Patient Access Specialist Job Description

Patient Access Specialist Job Description

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Patient access specialist provides benefits administration for programs including medical, dental, vision, life insurance, long-term disability, 401(k) savings plan, flexible spending accounts, health savings accounts, time off programs, work/life programs, voluntary benefits and tuition reimbursement.

Patient Access Specialist Duties & Responsibilities

To write an effective patient access specialist job description, begin by listing detailed duties, responsibilities and expectations. We have included patient access specialist job description templates that you can modify and use.

Sample responsibilities for this position include:

Pre-Registers new patients by making/receiving patient calls
Verifies insurance eligibility and benefits using automated eligibility systems, payer websites and or calls the insurance carriers during pre-registration
Conducts registration interview with new patients prior to their initial visit
Accurately explains how and why the patients should complete the Healthcare Proxy form
Must be able to push a WOW (Workstation on Wheels)
This position exists to ensure timely new patient access to provider services
The incumbent will handle all patient and provider referral interactions with the highest level of professionalism and personal attention while achieving maximum customer satisfaction
Strong interpersonal skills, accurate data collection, ability to identify available resources, & match the patient and/or referring provider to an accessible solution is necessary to achieve excellence in customer service
Collecting and verifying patient and insurance demographics, identifying patient preferences, and assisting patients and/or providers by scheduling appointments in a timely manner are key functions of this role
Identify accuracy trends

Patient Access Specialist Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Patient Access Specialist

List any licenses or certifications required by the position: BLS, CPR, CHAA, BCLS, HBI

Education for Patient Access Specialist

Typically a job would require a certain level of education.

Employers hiring for the patient access specialist job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and High School Degree in Education, Healthcare, Associates, Sound, Legal, Business, Patient Care, Medical Terminology, Medical, Supervision

Skills for Patient Access Specialist

Desired skills for patient access specialist include:

Medical terminology
ICD-9 and CPT coding
Computer programs
Microsoft programs and familiarity with database programs
Healthcare and health insurance
Explanation of Benefits
Medical and insurance terminology
Applicable Federal
Ethical
Local laws and regulations

Desired experience for patient access specialist includes:

Secures payment for services, contracts for payment, refer patients for financial counseling or collections of account balances
Requires a minimum of five (5) years directly related and progressively responsible experience in customer service, medical billing and coding, benefits verification, healthcare, business administration or similar vocations
Extensive knowledge of pharmacy operations and medical claims
Advanced knowledge of the health care industry is preferred
General knowledge of health care billing required
Advanced proficiency with Microsoft Excel, Outlook and Word

Patient Access Specialist Examples

1

Patient Access Specialist Job Description

Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of patient access specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for patient access specialist
  • Must be willing to perform them as needed for the good of our patients
  • Appeals/Denials
  • Establishes themselves as regional experts regarding payer trends and reports any reimbursement trends/delays to management team
  • Coordinates with internal and external service providers to ensure services are performed in accordance with program policy and within expected service level agreements (SLA’s)
  • Maintains confidentiality in regards to all patient sensitive information
  • Required to be self-motivated, working from a queue (phone or system)
  • Performs related duties as assigned, which could include well defined services generally performed by other program representatives
  • Text
  • Responsible for completing and coordinating each admission in a timely and accurate manner following a courteous and professional attitude
  • Responsible for securing information necessary to complete admission process and 100% data validation of patient demographics
Qualifications for patient access specialist
  • Must have oncology experience or healthcare related experience
  • Requires a minimum of four (4) years directly related and progressively responsible experience in customer service, medical billing and coding, benefits verification, healthcare, business administration or similar vocations
  • Must be proficient with Microsoft Excel, Outlook and Word
  • General knowledge of the healthcare industry is preferred
  • Proven knowledge of Microsoft Word
  • Responsible for PCP authorization/referral management
2

Patient Access Specialist Job Description

Job Description Example
Our innovative and growing company is looking to fill the role of patient access specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for patient access specialist
  • Responsible for monitoring and reviewing all ordered outpatient diagnostic scripts from physicians to ensure appropriate billing and coding occurs and entering accurate applicable data
  • Performs cashier functions
  • Explains Advanced Directives and consent information and obtains signatures, with witnesses when required by hospital policy, with no validated errors
  • Other customer service duties may be assigned such as escorting patients to appropriate area or any other clerical tasks as needed
  • Registration Management
  • Initiate electronic and/or telephone inquiries to employers, payers, and claim Administrators
  • Analyze available documentation and use software or hospital resources to calculate and explain the expected charges for services being provided, the amount expected from the payer, and the amount owed by the patient or responsible party
  • Explain hospital credit and collection policies, payment options and financial assistance to the patient or responsible party and negotiates acceptable resolution of expected self-pay balance
  • Review and analyze records of active patients to identify and resolve situations where future care is different than originally identified, including reverification of insurance coverage, recertification of payer requirements, and recalculation of patient liabilities
  • Work in conjunction with Case Management department
Qualifications for patient access specialist
  • Work all denials for resolution and identifies and communicates trends to prevent denials in the future
  • Work and monitor all WQs
  • Field calls from the team
  • Route paperwork
  • Register patients
  • Perform concierge services
3

