Patient Access Specialist - Part Time Evenings

Northwestern Memorial Healthcare•McHenry, IL

2d•Onsite

About The Position

The Patient Access Specialist reflects the mission, vision, and values of NMHC, adheres to the organizations Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. This role is responsible for practicing the Patients First philosophy and adhering to high standards of customer service, including setting an example for peers and coworkers by fostering a team atmosphere. The specialist will respond to questions and concerns, forwarding extraordinary issues to the Team Lead or Operations Coordinator as necessary. Maintaining patient confidentiality per HIPAA regulations is crucial. The role provides exceptional customer service to patients, establishing a positive first impression of Northwestern Medicine, and exceeding consumer requests while alerting management to issues or concerns requiring escalation. Key duties include correctly identifying and collecting patient demographic information, interacting with various hospital departments and physician offices to schedule and direct patients, and reaching out to patients to schedule appointments. The specialist will perform medical necessity checks, communicate options if an appointment fails, and inform patients of any issues with securing financial accounts. They will also complete out-of-pocket estimations, provide training and education, manage their work schedule efficiently, and complete other assigned duties. Cross-training between departments will occur to ensure coverage, and participation in Quality Assurance reviews is expected to maintain data integrity. The role requires using effective service recovery skills, adhering to departmental policies and compliance requirements, and avoiding putting patients at financial or safety risk. Communication and collaboration are key, involving communicating information about referrals and consultations, collecting authorization numbers, providing a professional communication environment, and resolving operational issues. The specialist may attend meetings, communicate customer satisfaction issues, demonstrate teamwork, and communicate effectively with diverse opinions and styles. They will interact with internal customers to provide excellent support services and accommodate all levels of communication ability. Technology utilization includes multiple online order retrieval systems, verifying insurance eligibility and benefit levels through online tools or phone, and completing accurate handoff instructions in Epic. The specialist must demonstrate proficiency in all computer applications, run real-time eligibility checks, and send descriptive and grammatically correct Epic Messages/Telephone encounters. Efficiency, process improvement, and business growth are also important, involving proactive issue prevention, understanding minimum data sets for registration, collecting and verifying critical data, understanding quality metrics, analyzing account activity, evaluating procedures for improvements, participating in quality improvement activities, monitoring registration and scheduling, adjusting processes to meet standards, using resources efficiently, acting as a training resource, and understanding that schedules may change to reflect business needs. The role requires evolving and learning as healthcare policies change.

Requirements

High School diploma or equivalent.
2-3 years customer service or medical office experience.
Excellent interpersonal, verbal, and written communication skills.
Proficiency in computer data-entry/typing.
Excellent verbal and written communication skills.
Ability to read, write, and communicate effectively in English.
Basic Computer Skills.
Ability to type 40 wpm.
Ability to multi-task.
Customer service oriented.
Excellent organizational, time management, analytical, and problem solving skills.

Nice To Haves

Additional education.
Additional language skills.
Healthcare finance and/or healthcare insurance experience.
Knowledge and experience in a healthcare setting, especially patient scheduling and/or registration.

Responsibilities

Consistently practices Patients First philosophy and adheres to high standards of customer service.
Responds to questions and concerns, forwarding extraordinary issues to the Team Lead or Operations Coordinator as necessary.
Maintains patient confidentiality per HIPAA regulations.
Provides exceptional customer service to patients, establishing a positive first impression of Northwestern Medicine.
Exceeds all consumer requests and alerts management of issues or concerns that require escalation.
Correctly identifies and collects patient demographic information in accordance with organization standards.
Interacts with various hospital departments and physician offices to effectively schedule and direct patients through the NMHC systems in a patient/customer friendly manner.
Reaches out to patients to schedule an appointment as defined.
Performs medical necessity checks as necessary for scheduled services, communicates options to patient if appointment fails.
Informs patients of any issues with securing the financial account for their encounter.
Completes out-of-pocket estimations as requested by patients.
Provides training and education as needed.
Manages work schedule efficiently, completing tasks and assignments on time.
Completes other duties assigned by manager.
Cross-training between various departments will take place to ensure coverage.
Participates in Quality Assurance reviews to ensure integrity of patient data information.
Uses effective service recovery skills to solve problems or service breakdowns when they occur.
Utilizes department and hospital policies and procedures to complete assigned tasks.
Adheres to all department policies and compliance requirements.
Avoids putting patient in financial or safety risk.
Communicates information to the patient regarding questions about physician referrals, insurance referrals and consultations.
Collects authorization numbers in appropriate systems as applicable.
Provides professional and constructive environment for communication across units/departments and resolves operational issues.
May attend intra/interdepartmental meetings which involve walking within NM Campus.
Communicates customer satisfaction issues to appropriate individuals.
Demonstrates teamwork by helping co-workers within and across departments.
Communicates effectively with others, respects diverse opinions and styles, and acknowledges the assistance and contributions of others.
Interacts with internal customers to provide excellent support service to staff in departments which provide direct patient care.
Accommodates all levels of communication ability.
Utilizes multiple online order retrieval systems to verify or print the patients order.
Verifies insurance eligibility and benefit levels through the use of online tools (NDAS, ASF, etc.) or over the phone as necessary.
Completes accurate handoff instructions and notes to scheduling staff, by noting appropriately in Epic.
Demonstrates ability to use all computer applications efficiently and to the capacity needed in this position.
Runs real time eligibility (RTE) on all patients to verify insurance and follows out of network policies as applicable.
Sends quality Epic Messages/Telephone encounters that are descriptive and grammatically correct.
Proactive in preventing issues with patient visit by double checking type of test, preps required, assuring no conflict with other tests, verifying time and location, communicating relevant information, verifying documenting order retrieval in notes for check-in person, ensures there are no duplicate patient records.
Understands minimum data set required for a complete registration, collects and verifies critical data and updates that information into registration system.
Understands departmental and individual quality metrics.
Proactively analyzes account activity, identifies problems, and initiates appropriate actions/resolutions.
Evaluates procedures and suggests improvements to enhance customer service and operational efficiency.
Participates in departmental quality improvement activities.
Provides ideas and suggestions for process improvements within the department.
Monitors registration and scheduling, including insurance verification to ensure processing within prescribed quality standards.
Adjusts processes as needed to meet standards.
Uses organizational and unit/department resources efficiently.
Acts as a training resource for new staff and a resource for coworkers, sharing process and workflow information.
Understands that schedule may change to reflect shifting business needs.
Evolves and learns as healthcare policies change.