Patient Access Specialist Resume Samples
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Patient Access Specialist Resume Samples
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CN
C Nicolas
Claud
Nicolas
9420 Aurelia Divide
Detroit
MI
+1 (555) 408 5614
9420 Aurelia Divide
Detroit
MI
Phone
p
+1 (555) 408 5614
Experience
Experience
Dallas, TX
Patient Access Specialist
Dallas, TX
Dooley-Lubowitz
Dallas, TX
Patient Access Specialist
- Establish functional and productive working relations with third-party payor agencies such as Managed Care Office and outside insurance companies
- Perform special assignments when requested by management
- Verify eligibility and benefit information for payers and work assigned work queues
- Work assigned work queues
- May be expected to perform clerical and secretarial work
- Maintains current working knowledge; adheres to Revenue Cycle policies and procedures; performs problem- solving activities
- // Perform special assignments when requested by management
New York, NY
Patient Access Specialist Per Diem
New York, NY
Beatty, Green and Leffler
New York, NY
Patient Access Specialist Per Diem
- Other duties related duties incidential to the work described herein
- Provide exceptional customer service to all patients, visitors, and customers
- Prioritize patient flow
- Triage phone calls and schedule appointments
- Respond to patient, visitor, and customer inquiries
- Verify insurance and obtain benefits
- Displays positive attitudes towards assignments and others
present
Houston, TX
Senior Patient Access Specialist
Houston, TX
Klocko Inc
present
Houston, TX
Senior Patient Access Specialist
present
- Answers the Patient Access Services telephone lines for department, prioritizes, screens, and redirects calls. Answers questions, handles routine matters and takes messages
- Schedules all appointments for patients on the computerized scheduling system and works with the manager and supervisor to meet these goals
- Completes multiple types of outpatient registrations in a professional, accurate, customer-oriented and timely manner
- Works with individual physician offices and their office managers/supervisors to obtain correct information for scheduling appointments
- Obtains information about patient’s health insurance electronically through the payer websites, and/or by information provided by the patient from the insurance issued identification card
- Secures payment for services, contracts for payment, as well as refers patients for financial counseling or collections of account balances
- Calculates patient liabilities and works with patients to set-up payment plans or secure other means of payment prior to scheduling. Assists patients and their families with billing and payment plans, and pre-payment service collections in order to increase cash flow
Education
Education
Bachelor’s Degree in Accuracy
Bachelor’s Degree in Accuracy
Loyola Marymount University
Bachelor’s Degree in Accuracy
Skills
Skills
- Good organizational and multi-tasking skills
- Strong Analytical Skills
- Ability to collaborate and work within a team environment
- // Good organizational and multi-tasking skills
- // Strong Analytical Skills
- // Ability to collaborate and work within a team environment
- 11 Ability to ask patient or responsible party for payment at time of service and maintain a cash drawer
- 10 Ability to operate routine office equipment (facsimile, copiers, plate production, scanners, printers)
- 8 Ability to work independently, exercising good judgment, and multi-task in a high stress, fast paced service environment with patients, patient’s family and physician’s
- Familiar with data entry systems and Microsoft Office Outlook, Word and Excel programs. This position provides research and metric reporting to department leadership as appropriate to role and skills. Able to enter data accurately from patient interview or other source into host system. Able to use phone, fax, copier and scanning equipment
15 Patient Access Specialist resume templates
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1
Patient Access Specialist Resume Examples & Samples
- Data Entry of applications for approval, denial or rejection
- Validate licensed practitioners
- Calculate scripts when applicable
- Troubleshoot order issues
- Determine case status
- Open and date stamp mail when applicable
- Meet department customer service, call and data entry standards
- Perform clerical duties: filing, faxing, shredding, folding letters, etc
- Perform special assignments when requested by management Education Required
- Ability to handle high volume calls
- General computer knowledge with experience in high-volume data entry Preferred
- Associates Degree, Pharmacy Technician certification, Registered Nurse, Clinical Experience or Bachelor’s Degree
- Bi-Lingual (Spanish) speaking
- Good organizational and multi-tasking skills
- Strong Analytical Skills
- Ability to collaborate and work within a team environment
2
Patient Access Specialist Project Based Resume Examples & Samples
- // Data Entry of applications for approval, denial or rejection
- // Troubleshoot order issues
- // Open and date stamp mail when applicable
- // Meet department customer service, call and data entry standards
- // Perform clerical duties: filing, faxing, shredding, folding letters, etc
- Strong Customer Service Experience
- // General computer knowledge with experience in high-volume data entry
- // Good organizational and multi-tasking skills
- // Strong Analytical Skills
3
Patient Access Specialist Resume Examples & Samples
- Handle patient access calls
- Perform special assignments when requested by management
- General computer knowledge with experience in high-volume data entry
4
Patient Access Specialist Resume Examples & Samples
- // Handle patient access calls
- // Validate licensed practitioners
- // Calculate scripts when applicable
- // Determine case status
- // Perform special assignments when requested by management
