Patient Access Specialist Troy Days PT
Required skills
- Patient Access
- Hospital Registration
- Insurance Verification
- Authorizations
- Medical Terminology
- Third-party payors
- EMR
- Patient Responsibility
- EMTALA
- Advance Directives
Nice to have
- Call center
- Reimbursements
Role summary
The Patient Access Specialist is responsible for serving as the primary point of contact for patients and families regarding appointments and treatment authorizations. This role involves obtaining and verifying insurance and demographic data, ensuring correct authorizations are in place, and explaining financial liabilities to patients. The specialist will also manage patient registration, schedule appointments, handle payments, maintain cash drawers, and scan patient information into the EMR. Collaboration with various departments for process and operational excellence is key, as is staying updated on payer requirements and regulations. The role requires excellent customer service skills and the ability to resolve issues or escalate them appropriately.
Children’s Hospital of Michigan is an international leader in pediatric and adolescent medicine. Surgical services include general, thoracic, reconstructive and cardiovascular. Imaging technology designed specifically for children provides advanced diagnostic services including Positron Emission Tomography (PET) and MRI. The Children’s Hospital of Michigan Emergency Department is a verified Level 1 Pediatric Trauma Center and dedicated pediatric burn center. Experts in pediatric critical care, rehabilitation, and neonatal and perinatal medicine provide care for thousands of children every year at Children’s Hospital of Michigan, Children’s Hospital of Michigan - Troy and six ambulatory sites.
Job Summary
- Be the system navigator and point of contact for patients and families regarding their appointments and authorizations for treatment.
- Assigns patient rooms, reconcile schedules, follow-up with patients to reschedule or coordinate appointments.
- Obtains insurance, medical, and demographic data and verifies insurance coverage and benefit levels with third-party payors.
- Ensure accurate and correct insurance verification and authorizations have been obtained and work with physician offices and third party payors to obtain referrals/authorizations for scheduled & unscheduled services as needed and secure inpatient visit notification to payors.
- Follow-up on bill holds to resolve in a timely manner. Thoroughly explains and secures Hospital and patient legal forms (i.e. Advance Directives, Conditions of Services, Consent for Treatment, EMTALA, Patient Responsibility, etc).
- Scan protected health information and forms into EMR and/or related systems. Notifies and educates patients about financial liabilities (co-payments, deductibles or required deposits and payment plans) and collects the liability when applicable while employing proper patient liability collection techniques.
- Post payments and maintain/reconcile cash drawer.
- Responsible for duties in support of departmental efficiencies including but not limited to collaborating with various departments in process and operational excellence.
- Participates in patient access team in department huddles and report out on Methods, Equipment, Supplies, and Staffing (MESS).
- Responsible for continuing self-education regarding payer requirements and third party regulations under limited guidance and assistance of department management.
- Maintains positive customer service at all times, refine and clarify referring unresolved issues to appropriate supervisor.
1. High school diploma, associate degree in related area preferred.
2. Three or more years prior work experience in patient access, hospital registration, health insurance or related area.
3.Two or more years prior experience in Customer Service or related call center environment preferred.
4. Advanced knowledge of third party payers requirements, reimbursements and copayments/deductible collections etc.
5. Course in medical terminology required.
