Pt Financial Access Spec- Op

Yale New Haven Health•New Haven, CT

About The Position

The Patient Financial Access Specialist - OP performs Patient Financial Access Facilitator functions and supports complex scheduling across multiple outpatient service areas. The role uses effective communication and technology to identify patients accurately, follow Red Flag procedures, and obtain and update demographic and financial information in multiple computer systems so visits can be processed promptly. The specialist coordinates internal and external appointments and procedures, working closely with patients, physicians, and nursing professionals. Responsibilities include making decisions about sequencing complex procedures, physician appointments, infusion or chemotherapy, and other multifaceted services; confirming that patients and physician offices have completed required instructions, preparations, and laboratory tests; coordinating appointments and insurance demographics to support appropriate reimbursement; and addressing medical necessity, including follow-up when a Waiver or ABN is required. The specialist considers imaging and satellite-site locations when aligning appointments and applies careful attention to accuracy, documentation, and patient sensitivity. The role also supports service excellence, performs statistical and quality-assurance functions, contributes to procedure development and system improvements, and participates in planning, implementation, and training.

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 their families.
Ability to multitask and reprioritize as volume changes.
Strong interpersonal skills and ability to build rapport with a wide range 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 education 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.
Consistent conduct in accordance with the Standards of Professional Behavior.

Nice To Haves

Associate degree.
Two to three years of work experience in a customer-service environment, preferably in a hospital or physician office, with an emphasis on 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.
Schedule patient follow-up physician appointments accurately in the appropriate scheduling system, following established guidelines and requirements.
Enter insurance information accurately and use eligibility and insurance systems to determine eligibility, benefits, and copayments; document findings according to departmental policies.
Coordinate complex and time-sensitive appointments using the Epic system.
Provide support and coverage in other outpatient service departments in collaboration with the Supervisor or Manager.
Manage time effectively while scheduling patient appointments.
Deliver service in accordance with Health System Standards of Professional Behavior and support a positive patient experience.
Work with clinical staff to maintain Epic templates for different locations and disciplines.
Perform other duties assigned by management.
Review and update training materials as needed and train other staff members.
Help develop procedures and participate in planning, implementation, and training for system improvements.
Perform statistical and quality-assurance functions.