Patient Access Specialist

Rowan Diagnostic Clinic, PA•Salisbury, NC

5d•Onsite

About The Position

The Patient Access Representative position encompasses several jobs – Front Desk Check In, Scheduling, Medical Records, and Referrals. Although you may work in one job area primarily you will be cross trained over time to be able to work in the other jobs. The main functions of this role are described in detail below. Primary Customers Served: T Adult T Family/Visitors T Geriatric T Physicians T Team Members T Social Work Team T Community Agencies FRONT DESK FUNCTIONS: Friendly and detail orientated. Duties will include but are not limited to checking patients in and out. Scheduling patients for all appointment types. Collecting copays/balances, current insurance cards, insurance eligibility, and filing claims, scanning all applicable paperwork into patient’s chart. Answer incoming patient telephone calls to the Front Desk Hunt Group in a timely manner (Front desk calls and portal question calls) Assign and/or answer unassigned Klara messages Following all safety and sanitation guidelines for self, staff and patients. Effective communication with all staff and patients Working as a team player with fellow front desk members Ability to alphabetize and put information (materials, forms, etc.) into chronological order. Ability to schedule time and assignments effectively. Ability to multitask effectively, dealing with phone calls, staff, patient communication. Ability to communicate calmly and clearly with patients about appointments in all circumstances, including when they are ill or have an emergency. Ability to analyze situations and respond appropriately. Adapting to busy high-volume environments Other duties as assigned Equipment Operated: Range of medical records equipment and supplies, including computer hardware/software, manual files, scanners, and printers. SCHEDULING / REFERRAL / MEDICAL RECORDS FUNCTIONS: Assembles patients’ health information including patient symptoms and medical history, exam results, X-ray reports, lab tests, diagnoses, and treatment plans. Checks to ensure all forms are completed, properly identified, and signed and that all necessary information is in the EHR (Electronic Health Record). Communicates as needed with physicians and other health care professionals to obtain any additional information needed. Submits files/documentation to physicians and other clinicians as requested for review, quality assurance checks, and other purposes. Provides charts/documents requested for use in legal actions, following patient consent and confidentiality protocols. Schedules appointments for patients when they call. If medical practice offers after-hours/one-day appointments, schedules these appointments following urgent/emergency protocols, which may mean scheduling the patient with a physician or nurse practitioner other than their primary physician. Uses Electronic Health Record to match physician/clinician availability with patient’s preferences in terms of date, time and patient need. Ensures that all cancellations or reschedules are properly recorded. Communicates as needed with physicians/clinicians and other staff about any patient concerns/issues related to scheduling. Consults with Office Manager about any system problems. Use customer service principles and techniques to deal with patients calmly and pleasantly. Receive and process referral orders from PCP physicians. Verify patient insurance eligibility and referral requirements. Initiate and manage electronic and paper-based referral processes. Schedule appointments with specialists and communicate appointment details to patients. Obtain necessary prior authorizations and pre-certifications from insurance companies. Track referral status and follow up on pending referrals. Maintain accurate and up-to-date referral records in the electronic health record (EHR). Provide clear and concise information to patients regarding the referral process. Answer patient questions and address concerns related to referrals. Assist patients with scheduling appointments and navigating the healthcare system. Provide patient education regarding pre-appointment instructions and necessary documentation. Communicate with patients and other clinical staff regarding referral status and appointment updates. Serve as a point of contact for specialists and their staff. Coordinate the exchange of medical information between primary care physicians and specialists. Communicate with insurance companies to resolve referral-related issues. Collaborate with other members of the healthcare team to ensure smooth patient transitions. Maintain relationships with specialist offices. Other duties as assigned.

Requirements

High School Diploma required (or equivalent)
Proficient in English
Knowledge of HIPPA Privacy Rules
Knowledge of medical practice protocols related to scheduling appointments.
Knowledge of manual/computerized scheduling systems.
Knowledge of customer service principles, techniques and conflict resolution.
Knowledge in Medical Insurance Account Balances - Collection of Payments
Excel Spreadsheets
Skill in dealing with masses of information in organized manner.
Skill in using computer and medical records software.
Skill in communicating effectively with physicians/clinicians about scheduling preferences.
Skill in manipulating several different schedules at once.
Skill in using Critical Thinking
Ability to sit for extended periods up to 8 hours working on a computer and telephone.
Ability to lift a minimum of 25 pounds.
Must be able and willing to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

Nice To Haves

2 years of college desired.
Proficient in Spanish

Responsibilities

Checking patients in and out.
Scheduling patients for all appointment types.
Collecting copays/balances, current insurance cards, and insurance eligibility.
Filing claims.
Scanning all applicable paperwork into patient’s chart.
Answering incoming patient telephone calls to the Front Desk Hunt Group in a timely manner.
Assigning and/or answering unassigned Klara messages.
Following all safety and sanitation guidelines for self, staff and patients.
Communicating effectively with all staff and patients.
Working as a team player with fellow front desk members.
Alphabetizing and putting information into chronological order.
Scheduling time and assignments effectively.
Multitasking effectively, dealing with phone calls, staff, and patient communication.
Communicating calmly and clearly with patients about appointments in all circumstances.
Analyzing situations and responding appropriately.
Adapting to busy high-volume environments.
Assembling patients’ health information including patient symptoms and medical history, exam results, X-ray reports, lab tests, diagnoses, and treatment plans.
Checking to ensure all forms are completed, properly identified, and signed and that all necessary information is in the EHR.
Communicating as needed with physicians and other health care professionals to obtain any additional information needed.
Submitting files/documentation to physicians and other clinicians as requested for review, quality assurance checks, and other purposes.
Providing charts/documents requested for use in legal actions, following patient consent and confidentiality protocols.
Scheduling appointments for patients when they call.
Using Electronic Health Record to match physician/clinician availability with patient’s preferences in terms of date, time and patient need.
Ensuring that all cancellations or reschedules are properly recorded.
Communicating as needed with physicians/clinicians and other staff about any patient concerns/issues related to scheduling.
Consulting with Office Manager about any system problems.
Using customer service principles and techniques to deal with patients calmly and pleasantly.
Receiving and processing referral orders from PCP physicians.
Verifying patient insurance eligibility and referral requirements.
Initiating and managing electronic and paper-based referral processes.
Scheduling appointments with specialists and communicating appointment details to patients.
Obtaining necessary prior authorizations and pre-certifications from insurance companies.
Tracking referral status and following up on pending referrals.
Maintaining accurate and up-to-date referral records in the electronic health record (EHR).
Providing clear and concise information to patients regarding the referral process.
Answering patient questions and addressing concerns related to referrals.
Assisting patients with scheduling appointments and navigating the healthcare system.
Providing patient education regarding pre-appointment instructions and necessary documentation.
Communicating with patients and other clinical staff regarding referral status and appointment updates.
Serving as a point of contact for specialists and their staff.
Coordinating the exchange of medical information between primary care physicians and specialists.
Communicating with insurance companies to resolve referral-related issues.
Collaborating with other members of the healthcare team to ensure smooth patient transitions.
Maintaining relationships with specialist offices.