Outpatient Access Lead/Expert

Responsibilities

The Expert-level Outpatient Access Specialist serves as the patient referral specialist, performing functions associated with registration, charge reconciliation process, appointment scheduling, eRecord task management, In Basket management and Telephone encounter management using the electronic medical record, patient access and revenue cycle systems.

The Expert-level Outpatient Access Specialist communicates regularly with patients, families, and staff, identifying barriers to appointment compliance, insurance company barriers and tracking all assistance provided. Makes decisions that are guided by protocols and practices requiring some interpretation; maintains an expert level understanding of the department/division. Assures patient satisfaction with information processing and reception service.

The Expert-level Outpatient Access Specialist will be responsible for monitoring own performance on assigned tasks; is self-directed. Expert at making complex decisions independently and assists staff in complex decision making and adaptation to technology and systems used.

JOB DUTIES AND RESPONSIBILITIES:

Prior Authorizations: Prepares and provides multiple, complex details and facts to insurance carrier or worker’s compensation carrier to obtain prior authorizations for both standard and complex imaging, or non-invasive procedures. Uses independent judgement to examine research and assemble necessary patient information via the scheduling system and multiple areas of the electronic medical record. Decides based on previous authorization approvals and denial experience, the relevant information to be included in the request.

Referral Coordination: Manages in-basket and referral work queue processing. Assembles from multiple tabs within the electronic medical record, the necessary details to identify what referral is needed. Determines if preliminary testing (i.e. Imaging) is needed based on office practices and procedures and is responsible for explaining to patient, assisting with scheduling and for completeness prior to office visit. Gathers documents as requested. Completes the referral request in the electronic medical record system once the patient has been seen by entering a new status as closed.

Direct Provider Support: Works one-to-one with assigned provider or multiple providers. Manages that providers schedule including template management and patient appointment scheduling. Oversees provider In- Basket to send messages and reminders for labs, etc. Address post visit items such as paperwork including form completion, letter templates and obtaining medical records, etc.

Template Management: Works with practice and clinic representatives to maintain clinic schedules, instructs appointment scheduling staff regarding schedule changes, and pro-actively reviews future schedules to identify problems. Reviews management reports and actual schedules and reports to supervisor trends affecting the schedules and recommends changes to improve patient flow.

QUALIFICATIONS:

High School Diploma and a minimum of two years of relevant experience required, or an equivalent combination of education and experience.

Medical Terminology, experiences with surgical/appointment scheduling software and electronic medical records, preferred.

How To Apply

All applicants must apply online.

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Pay Range

Pay Range: $ 17.50 - $ 22.75 Hourly

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Location: Medical Faculty Group
Full/Part Time: Full-Time
Opening: Full Time 40 hours Grade 008 Ortho Clinic Front Office
Schedule: 7 AM - 7 PM; ROT SAT