Patient Services Specialist II - Centralized QA, Access Center

University of Texas Medical Branch (UTMB)•Webster, TX

4h•Onsite

About The Position

The Patient Services Specialist II - Centralized QA supports quality oversight across UTMB Health's Access Center service lines. This role conducts call and workflow evaluations, documents findings, and provides coaching feedback to help maintain consistency and performance standards across Access Services. Candidates with familiarity in Access Center scripting and QA processes are strongly encouraged to apply. The Patient Services Specialist II has advanced Patient Services Specialist skills and is proficient in independently maintaining a positive patient experience by consistently exceeding expectations in customer service and patient care, by coordinating clerical and medical activities of a healthcare team, patient registration activities and facilitating access to UTMB services for new and returning patients.

Requirements

Associate’s degree and one year of clerical or customer service experience.
An equivalent combination of education and experience relevant to the role may be considered for this position.
Proficient in use of PC with experience in Excel, Word, and database management packages.
Analytical and ability to collect and trend data.
Knowledge of patient care and patient problems.
Excellent human relations and written and oral communication skills.
Ability to problem-solve.
For departments reporting under Health System Ambulatory Operations, a valid Basic Life Support (BLS) certification must be obtained within 90 days of hire. Certification must be maintained for the duration of their employment in this position.

Nice To Haves

Familiarity with Access Center scripting and quality assurance (QA) standards.
Previous experience in a healthcare setting and/or high-volume call center environment preferred.

Responsibilities

Conducts call and workflow evaluations.
Documents findings.
Provides coaching feedback to help maintain consistency and performance standards across Access Services.
Lead Responsibilities: Ability to function as a team leader.
Provides peer guidance and leadership.
Able to effectively triage problems.
Understand clinic flow to maximize clinic usage to meet patient needs.
Customer Service: Provides high level customer service in all interactions with internal and external customers.
Provides direct, professional, and knowledgeable interactions with patients, physicians, referral sources, and the treatment team.
Answers calls accurately and with exceptional customer service at all times.
Ensures caller’s needs are met and accurate information is obtained.
Ensures calls are documented and triaged appropriately ensuring patient satisfaction and patient safety. Completes telephone encounter process if appropriate.
Acts as patient advocate and liaisons with various departments to meet mutual goals.
Maintains patient confidentiality regarding access to patient and other clinical information via email, computer, fax and mail.
Addresses concerns of patients, provides service recovery, and escalates issues as needed.
Scheduling: Applies the policies of the clinical entity to schedule appointments.
Coordinates financial counseling for day surgery.
Completes reminder calls to patients for scheduled appointments.
Educates patient/responsible parties regarding billing process and any additional financial responsibilities including third party benefits information.
Provides out of pocket cost estimates to patients.
Counsels patients about unpaid bills.
Obtains future appointments at time of service for clinic follow-up, referrals, and ancillary services.
Arrival: Arrives patients and prepares paperwork/chart for visit.
Appropriately receipts all monies collected, tokens distributed, and deferments authorized.
Registration: Verifies, ensures eligibility, and pre-registers patients by obtaining patient demographics and third-party coverage(s) at every encounter.
Obtains and documents information required for third party reimbursement.
Ensures compliance with Medicare and third-party coverage.
Communicates with patient, referral source, UTMB physician and clinical staff regarding any obstacle to access or authorization.
Disposition: Fully dispositions each patient within the designated timeline.
Marginal or Periodic Functions: Performs related duties as required.
Adheres to internal controls established for department.
Reads all OSA Announcements and relevant communications relating to job duties.
Successfully completes competency-based training and testing on an annual basis.
Prioritizes and completes all work in an accurate, effective, and efficient manner.
Locks office and secures files containing money or confidential information when away from workstation.
Properly disposes of printed patient information, logs off computer when leaving workstation and keeps passwords confidential.
Participates in team meetings/activities and supports the philosophy and goals of the team/department.