- // Ability to collaborate and work within a team environment
5
Lead Patient Access Specialist Resume Examples & Samples
- Education: Completion of High School/GED
- 1-2 years' experience in Patient Access and/or Patient Accounting
- One year of experience related to healthcare insurance eligibility, insurance verification or insurance billing is preferred
- Ability to multi-task in a fast paced environment
- Proficient computing/keyboarding skills
- Proficient in Microsoft Office products
- Demonstrates teamwork, initiative and willingness to learn
- Demonstrates proficiency in copay and prior balance collections and batch reconciliation
- Exposure to staff scheduling and performance evaluations
6
Patient Access Specialist Resume Examples & Samples
- Education: High-School Diploma or equivalent
- Experience: 2-3 years related experience in patient access, registration, patient accounting, or revenue cycle or equivalent educational course work
- Skills & Abilities: Excellent oral, written and interpersonal communication skills, knowledge of ICD-9 and CPT coding, medical terminology, and/or revenue cycle knowledge. Ability to effectively manage multiple tasks. Knowledge and experience with a variety information systems, experience with spreadsheet and word processing software, and keyboard proficiency
- Wage rates for this position are governed by a collective bargaining agreement. Wage rates are available in the collective bargaining agreement and in the Human Resources Department
7
Patient Access Specialist Resume Examples & Samples
- 1-2 years of prior physician office or hospital registration or billing experience preferred
- Knowledge of insurance coverage and referral, authorization policies preferred
- Knowledge of physician or hospital registration or billing systems preferred
- GE Centricity systems experience preferred
- Strong understanding of Microsoft Office product suite
- Excellent customer service and communication skills, both written and verbal
- Must be able to effectively multi-task, and have advanced technical skills, as appropriate
8
Patient Access Specialist Resume Examples & Samples
- Pre-Registers new patients by making/receiving patient calls; Collects and accurately documents patient demographic, financial, and other relevant personal information into the hospital information system
- Verifies insurance eligibility and benefits using automated eligibility systems, payer websites and or calls the insurance carriers during pre-registration; Works eligibility exception reports to identify invalid insurance for patients and/or escalates patients as needed for Financial Counselor intervention
- Conducts registration interview with new patients prior to their initial visit; Confirms, updates patient demographic, financial, and other relevant personal information into the hospital information system. Ensures Privacy Policy Acknowledgement and consent forms; General and PCMP are signed; Verifies patient identification; Copies insurance cards; Confirms financial clearance; Escalates patients as required to Financial Counselors
- Accurately explains how and why the patients should complete the Healthcare Proxy form; Makes a copy the form for HIM
- Supports Institute initiates such as patient itinerary, RTLS badging, PCMP consenting, requests for copy of medical record
- Updates changes to patient insurance and/or demographic information as needed
- Manages referral and authorizations information as assigned through daily work queues and documents activities into the hospital information system; may require contacting physician offices and/or payors for referrals and authorizations via phone calls and/or websites
- Communicates regularly with physicians and other medical providers regarding clinical clarifications for referrals and authorizations, medical necessity requirements, and facilitating conversations with different payers
- Documents daily activities in a timely, thorough, and accurate manner into the hospital information system
- Completes assigned work queues, projects, and other duties as directed
- 1-2 years of prior physician office or hospital registration or billing experience required
- Knowledge of physician or hospital registration or billing systems preferred; GE Centricity systems experience preferred
9
Patient Access Specialist Resume Examples & Samples
- Appointing: Review medical chart to appoint according to scripts and guidelines
- Schedule/reschedule/cancel appointments for services, according to scripts and guidelines
- Places calls for appointment reminders and quality measure outreach
- Collect care specific information for Primary Care or Specialty Care services
- Messaging: Review medical chart to collect information for messages to send to health care team
- Routes incoming calls from patients, physicians, nurses and other departments according to scripts and guidelines
- Answers routine administrative inquires
- Forwards medical and other complex inquires to appropriate personnel
- Take messages as necessary
- Manage electronic in-basket in multiple system applications
- General Services: Assist patients by providing phone numbers, facility directions and office layouts; directing to other departments and administrative services for further information, for example (but not limited to) Membership Services, Dental and Pharmacy
- Handle ingoing and outgoing departmental mail and correspondence with patients
- Other related duties as developed per department need
- Registration: Verify insurance eligibility and/or update all demographic information per regional policies, including Personal Provider Selection, Language Preference and Special Needs
- Request and/or obtain a patient medical record number when necessary
- Verify health insurance coverage and follow appropriate policy/procedure
- Explain co-pays, cost shares and any other applicable fees
- Create Guarantor accounts as necessary before and after Membership Service Department hours
