Patient Access Specialist - Full Time 2nd Shift
: Job Details :

Position Summary Position Summary Provides complex registration, authorization, financial clearance, and financial clearance services for highly complex or high dollar specialty services (ie Synagis scheduling and authorization.) Responsibilities Essential Functions 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. Other Related Functions 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. Qualifications Education/Training Associate's degree required. Licensure/Certification None. Experience Three (3) years experience in a customer service, financial, business, or healthcare setting required.Education/Training Associate's degree required. Licensure/Certification None. Experience Three (3) years experience in a customer service, financial, business, or healthcare setting required.Essential Functions 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. Other Related Functions 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.