rotating weekend coverage every 6–7 weeks, Saturday and Sunday from 8:00 a.m. to 4:30 p.m. It is based with the INTEGRIS Health Access Center Inpatient Observation Team in Oklahoma City, Oklahoma.

Requirements

Four years of patient access operations experience in scheduling, registration, or insurance, or related experience in billing, collections, or accounts receivable.
Previous experience in at least one of scheduling, registration, insurance, billing, collections, or customer service in a hospital or physician's office setting.

Nice To Haves

Bachelor's degree in a related field or a healthcare certification, such as AAHAM CRCS, HFMA CRCR, or NAHAM CHAA.
Experience with Microsoft Office programs.
Experience with admission/discharge/transfer or billing/claims management software.
Experience with medical terminology, basic ICD-10 and CPT coding, healthcare program reimbursement, and methodologies.
Experience in three or more of scheduling, registration, insurance (including Medicare, Medicaid, and third-party regulations), billing, collections, and customer service in a hospital or physician's office setting.

Responsibilities

Ensure appropriate complex registration activity, including scheduling, demographic verification, point-of-service payment processing, obtaining required consent signatures, document imaging, and adherence to documentation standards.
Ensure appropriate complex patient access transactions, including coverage eligibility, insurance verification, patient portion calculations, and authorization requirements, using available systems and resources.
Use analytical thinking, independent judgment, and clinical knowledge to adjust service-area schedules and accommodate special requests from internal and external customers.
Accept inbound calls from patients, physician offices, and insurance carriers and seek to resolve concerns promptly.
Collect patient payments and follow authority levels to ensure financial clearance.
Document patient account activities concisely, including authorization and patient liability requirements.
Perform filing, data entry, and other assigned duties.
Respond promptly to patient inquiries about pre-care services, policies, coverage, benefits, and financial liability.
Use multiple resources to resolve patient or payer inquiries and to prepare or review patient accounts and prior authorization requirements.
Explain payer regulations, coverage benefits, and financial liability to patients.
Resolve complex patient access and account issues; respond to reimbursement questions; and serve as a resource and systems expert for patient access specialists.
Provide staff guidance, feedback, and training on processes, payers, and systems; monitor assignments and assess productivity.
Communicate effectively by telephone, email, and verbally with departments and caregivers throughout the health system.
Initiate and coordinate team-oriented process improvement initiatives for the department and organization.
Coordinate continuous quality improvement efforts, establish goals with supervisors, track progress, and prepare data for presentation.
Interpret and maintain compliance with performance standards, EMTALA, HIPAA, federal and state regulations, policies, procedures, guidelines, and third-party contracts.