Patient Access Specialist

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Location: Winchester, MA
Job ID: 169509-1A
Date Posted: Aug 4, 2021
Category: Specialist

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Job Description

Welcome To

Welcome to Winchester Hospital, part of Beth Israel Lahey Health. Winchester Hospital was the first hospital in Massachusetts to earn Magnet recognition, the American Nurses Association’s highest honor for nursing excellence, three times. It has since received the recognition a fourth time. As the northwest suburban Boston area’s leading provider of comprehensive health care services, the 229-bed facility provides care in general, bariatric and vascular surgery, orthopedics, pediatrics, cardiology, pulmonary medicine, oncology, gastroenterology, rehabilitation, radiation oncology, pain management, obstetrics/gynecology and a Level IIB Special Care Nursery.

 

About the Job

JOB SUMMARY:       

Contributes to the Hospital’s mission by ensuring that the patient experience in accessing healthcare at Winchester is efficient and welcoming and that patient confidentiality is respected and patient safety is preserved.  Ensures that all proper patient financial and demographic information is obtained and processed so Winchester is fully reimbursed for clinical services provided. 

 

QUALIFICATIONS:

Education/Experience

Required: 

·        High School Diploma or equivalent

·        Prior experience in a business setting providing customer service, while processing and verifying electronic demographic, financial or other busuness-related information and data.

Preferred:

·        1 year of patient access or billing experience preferred.

Other Skills/Knowledge

Required:

·        Able to work successfully in a fast-paced, multi-task environment, where some independent decision making is necessary.

·        Able to process electronic information and data accurately and efficiently.

·        For safety and quality reasons, must be able to read, write and communicate effectively in English with patients, visitors and fellow members of the hospital team.

·        Strong customer service/relations skills

 

LICENSES, REGISTRATIONS, CERTIFICATIONS:  N/A

                                    

LIFE SUPPORT CERTIFICATION REQUIRED:  N/A

 

POPULATION SPECIFIC REQUIREMENTS:  N/A

 

OTHER JOB REQUIREMENTS:

On-call Requirement:  N/A

Schedule Requirements:  Schedule and hours may vary based on department needs

Travel Requirements:   May be asked to work at various locations.

 

REPORTING RELATIONSHIPS:

·        Reports to Financial Clearance Supervisor

·        Not responsible for supervising the work of others.

As part of the Financial Clearance team, this position:

 

 

Scheduling:

·         Initiates patient scheduling activities by prioritizing and accessing a variety of sources, including patient phone calls, orders, recall lists, scheduled order work queues and MyChart.

·         Utilizes a variety of information sources to schedule, reschedule and cancel patient appointments. Information sources include online questionnaires, offline materials and subgroup searches. 

·         Establishes working relationship with staff of assigned clinical departments. Understands and correctly applies unique clinical department scheduling protocols. 

·         Remains current on scheduling protocols and applies judgment, or seeks management assistance, to ensure safe patient care when clinical department scheduling protocols do not meet patient needs.

·         Ensures all required key patient scheduling and registration information is captured and verified.  Key information includes referring physician information, insurance coverage, demographics and contact information. 

·         Identifies and communicates to Patient Access management issues that may impact the timeliness and accuracy of patient appointments and subsequent patient care.

Pre-Registration:

·         Efficiently registers patients, capturing and verifying all required information in order to identify the patient, contact the patient, and receive proper reimbursement for services on initial claim submission.

·         Ascertains, creates and assigns the guarantor for each patient, including personal/family relations, workers compensation insurance, third parties, behavioral health or others as required.

·         Identifies, records and verifies patient insurance coverage using real time eligibility (RTE); reviews the insurer’s response to each verification request and takes appropriate action based on this response.

·         Applies the appropriate guarantor and insurance to each patient visit.

·        Communicates financial clearance status to patients.  Advises patients of self-pay status and payment responsibility and schedules patients with Financial Counseling as needed.

·        Collects co-payments when appropriate and required.

Registration:

·         Registers patients presenting for visits.  Explains the registration process to patients and responds to patient questions.

·         Processes patient co-payments, co-insurance, deductibles and balances due. Safeguards cash, checks and receipts and reconciles cash drawer at end of each business day. Assists patients with Kiosk check-in as needed.

·         Completes the Medicare Secondary Payor Questionnaire for each patient and adjusts patient coverage based on results.

·         Instructs patients and obtains signatures on consent forms, financial forms and other documents required by the clinical department; distributes documents to patients; scans, processes and records receipt of all documents collected during registration encounter.

·         Counsels patients regarding non-covered services, obtaining signatures on Advance Notice Beneficiaries (ABNs) and waivers.

·         Monitors patient waiting area for a smooth, efficient registration flow. Advises patients of potential delays and takes steps to ensure a pleasant patient experience. 

 

·         Completes registrations on inpatient units who may be missing information from their original registration

·         Responds to patient concerns and potential patient safety issues accordingly. Recognizes health conditions that are a possible risk to others and adheres to appropriate established procedures to help contain risk.

·        Assures a neat, orderly registration desk and patient waiting area, securing all confidential patient information.

·        Collects co-payments when appropriate and required.

 

·        Demonstrate an understanding of the job description, performance expectations, and competency assessment.

·        Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.

·        Participate in departmental and/or interdepartmental quality improvement activities.

·        Participate and successfully completes Mandatory Education.

·        Perform all other duties as needed or directed to meet the needs of the department.

 

 

Shift

40 hours

About Us

Beth Israel Lahey Health is dedicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve.  Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health.  Beth Israel Lahey Health Performance Network is a unified joint contracting and population health management organization, jointly governed by participating physicians and hospitals.

Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.