Full time The Access Specialist III supports the Otolaryngology Department as a liaison between the provider and the patient to ensure patients’ access needs are met timely. This is a versatile position that supports provider activity at Nemours Children’s Hospital, Delaware, and our partner hospitals/locations by processing scheduling requests from patient families or Nemours providers to ensure quality standards are met.
The Access Center Specialist III schedules specialty appointments and is responsible for obtaining and entering accurate demographic insurance information for all encounters. The role performs registration and insurance verification activities in accordance with established hospital and departmental policies and procedures and ensures timely creation of a patient encounter. The Access Specialist III is required to discuss financial obligations with patient families and collect when appropriate.
The Access Specialist III is required to provide superior customer service to both internal and external customers and represent Nemours in a positive, professional manner. They are responsible for demonstrating a commitment to service, organization values, and professionalism through appropriate conduct and demeanor at all times.
Make outbound calls to families to schedule patient/provider requested appointments and follow up needed. Promptly answers incoming calls from patients/providers to schedule appointments for patients as needed. Process patient/provider consult requests received via email, EPIC in basket messages, or through the Nemours app.
Provide a smooth transition for all internal and external customers by utilizing excellent customer service skills and effective communication. Ensures efficient processing and documentation of all information required for insurance verification, registration, and billing in the Electronic Medical Record (EMR) system. Schedule patient appointment according to established division guidelines and communicate updates and barriers in a timely manner.
Ensure urgent diagnosis and appointments are handled with priority and escalation processes are utilized when necessary. Verify insurance eligibility and authorizations utilizing the available resource tools. Monitors registration and insurance related items that fall into patient work queues to ensure timely claim filing.
Utilize the Managed Care Manual to verify participating insurances and their requirements. When applicable, inform the caller of their financial responsibility that is due at the time of service/offer to collect in advance at the time of scheduling, and ensure accurate daily cash reconciliation. Adhere to the authorization process by informing the caller that an authorization is needed (if applicable) at the time the appointment is made.
Refer patients to the Financial Advocates if financial assistance is needed. Educate the callers on the preparation for the appointment or requirements needed to ensure a productive visit. Accurately notate the patient’s accounts to communicate pertinent information to clinic, registration, authorization, family financial, and billing departments.
Review work queues and reports on a daily basis, make corrections and/or escalate to leadership if necessary. Respond to and complete staff message. Provide support for Cancelled Clinic requests.
Review and take the necessary action to ensure patient scheduled appointments are accurate. Always offer specific directions to the clinic and location that they will be seen. Job
High School diploma 3-5 years of job related experience required. Minimum three years of scheduling or administrative assistant experience is required.