Patient Access Representative II - Roslindale

POSITION SUMMARY:

Under the direction of the Department Manager/Team Coordinator, the incumbent is responsible for all the functions and activities related to patient access, including, but not limited to: front end customer service, patient registration, insurance verification, appointment scheduling, call management, mail, medical records, managed care authorizations, referral management and a variety of administrative duties in support of the department (such as forms management, faxing, preparing letters, reports, photocopying, billing support).

Position: Patient Access Representative II

Department: Roslindale        

Schedule: Part Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

Performs a wide variety of administrative duties to ensure proper functioning of the department and excellent patient experience:

• Reception and customer service
• Registration – including insurance and demographics
• Appointment scheduling – including new patient appointments, follow-up, social services, specialty services, procedures, lab visits
• Obtains written consent, ABN and other authorizations from patient as required per compliance/regulatory
• Insurance verification
• Co-payment collection
• Front-end review and correction of registration and insurance as needed
• Visit management
• Prior authorization
• Referral coordination
• Mass Health enrollment support

Participates in Call Center rotation as directed.

• Receives and responds to patient calls
• Performs registration
• Schedules appointments
• Provides information as appropriate
• Routes call to appropriate resource (pharmacy, nursing, billing, etc.)
• Makes outgoing calls to patients as directed by clinical team

Processes referral requests per department protocol (urgent and routine) and obtains prior authorizations as needed. Performs referral reconciliation as directed.

Manages patient forms requests, collaborating with providers and care team members (community health worker, social worker, nurse)

Manages medical record requests from patients and outside organizations.  Scans external medical record documents into EHR per protocol.

Adheres to all of BMC’s RESPECT behavioral standards

Ensures excellent patient experience through customer service best practices

Supports department in achieving organizational goals

Participates in cultural competency training including diversity, equity and inclusion topics

Other duties

• Adapts to changes in the departmental needs including but not limited to: offering assistance to other team members, adjusting assignments, etc.
• Follows established infection control and safety procedures.
• Perform other duties as needed.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job.  The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

Bachelor’s degree or

Associates degree plus one year relevant experience or

HS/GED plus three years relevant experience

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

None

EXPERIENCE:

See notes under educational requirements.  Experience in healthcare setting preferred.

KNOWLEDGE AND SKILLS:

• Strong communication skills
• Demonstrated customer service skills, including the ability to use appropriate judgment, independent thinking and creativity when resolving customer issues.
• Must be able to maintain strict confidentiality of all personal/health sensitive information.
• Ability to effectively handle challenging situations and to balance multiple priorities.
• Strong computer skills and knowledge of Microsoft Office applications (MS Word, Excel, Access, PowerPoint) and web/internet is required. Experience with electronic health record, registration & billing systems or ability to learn such systems is also required.

Equal Opportunity Employer/Disabled/Veterans