Patient Access Specialist (3623)

REPORTS TO: Director of Billing Operations

JOB SUMMARY: The Patient Access Specialist serves as the first point of contact for patients seeking care and financial assistance. This role is responsible for scheduling appointments, verifying insurance coverage, creating and updating patient records, assisting with financial assistance programs, and ensuring patients have access to care without financial barriers. Specialists also manage eligibility certifications for in-house and state programs, follow up on applications, and provide education on cost transparency and MyChart access.

PRIMARY DUTIES

• Receive incoming calls from new and established patients to schedule medical appointments.
• Determine patient status (new or established) and update or create Epic and Medicaider charts with accurate demographics.
• Add household members to family lookup and create guarantor accounts.
• Schedule Qmatic appointments for financial assistance screening.
• Verify active insurance coverage (Medicaid, Medicare, Marketplace, Tricare, commercial plans) and update patient charts.
• Educate patients on Good Faith Estimates and financial responsibility.
• Screen patients for eligibility for in-house programs (Good Health Card, Title V, Family Planning Program) and state programs (Medicaid, CHIP, Healthy Texas Women’s Program).
• Collect and review supporting documents uploaded via patient portal.
• Complete certification processes in Medicaider for all applicable programs.
• Contact patients to communicate eligibility determinations and guide them through signing required documentation.
• Follow up on state program applications and liaise with HHSC for additional information requests.
• Create and assist patients with MyChart accounts, including password resets.
• Call self-pay patients with upcoming appointments to educate them on financial assistance options.
• Maintain accurate documentation of all interactions and updates in Epic and Medicaider.
• Demonstrates a commitment to the mission, core values, and goals of Waco Family Medicine and its healthcare delivery, including the ability to deliver exceptional patient focus with quality, compassion, and respect.
• Other duties as assigned by supervisor.

PHYSICAL AND MENTAL REQUIREMENTS:

• Visual and auditory accuracy
• Shift length: 8-9 hours
• Indoor setting
• Continuous use of computer, calculator
• Long periods of sitting and walking
• Frequent use of telephone
• Continuous repetitive grasping and manipulation of both hands
• Continuous conversational communication
• Occasional reaching, standing, squatting, bending, kneeling, twisting and climbing
• Occasionally carrying, lifting, pushing, and pulling up to 25 lbs.
• Infrequent use of personal transportation (possess a valid Texas driver’s license and appropriate liability insurance)
• Occasionally working in confined, noisy, dusty areas
• Understand/carry out simple/detailed, oral/written instructions
• Memorize and retain instructions
• Read and interpret detailed specifications.

EDUCATION AND EXPERIENCE:   High school diploma or equivalent; associate degree preferred. Minimum of 1–2 years of experience in healthcare registration, billing, or patient financial services. Knowledge of Medicaid, CHIP, and other state assistance programs preferred.

SKILLS: Strong customer service and communication skills to interact effectively with patients and staff. Ability to maintain accurate patient records and verify insurance coverage. Proficiency in Epic, Medicaider, and Microsoft Office Suite, Knowledge of healthcare billing fundamentals, financial assistance programs, and organizational policies. Ability to manage multiple tasks in a fast-paced environment and prioritize work efficiently. Attention to detail and strong problem-solving skills. Commitment to providing excellent service and removing barriers to care. Ability to exercise initiative, judgment, and discretion to achieve organizational objectives. Contribute to a team environment supporting diversity, equity, inclusion, and belonging. Identify and communicate challenges in day-to-day activities.