Patient Financial Access Spec - OP

Yale New Haven Health•Trumbull, CT

About The Position

The Patient Financial Access Specialist - OP performs all Patient Financial Access Facilitator functions and responsibilities and supports complex scheduling across more than one outpatient service area. The role uses effective communication and technology to identify patients accurately, follow Red Flag procedures, and obtain and update demographic and financial information across multiple computer systems to support timely processing of patient 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 in clinic settings, the role coordinates complex procedures, physician appointments, infusion and chemotherapy visits, and other multifaceted services. The specialist confirms that required instructions, preparations, and laboratory tests have been completed, coordinates multiple appointments, and manages patient and insurance demographics to support appropriate reimbursement. The position also makes decisions about whether ordered exams meet Medical Necessity requirements and follows up with patients or physician offices when a Waiver or ABN is required. The specialist considers imaging and satellite locations across the System when coordinating appointments. Accuracy, attention to detail, and patient sensitivity and compassion are essential. The role represents YNHHS service excellence, performs statistical and quality-assurance functions, helps develop procedures, and participates in planning, implementing, and training on system improvements.

Requirements

High school diploma or GED required.
Two to three years of work experience in a customer-service environment is preferred, preferably in a hospital or physician office, with emphasis on registration, scheduling, medical insurance, and eligibility requirements.
Self-directed, well organized, and team oriented, with the ability and desire to educate and advocate for patients and their families.
Ability to multitask and reprioritize as volumes fluctuate.
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.
Proficiency in understanding registration work queues that affect workflow.
Ability to provide training or in-service sessions to staff in the department and hospital.
Effective written and oral communication skills, including the ability to communicate complex requirements across clinical and financial disciplines.
Demonstrated attention to detail, specificity, and accuracy, along with patient sensitivity and compassion.

Nice To Haves

Associate degree preferred.
Customer-service experience in a hospital or physician office, particularly in registration, scheduling, 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.
Accurately schedule patient follow-up physician appointments in the appropriate scheduling system, following system guidelines and requirements.
Enter insurance information accurately and understand carrier options, eligibility, benefits, and copayments; document information in the appropriate computer system according to departmental policies.
Coordinate patient appointment-scheduling tasks and schedule complex, time-sensitive appointment types using Epic.
Support other outpatient service departments and provide coverage as needed, in collaboration with the Supervisor or Manager.
Manage time effectively while scheduling patient appointments.
Provide service excellence consistent with Health System Standards of Professional Behavior; welcome and acknowledge patients and visitors and support a positive patient experience.
Work with clinical staff to maintain Epic templates across locations and meet with clinical teams to plan and create scheduling templates for various disciplines.
Review and update training materials as needed and train other staff members.
Perform other duties as assigned by management.
Accurately identify patients and follow Red Flag procedures.
Obtain and update patient demographic and financial information across multiple computer systems.
Coordinate complex procedures, physician appointments, infusion and chemotherapy visits, and other multifaceted services.
Confirm with patients or physician offices that required instructions, preparations, or laboratory tests have been completed before procedures or appointments.
Coordinate multiple patient appointments and manage patient and insurance demographics to support appropriate reimbursement.
Determine whether ordered exams meet Medical Necessity requirements and follow up when a Waiver or ABN is required.
Align appointments with appropriate imaging and satellite locations across the System.
Perform statistical and quality-assurance functions and participate in developing procedures and implementing and training on system improvements.