- Complete Scheduling form with above data and transfer to the Registration for completion of the pre-registration and pre-verification functions
- Refers to the financial counselor as appropriate
- Collect past due balances as appropriate
- Practice Organization: Coordinate referrals process including wait lists per department policies and procedures
- Track referrals to specialty care by utilizing the consultation/referral system as needed in those areas where this responsibility currently exists for the individual in this classification
- Request copies of films, CD's, test reports, and results from outside facilities
- Coordinate schedules per department guidelines to maximize access
- Collect and organize data per department guidelines
- For example, researching and collating data from Health Connect, online quality and performance reports, MOV data, and other sources, on an ongoing basis
- Develop and submit ongoing reports as requested including statistics, charts, and graphs using multiple computer programs and business math skills
- Update departmental policies and forms
- One (1) year of call center experience OR two (2) years of customer service experience using multiple telephone lines
- Two (2) years of experience keyboarding/typing and navigating multiple computer applications in a Windows environment including data input
- Final candidates will need to complete Contact Center Simulation assessment with minimum competency score of fiftieth (50th) percentile or higher
- Final candidates will complete approved medical terminology course within six months of date of hire
- Excellent organizational skills, flexibility and ability to switch tasks frequently
- Strong complex problem solving skills and the ability to make decisions independently
- Five (5) years of call center experience OR five (5) years of customer service experience using multiple telephone lines preferred
- Experience or education in the Health Care field preferred
- Two (2) years post-high school education preferred
10
Patient Access Specialist Resume Examples & Samples
- Registers patients and processes related paperwork
- Interviewing patients, collections of patient portions, preparing standard registration forms, and performing other admission or transfer related tasks
- May be expected to perform clerical and secretarial work
- Minimum of a High School Diploma or equivalent required
- Minimum 1-2 years of patient registration experience in a hospital/healthcare setting
- Experience with HMS/Medhost systems preferred
11
Patient Access Specialist Resume Examples & Samples
- Use professional phone skills to contact insurance companies
- Identify Prior Authorization requirements and/or coverage limitations; submit for authorizations
- Communicate effectively and efficiently with insurance representatives, providers and clinic staff
12
SSC Patient Access Specialist Resume Examples & Samples
- Creation and maintenance of payor plans for all facilities that are part of the Franklin Shared Services Center working with other departments as needed
- Assist Regional Director(s) with monitoring Patient Access related reports identifying trends
- Review unbilled reports, identify trends, escalate to RPAD(s)
- Act as a resource to other SSC departments for Patient Access processes
- Researching accounts in HMS, SSI, Passport and other front end systems to identify issues or trends
- Ability to work in a fast paced environment that requires flexibility
- Strong knowledge of Patient Access functions and Front End billing processes
- 1+ years of payor plans, billing experience and working unbilled reports in Medhost/HMS
- 2+ years Patient Registration or Acute Care Billing experience
- 1+ years experience with Medicare, Medicaid and Commercial insurance plans
- 1+ years working with financial classes as they relate to specific insurance products
- Ability to work under limited supervision and adhere to deadlines
- Ability to type 30-35 wpm
- Strong knowledge of Medhost/HMS systems is required
- Strong knowledge of MS Office products
- Previous Patient Access and/or Hospital Billing experience
13
Patient Access Specialist Resume Examples & Samples
- Demonstrates full knowledge of front desk and registration operations, obtains complete demographic and financial information or equivalent from patient
- Attend training programs and meetings as required
- Enters complete insurance information into the computer including network payor, mailing address, telephone number, policy, policyholder, and group number
- Recognize patient’s level of care needed upon arrival
- Identifies insurance plans and requirements and obtains authorizations and referrals as needed
- Demonstrates proper body mechanics in all functions
14
Patient Access Specialist Resume Examples & Samples
- Ensures that all necessary demographic, billing, and clinical information is obtained and entered in the registration system with timeliness and accuracy
- Communicates with scheduling physician's office, nursing unit staff, and/or other appropriate personnel regarding authorization and to exchange necessary information
- Verifies insurance benefits, medical necessity, and obtains precertification/authorization as necessary. Determines and accepts required payments, including co-pays and deductibles, or refers to financial counselors for follow up
15
Patient Access Specialist Resume Examples & Samples
- Familiar with data entry systems and Microsoft Office Outlook, Word and Excel programs. This position provides research and metric reporting to department leadership as appropriate to role and skills. Able to enter data accurately from patient interview or other source into host system. Able to use phone, fax, copier and scanning equipment
- Communicates effectively under stressful and time constrained circumstances. Provides information to patients and others in a positive and professional manner. Speaks clearly with good diction and choice of words. Written communication is clear, professional and factual. Provides warm transfer of phone calls
