Patient Access Specialist - Clinic (Full Time)

Patient Access Specialist

DESCRIPTION OF POSITION:

• The patient access specialist performs administrative duties including, but not limited to: referrals, maintain provider schedules, prior authorizations for procedures/tests/medications, schedule outside procedures/testing, and performs related processing duties for all patients being served by respective clinic. Duties are performed in the EMR system as appropriate. The patient access specialist is trained in performing a wide range of skilled administrative and clerical duties. Reports to the Manager.

RESPONSIBILITIES AND DUTIES:

• Knowledge of CPT coding and Medical Necessity of testing. Ensures criteria met prior to scheduling testing and/or procedures, including surgery.

• Greets each patient warmly and cheerfully.

• Knowledgeable about insurance processing and able to explain deductibles, co-insurance, co-payments, and how processing occurs.

• Handles incoming referrals.

• Answers phone with correct salutation. Takes messages when appropriate.

• Records all messages into electronic EMR.

• Verifies patient information, demographics and insurance coverage is correct. If changes are required, changes the information in the EMR.

• Updates and scans updated information and forms into appropriate EMR system.

• Scan and attach all paperwork received into EMR system and attach and send appropriately.

• Schedules all testing after obtaining precertification per physician checkout orders.

• Completes and sends medical records request per physician orders.

• Completes all referrals through the EMR following correct protocol.

• Verification of insurance should be performed when necessary.

• Performs other job duties as assigned.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND WORK EXPERIENCE

• High school diploma or equivalent required.

• Knowledge and training in medical terminology, keyboarding, and computer skills preferred.

• Basic skills in Microsoft Office preferred.

• Previous experience preferred in the areas of scheduling.

• Computer literacy, required.

• Broad range of administrative and technical skills in the context of the healthcare environment.

• Impacts activities in other work areas on a frequent basis and contributes in multiple work areas.

• Make decisions based on departmental policy.

• Demonstrates critical thought process and can work independently.

• Provides feedback to assist with decision making process.

• Works well with others.

• Documents detailed information in patient chart.

• Requires listening skills to maintain cooperative associations.

Physical Demands/Work Environment

• Work requires a variety of physical activities, including moving about within and outside of all hospital properties for long periods of time.

• Must be able to respond quickly and effectively to emergency and non-emergent situations.

• May be required to assist in controlling disorderly conduct or combative patients.

• Must be able to exchange accurate information with patient, family, peers and medical personnel.

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.