Pt Financial Access Spec-OP

Yale New Haven Health•Fairfield, CT

About The Position

The Patient Financial Access Specialist - OP performs the functions and responsibilities of a Patient Financial Access Facilitator and supports complex scheduling across multiple outpatient service areas. The role uses effective communication and technology to accurately identify patients, follow Red Flag procedures, and obtain and update demographic and financial information in multiple computer systems to support timely processing of visits. Serving as a liaison between physicians and patients, the specialist manages internal and external appointments and procedures. The role works closely with patients, physicians, and nursing professionals to sequence complex procedures, physician appointments, infusion and chemotherapy visits, and other multifaceted services. The specialist communicates with patients and physician offices to confirm that required instructions, preparations, and laboratory tests are completed before appointments or procedures. The role also coordinates appointments and manages patient and insurance demographics to support appropriate reimbursement. The specialist makes decisions about whether ordered exams meet Medical Necessity requirements and follows up with patients or physicians when a Waiver or ABN is needed. The position requires awareness of imaging and satellite sites across the system and alignment of appointments with patient locations. Attention to detail, accuracy, and patient sensitivity are essential. The specialist represents YNHHS service standards, performs statistical and quality assurance functions, and helps develop procedures and plan, implement, and train staff on system improvements. Additional responsibilities include supporting other outpatient service departments as needed, maintaining Epic scheduling templates with clinical staff, and reviewing or updating training materials and training other staff members.

Requirements

High school diploma or GED required.
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 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 different programs and systems.
Demonstrated proficiency in understanding registration work queues that affect workflow.
Ability to provide training or in-service instruction 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.
Strong attention to detail, specificity, and accuracy, with patient sensitivity and compassion.

Nice To Haves

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

Responsibilities

Obtain required information from referring physicians and clinical providers and ensure it is provided to third-party payers to support reimbursement for outpatient services.
Accurately schedule patient follow-up physician appointments in the appropriate scheduling system according to applicable guidelines and requirements.
Enter insurance information accurately and use eligibility and insurance systems to determine patient eligibility, benefits, and copayments; document findings according to departmental policies.
Coordinate complex and time-sensitive patient appointments using the Epic system.
Support other outpatient service departments and provide coverage as needed to maintain skills and service continuity.
Manage time effectively while scheduling patient appointments.
Provide service in accordance with Health System Standards of Professional Behavior and support a positive patient experience.
Work with clinical staff to maintain Epic templates and plan and create scheduling templates for different locations and disciplines.
Review and update training materials and train other staff members as needed.
Perform statistical and quality assurance functions.
Help develop procedures and participate in planning, implementing, and training for system improvements.
Sequence complex procedures, physician appointments, infusion and chemotherapy appointments, and other multifaceted services.
Confirm with patients or physician offices that required instructions, preparations, and laboratory tests are completed before procedures or appointments.
Assess ordered exams for Medical Necessity requirements and follow up with patients or physicians when a Waiver or ABN is required.
Align appointments with appropriate imaging and satellite locations across the system.