Patient Access Specialist

UPMC Mercy is hiring a Patient Access Specialist to support the Pain Center!

This position works Monday-Friday from 7:30am-4pm with no weekends or holidays.

Preferred candidates will have previous admin experience, plus experience with scheduling appointments, checking patients in, and prior authorizations.

Purpose:

Typically, function under the direction of the Supervisor/Manager responsible for patient access. Schedule appointments for a similar group or specialty of physicians generally at one location or multiple session timeshares. Serve as front line resource for PSD Departments to coordinate access of external public to our care providers and ensure goal of 72 hours patient access are met.

Responsibilities:

• Review, verify and enter the patient's demographic information to ensure data integrity.
• Schedule appointments according to the physician templates for similar types of physicians, generally at one office or multiple session timeshares (single specialty phone room or front desk environment).
• Schedule appointments according to the templates/departmental scripts while meeting business unit scheduling accuracy requirements.
• Obtain chief complaints in order to schedule appropriately.
• Take incoming calls demonstrating the essential skills documented in the Telephone Courtesy Standards.
• Understand UPMC 72-hour appointment requirement and work to ensure guidelines are met.
• Appropriately distribute/triage phone calls to other areas and/or clinical providers (billing, nurse, operations lead, etc.).
• Treat all patients with respect and demonstrates the behaviors learned in the Patient Ambassador Program.
• Routinely attend department meetings and on-going in-service and training programs, to present and exchange pertinent information.
• Work the overflow call list and Audiocare report.
• Review and verify the patient's insurance information.
• Coordinate access to care for patients within own department or location.
• Monitor patient wait list report.
• Compile and send new patient packets or flags patient if needs to be completed upon arrival.
• Knowledgeable about various reasons for patient calls such as prescription refills, how to triage clinical issues, participating insurances, questions about physicians, etc.
• Take responsibility to escalate to appropriate clinical or supervisory personnel when needed, including thorough and accurate documentation of telephone encounter for messaging.
• Function at multiple sites as requested by supervisor.
• Answer multi-line telephone system. The number of calls taken must be within 90% of the daily average calls per day per agent.
• Give basic information to patients (directions, parking information, and required preparation for appointment).

• One of the following:
• Completion of HS Diploma/equivalent and 1 year of experience in a medical office, customer service, inbound call center (preferred), or other relevant health care setting will be considered.
• Associates degree and 6 months of experience in a medical office, customer service, inbound call center (preferred), or other relevant health care setting preferred
• Must have experience with personal computer based applications, including email and experience with other various office equipment.
• Must be able to multitask at a high level.
• Able to interact with a variety of external and internal constituents, including patients, patients' families, internal physicians, referring physicians or their clinical/office staff, insurance companies, nurses.
• Experience with/knowledge of medical terminology and multi-line telephone systems is preferred.
• Electronic scheduling system experience is preferred.
• Must be able to learn and apply third party payer guidelines and reimbursement practices.
• Basic knowledge of health insurance preferred.
• Must be able to maintain confidential information.
• Must have strong interpersonal, organizational, and communication skills and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances.
  
  

Licensure, Certifications, and Clearances:

• Act 34
  
  

UPMC is an Equal Opportunity Employer/Disability/Veteran