Pt Financial Access Specialist

Yale New Haven Health•New Haven, CT

About The Position

The Patient Financial Access Specialist - OP performs the functions of a Patient Financial Access Facilitator and provides support for complex scheduling across multiple outpatient service areas. The role uses effective communication and technology to identify patients accurately, follow Red Flag procedures, and collect and update demographic and financial information across computer systems to support timely processing of visits. The specialist serves as a liaison between physicians and patients for internal and external appointment and procedure scheduling. Working with patients, physicians, and nursing professionals, the role coordinates complex procedures, physician appointments, infusion and chemotherapy services, and other multifaceted visits. The specialist communicates preparation, instruction, and laboratory requirements, coordinates multiple appointments, and manages patient and insurance demographics to support appropriate reimbursement. The position also evaluates ordered exams in relation to Medical Necessity and follows up when a Waiver or ABN is required. It considers imaging and other satellite locations when aligning appointments with patient locations. The work requires attention to detail, accuracy, and patient sensitivity and compassion, along with a commitment to service excellence. The specialist performs statistical and quality assurance functions and helps develop procedures, plan and implement system improvements, and train staff.

Requirements

High school diploma or GED.
Self-directed, well organized, and team-oriented, with the ability and desire to educate and advocate for patients and families.
Ability to multitask and reprioritize in response to changing workload volume.
Strong interpersonal skills and ability to build rapport with a wide variety of people, including clinical staff.
Excellent investigative, critical-thinking, and problem-solving skills.
Intermediate computer skills and ability to adapt to various programs and systems.
Demonstrated proficiency in understanding registration work queues that affect workflow.
Ability to provide training or in-service to staff and departments within the department and hospital.
Effective written and oral communication skills, including the ability to communicate complex requirements across clinical and financial disciplines.

Nice To Haves

Associate degree.
Two to three years of customer service experience, preferably in a hospital or physician office, with emphasis on registration, scheduling, and medical insurance and eligibility requirements.

Responsibilities

Obtain required information from referring physicians and clinical providers and provide it to third-party payers to support reimbursement for outpatient services.
Schedule patient follow-up physician appointments accurately in the appropriate scheduling system, following applicable guidelines and requirements.
Enter insurance information accurately and meet billing requirements to support payable accounts.
Use online eligibility and insurance systems to assess eligibility, benefits, and copayments, and document findings according to departmental policies.
Coordinate patient appointment scheduling, including complex and time-sensitive appointments using Epic.
Provide coverage in other outpatient service departments in collaboration with the Supervisor or Manager, maintaining relevant skills.
Manage time independently to optimize patient appointment scheduling.
Provide service excellence and follow Health System Standards of Professional Behavior when receiving and assisting patients and visitors.
Work with clinical staff to maintain Epic templates for various locations and disciplines.
Perform other duties as assigned by management.
Review and update training materials as needed and train other staff members.
Coordinate complex procedures, physician appointments, infusion or chemotherapy services, and other multifaceted appointments.
Communicate appointment instructions, preparation requirements, and laboratory test requirements to patients or physician offices.
Assess ordered exams for Medical Necessity and follow up with patients or physicians when a Waiver or ABN is required.
Perform statistical and quality assurance functions and participate in developing procedures and implementing system improvements.