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.