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 consistently practicing a Patients First philosophy and adhering to high standards of customer service, including setting an example to peers and fostering a team atmosphere. The specialist will respond to questions and concerns, and forward extraordinary issues to the Team Lead or Operations Coordinator. 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 hospital departments and physicians' offices to schedule and direct patients, reaching out to patients to schedule appointments, performing medical necessity checks, informing patients of financial account issues, and completing out-of-pocket estimations. The specialist will also provide training and education as needed, manage their work schedule efficiently, and complete other assigned duties. Cross-training between various departments will occur to ensure coverage. Participation in Quality Assurance reviews to ensure data integrity, and the use of effective service recovery skills are also essential. The role utilizes department and hospital policies and procedures, adheres to all department policies and compliance requirements, and avoids putting patients at financial or safety risk. Communication and collaboration involve communicating information to patients regarding referrals and consultations, collecting authorization numbers, providing a professional communication environment across units, attending meetings, communicating customer satisfaction issues, demonstrating teamwork, and interacting with internal customers to provide excellent support. Accommodating all levels of communication ability is expected. Technology utilization includes multiple online order retrieval systems, verifying insurance eligibility and benefit levels through online tools or phone, completing accurate handoff instructions in Epic, and efficiently using all necessary computer applications. Running real-time eligibility (RTE) and following out-of-network policies are also required, along with sending quality Epic Messages/Telephone encounters. Efficiency, process improvement, and business growth are fostered by proactively preventing patient visit issues, understanding the minimum data set 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, understanding schedule changes, and evolving with healthcare policy changes.
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Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED