What are the responsibilities and job description for the Patient Access Call Center Specialist - ARC position at jpshealthnet?
Job Summary: The Patient Access Call Center Specialist - ARC is responsible for inbound/outbound calls of appointment scheduling, specified elements of pre-registration, registration, and referrals management to ensure patient care is expedited and reimbursement is maximized for multiple clinic sites and the Access Resource Center, and payment collections where appropriate.
Essential Job Functions & Accountabilities:
- Delivers a high-quality patient experience through inbound and outbound call resolution within established protocols.
- Appropriately mitigates issues and assists patients with needs and /or questions in a timely manner using Acknowledge, Introduce, Duration, Explanation and Thank You (AIDET) principles.
- Interviews and updates the patient’s demographics, and insurance, by phone in a respectful, professional, accurate and efficient manner, obtaining all necessary demographic, financial and clinical information required to facilitate timely scheduling and registration; collects payments where appropriate and performs elements of pre-registration.
- Coordinates and schedules appointments, selects appropriate referral, provider, visit type and location to expedite patient access to care, to minimize “no shows” and maximize reimbursement.
- Accurately identifies patient and registers JPS patients while maintaining regulatory and functional knowledge of all information required to register patient types in database ensuring timely and accurate reporting/billing.
- Provides awareness as needed related to notice of privacy practices, patient rights and responsibilities, MyChart enrollment, etc.
- Collects patient owed cost sharing amounts (copays, deductibles, coinsurance, full costs [non-covered/self-pay]) in accordance with ARC Standard Operating Procedures. Reconciles case drawer at end of shift.
- Utilizes critical thinking skills to determine if escalation is required to resolve individual patient situations and help identify trends requiring management intervention. Takes ownership and accountability to ensure issues presented on the call are handled effectively.
- Maintains, coordinates and provides high level scheduling support for the Network utilizing the template format designed for each service area/physician and ensures referrals, pre-authorizations, pre-certifications have been accurately obtained as required by the patient’s payer.
- Coordinates diagnostic and ancillary scheduling; schedules appointments, selecting appropriate referral, provider, visit type and location to expedite patient access to care.
- Performs, organizes, and streamlines operational tasks to reduce the potential for errors.
- Assists Out of Network patients with financial questions and escalates to the appropriate party.
- Provides information regarding services and provides additional assistance as needed.
- Identifies existing Medical Record Number (MRN) or creates new MRN, taking care to avoid duplicates and overlays in accordance with National Patient Safety Goals.
- Maintains productivity levels, with minimal errors, as established by department and Network standards.
- Provides the highest level of care to our patients by complying with JPS Health Network’s attendance and punctuality procedure. May be required to work beyond normal scheduled shifts.
- Attends all mandatory educational, compliance and safety program sessions.
- Assists in staff training of peers, colleagues and management as applicable or requested.
- Job description is not an all-inclusive list of duties and may be subject to change with or without notice. Staff are expected to perform other duties as assigned.