Patient Access Specialist Job Description

Job Description Example
Our growing company is hiring for a patient access specialist. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for patient access specialist
  • Escort players to visits
  • Field calls from Oncology patients
  • Obtain pathology slides required for new patients to see MD
  • Other duties as assigned to support the Orthopaedic practice
  • Greet patient in a respectful, warm, and professional manner by phone and in-person
  • Use resources, tools and procedures to complete registrations for complex account(s)
  • Identify Prior Authorizations for services
  • Identify, verify and complete eligibility and benefits via electronic resources/phone, interpret results and enter into Excellian
  • Use resources, tools and procedures to complete accounts in assigned work queues
  • Explain copays, coinsurance, and/or deductible to patient(s) and collect on financial obligation owed
Qualifications for patient access specialist
  • Associates Degree from an accredited educational body
  • Associates Degree or equivalent education in health sciences, managed healthcare, public policy, social work or related disciplines
  • Proven track record for consistently meeting or exceeding qualitative, any relevant quantitative, targets and goals
  • Must be able to support all hours of operations (Hours of operations are 8am-8pm ET)
  • Responsible for production and adherence to measurable strategic departmental and system goals in relation to the expected
  • 6 months pharmacy technician experience or minimum 2nd year pharmacy student
4

Patient Access Specialist Job Description

Job Description Example
Our growing company is searching for experienced candidates for the position of patient access specialist. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for patient access specialist
  • Maintains a productive, collegial level of communication and collaboration with the staff of referring practices, patients and clinical departments to assist in the execution of daily workload tasks and the overall mission of the Physician Organization
  • Represents the Practice Manager when unavailable
  • Participates in pilot programs as they are developed
  • Under direction, delegates follow-up activities to fellow staff
  • Verifies patient insurance eligibility and obtains necessary pre-authorization numbers, if required, prior to appointment date
  • Monitors referrals to facilitate patient appointments for urgent care cases
  • Reviews electronic appointment requests and schedules or assigns to staff for resolution
  • Monitors quality of customer service and accuracy of information provided by staff by listening to live and recorded calls
  • Attends off-site outreach events on behalf of the department as needed, in order to promote the department’s services to potential new customers
  • Initiating patient scheduling
Qualifications for patient access specialist
  • Associate’s Degree or higher in Health Sciences, Managed Healthcare, Public Policy, Social Work, or other related disciplines
  • 2+ years of healthcare or healthcare reimbursement experience and possess a high level of proficiency in all aspects of reimbursement and access
  • Two (2) years retail/inpatient pharmacy technician experience preferred
  • Must be very articulate and posses a professional demeanor and appearance
  • Manage day to day activities of health care provider support requests and deliverables across multiple communication channels Phone, Fax, Chat, eMail
  • Associates or Bachelor’s Degree in health sciences, managed healthcare, public policy, social work or related disciplines strongly preferred
5

Patient Access Specialist Job Description

Job Description Example
Our innovative and growing company is hiring for a patient access specialist. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for patient access specialist
  • Identify, record and verify patient insurance coverage using real time eligibility (RTE)
  • Register and explain the process to patients presenting for visits
  • Process patient co-payments, co-insurance, deductibles and balances due
  • Complete the Medicare Secondary Payor Questionnaire for each patient and adjust accordingly
  • Counsel patients regarding non-covered services
  • Monitor patient waiting area for a smooth, efficient registration flow and advise patients of potential delays
  • Ensure a pleasant patient experience
  • Respond to patient concerns and any patient safety issues
  • Investigate patient’s insurance coverage when applicable by conducting payer calls, utilizing insurance intel and web tools
  • Review financial documents for completion to assist with assessing for program eligibility
Qualifications for patient access specialist
  • Manage day to day activities of health care provider support requests across multiple communication channels (Phone, Fax, Chat, e-mail)
  • In lieu of an AA or BA degree a minimum 2 years of healthcare/healthcare reimbursement experience
  • Previous registration experience in a healthcare setting preferred
  • Must possess excellent guest relation/customer service skills excellent communication skills, both verbal and written
  • Vocational/Technical Training or working toward degree
  • Ability to problem solve, think on your feet and work under pressure without direct supervision

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