Access Specialis

Yale New Haven Health•Fairfield, CT

21d

About The Position

The Patient Financial Access Specialist - OP performs all 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 collect and update demographic and financial information across multiple computer systems to support timely processing of visits. The specialist serves as a liaison between physicians and patients for internal and external appointments and procedures. Working with patients, physicians, and nursing professionals, the role coordinates complex procedures, physician appointments, infusion and chemotherapy appointments, and other multifaceted services. It involves confirming that patients have completed required instructions, preparations, or laboratory tests; coordinating appointments; managing patient and insurance demographics; and addressing medical necessity, Waivers, and ABNs. The specialist also considers imaging and satellite locations when arranging appointments. The position requires careful, accurate handling of procedure and appointment details and supporting documentation, along with patient sensitivity and compassion. The specialist represents YNHHS service excellence, performs statistical and quality-assurance functions, helps develop procedures, and participates in planning, implementing, and training staff on system improvements.

Requirements

High school diploma or GED required.
Two to three years of work experience in a customer service environment preferred, ideally 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 families.
Ability to multitask and reprioritize in response to changes in volume.
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 different 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 and ability to communicate complex requirements across clinical and financial disciplines while following Standards of Professional Behavior.
Attention to detail, specificity, and accuracy, with patient sensitivity and compassion.

Nice To Haves

Associate degree preferred.
Customer service experience in a hospital or physician office, particularly involving registration, scheduling, medical insurance, and eligibility requirements.

Responsibilities

Obtain information from referring physicians and clinical providers and ensure it is supplied to third-party payers to support reimbursement for outpatient services.
Schedule patient follow-up physician appointments accurately in the appropriate scheduling system according to established guidelines.
Enter insurance information accurately and use eligibility and insurance systems to determine patient eligibility, benefits, and copayments; document information according to departmental policy.
Coordinate complex and time-sensitive patient appointments using the Epic system.
Support other outpatient service departments and provide coverage as needed to maintain skill sets.
Manage time effectively while scheduling patient appointments.
Provide service excellence and follow Health System Standards of Professional Behavior when assisting patients and visitors.
Work with clinical staff to maintain Epic templates across locations and plan and create templates for various disciplines.
Review and update training materials as needed and train other staff members.
Perform other duties assigned by management.
Coordinate complex procedures, physician appointments, infusion and chemotherapy appointments, and other multifaceted services.
Communicate with patients and physician offices to confirm required instructions, preparations, and laboratory tests before appointments or procedures.
Manage patient and insurance demographics and coordinate multiple appointments to support appropriate reimbursement.
Review ordered exams for medical necessity and follow up with patients or physician offices when a Waiver or ABN is required.
Align appointments with appropriate imaging and satellite locations.
Perform statistical and quality-assurance functions and participate in developing, planning, implementing, and training on system improvements.