Full-Time Patient Access Specialist

Patient Access Specialist reflects the mission, vision, and values of NMHC, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

Responsibilities:

• Practices Patients First philosophy and adheres to high standards of customer service, fostering a team atmosphere.
• Responds to questions and concerns, forwarding, directing, and notifying the Team Lead/Operations Coordinator of extraordinary issues.
• Maintains patient confidentiality per HIPAA regulations.
• Provides exceptional customer service to patients, establishing a positive first impression of Northwestern Medicine.
• Exceeds consumer requests and alerts management of issues needing escalation.
• Correctly identifies and collects patient demographic information according to organization standards.
• Interacts with hospital departments and physicians' offices to schedule and direct patients through NMHC systems.
• Reaches out to patients to schedule appointments.
• Performs medical necessity checks and communicates options if appointments fail.
• Informs patients of any issues with securing financial accounts.
• Completes out-of-pocket estimations.
• Provides training and education as needed.
• Manages work schedule efficiently, completing tasks on time.
• Completes other duties as assigned.
• Cross-trains in various departments.
• Participates in Quality Assurance reviews to maintain patient data integrity.
• Uses service recovery skills to solve problems.
• Utilizes department and hospital policies and procedures.
• Adheres to department policies and compliance requirements.
• Avoids putting patients at financial or safety risk.

Communication and Collaboration:

• Communicates information regarding physician referrals, insurance referrals, and consultations.
• Collects authorization numbers in appropriate systems.
• Provides a professional and constructive communication environment across units/departments, resolving operational issues.
• May attend intra/interdepartmental meetings.
• Communicates customer satisfaction issues to appropriate individuals.
• Demonstrates teamwork by helping coworkers.
• Communicates effectively, respects diverse opinions, and acknowledges others' contributions.
• Provides excellent support service to staff in departments providing direct patient care.
• Accommodates all levels of communication ability.

Technology:

• Utilizes online order retrieval systems to verify or print orders.
• Verifies insurance eligibility and benefit levels.
• Completes accurate handoff instructions and notes in Epic.
• Demonstrates proficiency in computer applications.
• Runs real-time eligibility (RTE) to verify insurance and follows out-of-network policies.
• Sends quality Epic Messages/Telephone encounters.

Efficiency, Process Improvement, and Business Growth:

• Proactively prevents patient visit issues.
• Understands the minimum data set for complete registration and updates registration information.
• Understands departmental and individual quality metrics.
• Proactively analyzes account activity, identifies problems, and initiates resolutions.
• Evaluates procedures and suggests improvements.
• Participates in departmental quality improvement activities.
• Provides process improvement ideas.
• Monitors registration and scheduling, including insurance verification to meet quality standards.
• Adjusts processes as needed to meet standards.
• Uses organizational and unit resources efficiently.
• Acts as a training resource for new staff and coworkers, sharing process and workflow information.
• Understands that schedules may change to reflect shifting business needs.
• Evolves and learns as healthcare policies change.

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