Patient Access Specialist

Northwestern Memorial Healthcare•Sandwich, IL

11d

About The Position

The Patient Access Specialist reflects Northwestern Medicine’s mission, vision, and values and follows its Code of Ethics, Corporate Compliance Program, policies, procedures, and applicable regulatory and accreditation standards. The role provides patient-focused customer service and supports scheduling, registration, insurance verification, and access to care. The position works a repeating six-week schedule with shifts that vary by week and includes some weekend work. Cross-training across departments may be required to ensure coverage, and schedules may change to reflect business needs. The specialist communicates with patients, hospital departments, physician offices, and scheduling staff; gathers and verifies demographic and registration information; schedules appointments; checks medical necessity and insurance eligibility; and documents information in Epic and other systems. The role also supports quality assurance, process improvement, staff training, and effective resolution of service issues while protecting patient confidentiality and avoiding financial or safety risks.

Requirements

High school diploma or equivalent.
2–3 years of customer service or medical office experience.
Excellent interpersonal, verbal, and written communication skills.
Ability to read, write, and communicate effectively in English.
Proficiency in computer data entry and typing; ability to type 40 words per minute.
Basic computer skills and ability to use computer applications required for the position.
Ability to multitask.
Customer-service orientation.
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

Provide courteous, patient-first customer service and create a positive first impression of Northwestern Medicine.
Respond to patient questions and concerns, escalate extraordinary issues, and use service-recovery skills to resolve problems or service breakdowns.
Maintain patient confidentiality in accordance with HIPAA regulations.
Collect and verify patient demographic, registration, and other required information; prevent duplicate patient records and maintain data integrity.
Interact with hospital departments and physician offices to schedule and direct patients through Northwestern Medicine systems.
Contact patients to schedule appointments and communicate information about physician referrals, insurance referrals, and consultations.
Perform medical necessity checks, explain options when an appointment does not meet requirements, and inform patients about issues securing a financial account for an encounter.
Provide out-of-pocket cost estimates when requested and collect authorization numbers when applicable.
Verify insurance eligibility and benefits using online tools or by phone, run real-time eligibility checks, and follow out-of-network policies.
Use online order retrieval systems to verify or print patient orders and document accurate handoff instructions and notes in Epic.
Communicate effectively across departments, support internal customers, demonstrate teamwork, and accommodate differing communication abilities.
Participate in quality assurance reviews and departmental quality-improvement activities; monitor registration, scheduling, and insurance verification against quality standards.
Analyze account activity, identify and resolve problems, double-check visit details, and suggest process improvements to enhance service and efficiency.
Train and educate as needed and serve as a workflow resource for new staff and coworkers.
Manage work efficiently, complete assignments on time, use organizational resources appropriately, follow department policies, and perform other duties as assigned.