Patient Access Specialist

Quick Facts

• Role: Patient Access Specialist

Description

The Patient Access Specialist supports patient access by collecting accurate patient demographic information, verifying insurance eligibility and benefits, and assisting with appointment scheduling through hospital systems. The position provides exceptional customer service, completes medical necessity and eligibility checks for scheduled services, and helps patients understand financial/account issues related to their encounter.

Responsibilities

• Provide customer service and support following a Patients First philosophy

• Respond to questions and concerns; escalate extraordinary issues

• Maintain patient confidentiality (HIPAA)

• Collect and verify patient demographic information

• Schedule and direct patients through NMHC systems in a patient-friendly manner

• Reach out to patients to schedule appointments

• Perform medical necessity checks; communicate options if an appointment fails

• Inform patients of issues securing the financial account for the encounter

• Complete out-of-pocket estimations when requested

• Provide training and education as needed; manage schedules efficiently

• Perform cross-training across departments for coverage

• Participate in Quality Assurance reviews to ensure data integrity

• Use service recovery skills to address problems

• Follow department policies and compliance requirements; avoid patient financial/safety risk

• Double-check test types, preps, conflicts, time/location, order retrieval, and prevent duplicate records

• Collect and verify minimum registration dataset; update registration system

• Proactively analyze account activity and initiate resolutions

• Evaluate procedures and suggest process improvements

• Monitor registration and scheduling standards, including insurance verification

• Act as a training resource for new staff and coworkers

Communication and Collaboration

• Communicate with patients about physician referrals and insurance referrals/consultations

• Collect authorization numbers in applicable systems

• Communicate customer satisfaction issues to appropriate individuals

• Collaborate with internal teams and resolve operational issues