Ops Access Specialist Outpatient

JOB RESPONSIBILITIES

• The Ops Access Specialist title is used in multiple departments within Shepherd Center and performs various duties in order to ensure proper functioning as applicable to role and assigned unit.
• Patient Financial Services Summary: Responsible for accurate and timely follow up and collections of Patient Accounts as assigned. Follows through on assigned accounts until paid in full.
• Mild TBI/Concussion Clinic Outpatient Registration Pathways Summary: Performs administrative services for assigned unit to include maintaining efficient office organization; screening and handling incoming telephone calls; managing routine assignments; assisting with special events and projects; and managing patients visits.
• Calls carrier and completes follow up on all assigned claims not paid within 30 days of initial claim submission.
• Print rebills as necessary to mail or fax in effort to expedite payment.
• Works closely with the PFS supervisor to assure feedback is routed to registration and billing areas as identified.
• Notes all activity in patient notes thoroughly.
• Reviews all EOBs on insurance payments received to assure accurate payment received accurate charges processed and contractual allowances posted accurately as time allows.
• Identifies bad debt and charity accounts and forwards to PFS Supervisor for approval.
• Assures all documentation and additional information requested by attorneys physician offices insurance carriers patients and other external sources is provided in a timely manner.
• Responds to correspondence and phone messages in a timely manner.
• Keeps abreast of current billing requirements.
• Is proactive in developing solutions or improvements related to the position.
• Notifies management of any unresolved issues problems related to the position. Resolves accounts per policy and procedure
• Completes special projects and requests as assigned by management.
• Prints EOBs and Medical Records via ImpactMD as needed
• TBI/CC: Effectively handles incoming/outgoing phone calls on multiple lines. Information needs of telephone callers are met when possible. If caller cannot be helped caller is directed to correct source.
• Greets clients families and visitors in a friendly and considerate manner. Assists customers in receiving services from appropriate staff member. Assists clients in signing in/out
• Maintains appropriate office supplies. Supply room is kept clean and organized.
• Types all delegated material (graduation certificates general correspondence reports memos team reports special assignments etc. within a reasonable time frame or by specified deadline.
• Responds promptly to changes in schedule and notifies appropriate parties of changes and assists staff as requested.
• Maintains cleanliness of reception and common areas. Notifies appropriate staff for any needed clean up or repairs in these areas.
• Distributes department mail promptly and accurately. Ensure outgoing mail is sent out daily
• Reviews messages from overnight answering service daily and notifies appropriate staff of client illness/tardiness/out of center.
• Places phone on night service at end of day.
• Ensures all doors to client building and garage are locked each day prior to end of shift.
• Performs special assignments and projects as instructed by supervisor in a timely and thorough manner.
• Organizes work/time effectively and prepares for coverage of Accountabilities during scheduled time off.
• Keeps track of client cancellations compiles and types Actual Versus Scheduled Report at the end of every month.
• Completes registration process of all new admissions.
• Maintains confidentiality in all interactions.
• Outpatient: Schedule outpatient appointments with the appropriate service professional or disciplines according to established guidelines.
• Schedule appointments for new evaluation post discharges followup visits diagnostics therapy and counseling appointments.
• Confirm demographic and insurance data when patient is scheduled/registered.
• Return all phone calls regarding scheduling within 24 hours.
• Communicate with physicians and management regarding the changes in schedules addressing problem/issues effectively.
• Proactive in the overall effective management of the schedules. (e.g. maintain patient waitlist send confirmation letters etc.
• Monitor all computer software maintenance functions related to patient access.
• Collect complete referral intake information on New Patients.
• Complete all steps to schedule and prepare daily appointment packet accurately.
• Confirm update and/or make copies of insurance cards and patient identification at each visit.
• Obtain consent to treat with the signature of responsible party and ensure it is completed accurately.
• Notify clinical staff immediately after patient completes registration process
• Follow checkin and checkout process according to policy.
• Complete MSPQ as required during registration
• Notify Financial Counselors of any benefits that require precertification or referral authorization.
• Obtain complete referral information if required.
• Review and respond promptly to all intra and interdepartmental communications (i.e. staff meetings minutes attachments emails P&P etc.
• Proactively notify supervisor as appropriate regarding patient complaints when registration is backed up when tasks/expectations are not able to be met.
• Perform other duties as assigned by management.
• Accountabilities Pathways: Maintain efficient office organization taking inventory and ordering new supplies as needed.
• Greet clients families and visitors in a friendly and considerate manner; assists customers in receiving services from appropriate staff member.
• Screen and handle incoming telephone calls.
• Assist with special events and projects.
• Complete registration process of all new admissions: obtain consent forms obtain copy of client insurance card and take a picture of client.
• Keep track of client cancellations compiles and types Actual Versus Scheduled Report at the end of every month.
• Type all delegated material (graduation certificates general correspondence reports memos team reports special assignments etc..
• Distribute department mail and ensure that outgoing mail is sent out daily.

REQUIRED MINIMUM EDUCATION

• High School Diploma or equivalent

REQUIRED MINIMUM CERTIFICATION

• N/A

REQUIRED LICENSURE

• N/A

REQUIRED MINIMUM EXPERIENCE

• Minimum of two years professional experience in an outpatient setting rehabilitation center or as an external case manager.
• Knowledge of Commercial Managed Care Contracts and Governmental Insurance Plans.
• Experience in automated systems overall knowledge of business office procedures and hospital policy knowledge of thirdparty payors.
• Excellent communication and customer service skills.
• Familiar with general office equipment.

REQUIRED MINIMUM SKILLS

• Must have a working knowledge of PC spreadsheet and database software.
• Strong math aptitude required.
• Personal computer experience required.
• Expertise in the following software preferred: Outlook Word Excel Epic and medical terminology.

PREFERRED QUALIFICATIONS

• Certified Healthcare Access Associate (CHAA) certification preferred.
• Certified Patient Account Representative (CPAR) certification preferred.

PHYSICAL DEMANDS

• Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time or exerting up to 15 pounds of force occasionally or a negligible amount of force frequently to lift carry push pull or otherwise move objects including the human body.

WORKING CONDITIONS

• Some potential for exposure to blood and body fluids.