Patient Access Specialist - Emergency Department

The Patient Access Specialist is responsible for the capture of demographic and insurance information either by telephone or patient facing. This role uses eligibility applications to verify insurance eligibility, interprets responses, and captures appropriate health insurance information as it pertains to the service being rendered. The position requires the ability to understand and apply contractual benefits, and to have a financial discussion with patients regarding payment responsibility. The role includes collecting financial responsibility from patients based on eligibility responses or estimates for services.

Qualifications

• HS Diploma, Associates Preferred
• CHAA (or acquired within 2 years of hire)
• Strong computer skills
• 3 – 5 years experience
• Hospital or Physician office experience preferred
• Strong insurance knowledge regarding payer contract interpretation including Authorization Requirements and Setting of Care
• Proven customer service skill with ability to exceed expectations
• Ability to multi-task in stressful and high patient volume unit; manage pressure of tight timeframes to complete tasks
• Ability to learn in classroom setting; utilizing resources
• Ability to remain composed under pressure
• Ability to review information and draw appropriate conclusions
• Good judgment and resourcefulness to problem solve; escalate issues as needed
• Team-minded work ethic
• Demonstrated ability to interpret patient insurance benefits and apply applicable contractual obligations
• Critical thinking regarding issues with financially securing payment
• Ability to discuss sensitive concepts with patients regarding financial obligations

Essential Duties & Responsibilities

• Contributes to the creation of a compassionate and caring environment for patients, families and colleagues through displays of kindness and active listening.
• Recognizes and appreciates that each employee’s work is valuable and contributes to the success of the Mission.
• Demonstrates excellence in daily work.
• Actively participates in performance and quality improvement activities and works toward enhancing customer/patient satisfaction.
• Exhibits positive service excellence skills to patients, visitors and coworkers by greeting others in a friendly manner, keeping customers/patients/colleagues informed about progress, delays and changes.
• Demonstrates effective teamwork by interacting in a positive manner with colleagues and creating a collaborative work environment.
• Initiates open communication, conveys positive intent, offers to assist.
• Contributes to a safe and secure environment for patients, visitors, colleagues by following established procedures and protocols, addressing the needs of a diverse patient population and workforce.
• Demonstrates stewardship by thoughtful and responsible use of resources including maintaining a clean and hospitable environment, starting work on time, displaying cost consciousness, and managing supplies and department finances.
• Demonstrates respect for individual differences by acknowledging and responding to unique, spiritual, personal and cultural backgrounds of patients, families and colleagues.

This role may require access to information considered sensitive, including HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a “need to know” basis and is the minimum necessary to perform duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.