Patient Services Specialist I - Bay Colony Pediatric Specialties

EDUCATION & EXPERIENCE:

Minimum Qualifications:

• Associate’s degree and no experience. An equivalent combination of education and experience relevant to the role may be considered for this position.

LICENSES, REGISTRATIONS OR CERTIFICATIONS:

Required:

For departments reporting under Health System Ambulatory Operations, a valid Basic Life Support (BLS) certification must be obtained within 90 days of hire. Certification must be maintained for the duration of their employment in this position.

JOB SUMMARY:

The Patient Services Specialist I creates a positive patient experience by consistently exceeding expectations in customer service and patient care, by coordinating clerical and medical activities of a healthcare team, patient registration activities, and facilitating access to UTMB services for new and returning patients.

ESSENTIAL JOB FUNCTIONS:

Customer Service:

• Provides high level customer service in all interactions with internal and external customers.
• Provides direct, professional, and knowledgeable interactions with patients, physicians, referral sources, and the treatment team.
• Answers calls accurately and with exceptional customer service at all times.
• Ensures caller’s needs are met and accurate information is obtained.
• Ensures calls are documented and triaged appropriately ensuring patient satisfaction and patient safety. Completes telephone encounter process if appropriate.
• Acts as patient advocate and liaisons with various departments to meet mutual goals.
• Maintains patient confidentiality regarding access to patient and other clinical information via email, computer, fax and mail.
• Addresses concerns of patients, provides service recovery, and escalates issues as needed.

Scheduling:

• Applies the policies of the clinical entity to schedule appointments.
• Coordinates financial counseling for day surgery.
• Completes reminder calls to patients for scheduled appointments.
• Educates patient/responsible parties regarding billing process and any additional financial responsibilities including third party benefits information.
• Provides out of pocket cost estimates to patients.
• Counsels patients about unpaid bills.
• Obtains future appointments at time of service for clinic follow-up, referrals, and ancillary services.

Arrival:

• Arrives patients and prepares paperwork/chart for visit.
• Appropriately receipts all monies collected, tokens distributed, and deferments authorized.

Registration:

• Verifies, ensures eligibility, and pre-registers patients by obtaining patient demographics and third-party coverage(s) at every encounter.
• Obtains and documents information required for third party reimbursement.
• Ensures compliance with Medicare and third-party coverage.
• Communicates with patient, referral source, UTMB physician and clinical staff regarding any obstacle to access or authorization.

Disposition:

• Fully dispositions each patient within the designated timeline.
• Adheres to internal controls established for department.

Marginal or Periodic Functions:

• Performs related duties as required.
• Adheres to internal controls established for department.
• Reads all OSA Announcements and relevant communications relating to job duties.
• Successfully completes competency-based training and testing on an annual basis.
• Prioritizes and completes all work in an accurate, effective, and efficient manner.
• Locks office and secures files containing money or confidential information when away from workstation.
• Properly disposes of printed patient information, logs off computer when leaving workstation and keeps passwords confidential.
• Participates in team meetings/activities and supports the philosophy and goals of the team/department.

KNOWLEDGE/SKILLS/ABILITIES:

• Proficient in use of PC with experience in Excel, Word, and database management packages.
• Analytical and ability to collect and trend data.
• Knowledge of patient care and patient problems.
• Excellent human relations and written and oral communication skills.
• Ability to problem-solve.

WORKING ENVIRONMENT/EQUIPMENT:

• Standard hospital, clinical, and/or office environments.
• Standard office equipment.

SALARY RANGE:

Actual salary commensurate with experience.

WORK SCHEDULE:

On-site, Monday through Friday, 8:30 am to 5:30 pm, with occasional weekends as needed.

Equal Employment Opportunity

UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.