The Patient Access Specialist reflects the mission, vision, and values of Northwestern Medicine, adheres to the organization鈥檚 Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
Responsibilities:
- Ensures patient safety and satisfaction through courteous, timely and accurate registration.
- Collects and enters pertinent patient information and informs of hospital policies and procedures.
- Demonstrates I-CARE values (Integrity, Compassion, Accountability, Respect and Excellence) in daily work and interactions.
- Presents a friendly, approachable, professional demeanor and appearance.
- Provides accurate information and timely updates to patients and customers. Addresses questions and concerns promptly, or identifies appropriate person and resources to do so. Provides directions or help to patients and customers with finding their way.
- Uses effective service recovery skills to solve problems or service breakdowns when they occur.
- Demonstrates teamwork by helping co-workers within and across departments. Communicates effectively with others, respects diverse opinions and styles, and acknowledges the assistance and contributions of others.
- Uses organizational and unit/department resources efficiently.
- Manages work schedule efficiently, completing tasks and assignments on time.
- Contributes to opportunities and processes for continuous improvement.
- Participates in efforts to reduce costs, streamline work processes, improve and grow services we provide.
- Demonstrates knowledge of Revenue Cycle and the impact of Patient Access on all areas, from point of service collections to timely and accurate billing.
- Demonstrates knowledge and is able to navigate competently in multiple computer systems.
- Completes and scans the following documents with 95% accuracy: Consents, MFM, Coordination of Benefits, insurance cards, photo identification, and any other paperwork
- Electronically records and updates patient information in a timely, accurate fashion.
- Initiates electronic and/or telephone inquires to physician offices, insurance payers, employers and internal business partners.
- Completes insurance eligibility checks and verifies benefits through electronic means.
- Demonstrates knowledge concerning the operations of the various hospital departments.
- Answers or refers the questions of patients, visitors, and fellow employees in an appropriate manner.
- Keeps open lines of communication with both internal and external customers allowing issues to be resolved with little or no conflict.
- Appropriately and effectively explains, secures and witnesses all signatures required to provide medical treatment, assign insurance benefits, complete release of information, establish financial responsibility, and meet other internal regulator or payer requirements, including "Important Message from Medicare" and Care Everywhere. Appropriately identifies Self-Pay patients and provides Presumptive Eligibility and/or Financial Assistance.
- Assesses and responds appropriately to patients' communications needs and secures an interpreter or other necessary assistance, when appropriate.
- Maintains an effective working relationship with all Revenue Cycle Departments.
- Adheres to the designated dress code/uniform requirements when reporting to work.
- Answers telephone in a polite manner, stating name and department name.
- Displays sensitivity to the needs and problems of patients, visitors and fellow employees and understands the individual's right to confidentiality must be maintained.
- Understands that the Patient Access Specialist is an agent of the hospital and is to act in a manner, which is in the best interests of the hospital.
- Creates a positive image with patients, visitors and fellow employees.
- Maintains a productivity standard for the specific area of registration (3 registrations/hr ED or 5 registrations/hr OP).
- Accurately collects and analyzes all required demographic, insurance/financial, and clinical data necessary to register patients from all payor classes with 95% accuracy. Apply critical thinking to eliminate duplicate Medical Records numbers or accounts.
- Possesses a working knowledge of insurance and the RTE function for insurance verification purposes to ensure timely and accurate billing.
- Demonstrates job skills for multiple areas and is proficient enough to handle all tasks defined for that area in order to support that area, if necessary.
- Demonstrates ability to accurately identify valid physician orders, and transcribe valid order into an electronic order accurately.
- Demonstrate a working knowledge of Medical Necessity, Medicare as Secondary Payor Questionnaire, and the Advanced Beneficiary Notice for Medicare patients.
- Collects co-payment from patients covered by managed care insurance using scripting provided and in accordance with department policy and EMTALA guidelines.
- Collects prior balances and pre-payments using scripting provided and in accordance with department policy.
- Demonstrates knowledge regarding department and hospital policies and procedures and utilizes these to complete assigned tasks.
- Reads all policy/procedure updates upon posting or next shift, whichever comes first.
- Daily monitoring and timely response to email communication and department announcements.
- Attend 75% of all department staff meetings, and read all follow up information regarding these meetings if not in attendance.
- Acts as training resource for new staff and a resource for co-workers, sharing process and workflow information.
- Demonstrates critical thinking and an ability to be flexible, organized and function well in stressful situations.
- Keeps department neat, uncluttered. Takes ownership to ensure work areas present a professional, neat image, as well as own work area, to keep walls, desks and work surfaces clear and uncluttered
- Performs other duties as assigned.