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Patient Access Specialist

  • Job
    Full-time
    Junior & Mid Level
  • Customer Relations
    Healthcare
  • Orlando

AI generated summary

  • You must understand clinical services, build relationships, be cross-trained in various roles, comply with regulations, and have an associate's degree. Knowledge of registration and scheduling systems is essential.
  • You will build relationships with staff, gather patient information, verify insurance, manage authorizations, resolve customer service issues, collect payments, and assist with scheduling tasks.

Requirements

  • Requires understanding of the clinical nature of these services and takes responsibilities for building relationships with staff and physicians to remove roadblocks that may cause denials or poor patient service or outcomes.
  • Exhibits thorough knowledge in the use of all registration and scheduling systems, electronic verification tools and Web based resources.
  • Cross-trained with appropriate knowledge and skills necessary to staff at any facility, including but not limited to Front Desk, Admitting Office, Cashier, Insurance Verification, Floor Representatives, Pre-Registration, Scheduling and Emergency Department Business Office.
  • Meets federal, state and hospital requirements related to compliance issues.
  • Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
  • Maintains compliance with all Orlando Health policies and procedures.
  • Associate’s degree required.

Responsibilities

  • Requires understanding of the clinical nature of these services and takes responsibilities for building relationships with staff and physicians to remove roadblocks that may cause denials or poor patient service or outcomes.
  • Monitors and reports issues in a timely manner, identifies trends, and problem solves to ensure complete resolution. Provides exemplary customer service and performs job functions in a manner that helps meet the department customer service goals.
  • Identifies customer service issues and resolves or initiates necessary follow-up. Implements service recovery efforts as appropriate.
  • Efficiently and accurately gathers and inputs patient/guarantor demographic and financial information.
  • Explains necessary forms and obtains signatures from patient/guarantor.
  • Contacts appropriate payers, verifying benefits and obtaining necessary authorizations.
  • Explains insurance benefits and collects co-pays, deductibles and self pay portions due.
  • Collects copays, coinsurance, and deductibles as appropriate and meets all cash collection metrics as set forth by the department. In addition, collects outstanding balances due from previous accounts or establishes payment arrangements for these balances as appropriate.
  • Contacts Primary Care or Admitting Physician to obtain authorizations, diagnosis, and procedure detail as necessary.
  • Documents authorization and benefit information in registration system and obtains authorization on behalf of the patient or physician as applicable.
  • Ensures capture of information on patient’s Primary Care Physician and Ordering Physician.
  • Exhibits thorough knowledge in the use of all registration and scheduling systems, electronic verification tools and Web based resources.
  • Screens patient/guarantor for federal, state, county or other assistance programs and completes necessary forms and applications per facility guidelines.
  • Collects and inventories patient valuables following policy guidelines as needed.
  • Maintains thorough understanding of the medical necessity screening process and appropriate systems.
  • Cross-trained with appropriate knowledge and skills necessary to staff at any facility, including but not limited to Front Desk, Admitting Office, Cashier, Insurance Verification, Floor Representatives, Pre-Registration, Scheduling and Emergency Department Business Office.
  • Performs scheduling functions and maintains open communication with physicians and their offices, patients, all ancillary and surgical areas to include scheduling, rescheduling and cancellations of single/multiple tests and procedures.
  • Meets federal, state and hospital requirements related to compliance issues.
  • Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
  • Maintains compliance with all Orlando Health policies and procedures.
  • Attends and participates in department staff meetings and attends other meetings as assigned.
  • Responsible for reviewing and adhering to all departmental education initiatives.
  • Attends educational opportunities outside of department as directed by management.

FAQs

What is the primary responsibility of a Patient Access Specialist?

The primary responsibility is to provide complex registration, authorization, and financial clearance services for highly complex or high dollar specialty services.

What educational background is required for this position?

An Associate's degree is required for this position.

Is any specific licensure or certification necessary for this role?

No specific licensure or certification is required for this role.

What skills are essential for a Patient Access Specialist?

Essential skills include strong customer service, effective communication, problem-solving abilities, and proficiency in using registration and scheduling systems.

How does a Patient Access Specialist ensure excellent customer service?

A Patient Access Specialist ensures excellent customer service by identifying customer service issues, resolving them promptly, and implementing service recovery efforts as appropriate.

What types of financial information must the Patient Access Specialist gather?

The Patient Access Specialist must accurately gather and input patient/guarantor demographic and financial information, including co-pays, deductibles, and self-pay portions.

Are there opportunities for professional development in this position?

Yes, there are opportunities for professional development, including attending departmental and external educational initiatives as directed by management.

Will the Patient Access Specialist be required to handle insurance verification?

Yes, the Patient Access Specialist is responsible for contacting payers to verify benefits and obtain necessary authorizations.

Is cross-training provided for this role?

Yes, the Patient Access Specialist is cross-trained with the necessary knowledge and skills to staff at various facilities, including Front Desk, Admitting Office, and more.

How often does attendance need to align with the policies of Orlando Health?

The Patient Access Specialist is expected to maintain reasonably regular and punctual attendance consistent with Orlando Health policies, as well as federal and state standards.

A trusted leader inspiring hope through the advancement of health.

Science & Healthcare
Industry
10,001+
Employees
1918
Founded Year

Mission & Purpose

Orlando Health is a not-for-profit healthcare organization with $7.6 billion of assets under management that serves the southeastern United States. Headquartered in Orlando, Florida, the system was founded more than 100 years ago.