- Consistently communicates in a timely manner
- Works closely with department leadership to provide consistent and timely messaging to staff
- Maintains patient confidentiality at all times in accordance with HIPAA regulations and standard operating practices to protect patient privacy. Maintains confidentiality of staff performance and
- Determines upfront payment or deposit based on the patient’s third party coverage and requests following department scripting for POS collections. Logs payment, produces receipt and prepares deposit records according to cash handling policy and procedure
- Associate degree or higher preferred, May substitute High School diploma or equivalent with CPAR, CHAR, or CHAM certification
- Minimum 2 years’ experience in Patient Access Department and the following criteria: meets expectations or higher on most recent performance evaluation, no active performance improvement plan or disciplinary action in most recent 6 month period
- Minimum of 3+ years’ experience in a lead role in Patient Access, HIM or billing department in a hospital or medical office setting
- Performs clerical functions as needed, including answering phones, taking messages, chart processing, filing, faxing, etc
- Assists performance issues, patient safety issues, policy violations and poor staff performance issues
- Performance measures include registration accuracy, cash collections, productivity, staff and customer service survey feedback
16
Patient Access Specialist Resume Examples & Samples
- Manage day to day activities of health care provider support requests and deliverables across multiple communication channels i.e. Phone, Fax, Chat, eMail, etc
- Perform intake of cases and capture all relevant information in the Access 360 Case Management system
- Ensure all support requested is captured within the Case Management system
- Ensure timely processing and resolution of cases
- Escalate cases appropriately to the Patient Access Associate team
- Coordinate all appropriate aspects of patient case management through to completion, using effective interpersonal skills to manage interactions
- Serve as a resource for Health Care Providers and patients and use regional reimbursement, distribution and payer policy expertise to provide solutions for complex patient access situations, working closely with the PAA team to appropriately escalate/resolve issues
- Communicate effectively with payers, third party administrators and other departments
- Perform in-depth research into patient’s insurance, prior authorization and appeal requests on behalf of the provider
- Educate offices on Access 360 programs and referral process to ensure timely case processing
17
Patient Access Specialist Resume Examples & Samples
- Check in or interview patient
- Complete appropriate signatures, affix armband
- Direct patient to their appt/procedure
- Call for escort if necessary
- Ensure the assigned WQ is worked appropriately
- Complete productivity tracking per department policy
- Follow department procedures for account documentation
- Complete eligibility query using electronic resources or phone as time allows and interpret results
- Obtain signatures from patients who require a waiver
- Collect co-pay or deductibles
- Respond to basic questions regarding financial assistance programs available
- Refer to Intermediate or Senior level as appropriate
- Mentor new staff
18
Patient Access Specialist Days Thurs Resume Examples & Samples
- Certified Healthcare Access Associate (CHAA) credentials by the National Association of Healthcare Access Management (NAHAM) and/or Certified Patient Account Technician (CPAT) credentials by the American Association of Healthcare Administrative Management (AAHAM) preferred
- Ensures patient safety by authenticating patient identity throughout all essential functions
- Assures all financial clearance activities have been completed and patient financial responsibilities are met. Completes the financial clearance activities prior to service on non-complex cases and refers patient to financial counseling or financial clearance as necessary for complex cases
19
Patient Access Specialist Resume Examples & Samples
- Associates degree in healthcare or business field preferred
- Must be able to work Monday thru Friday 9:30AM to 6:00PM
- Requires at least one year experience in customer service and general clerical/office procedures
- Knowledge of Medical Terminology a plus!
20
Senior Patient Access Specialist Resume Examples & Samples
- Schedules all appointments for patients on the computerized scheduling system and works with the manager and supervisor to meet these goals
- Completes multiple types of outpatient registrations in a professional, accurate, customer-oriented and timely manner
- Secures payment for services, contracts for payment, as well as refers patients for financial counseling or collections of account balances
- Calculates patient liabilities and works with patients to set-up payment plans or secure other means of payment prior to scheduling. Assists patients and their families with billing and payment plans, and pre-payment service collections in order to increase cash flow
- Schedules patients across all ambulatory clinics and HCMC departments
- Handles video relay for deaf and hard-of-hearing patients
- Performs MyChart functionality
- Performs live chat with patients over the internet
- Assists Telehealth Nurses with coordinating care
- Responds to and handles all professional calls (MD’s, Pharmacists, Nursing Homes, etc) internally and externally
- Two years data look-up/data entry experience
- Two years experience in customer service involving complex analytical problem-solving skills
- Two years experience in a call center with emphasis in a customer service/medical industry
- Knowledge of medical terminology and medical scheduling
- Knowledge of medical insurance theory
- Ability to organize work under pressure
- Ability to work in a fast-paced, continually changing environment
21
Patient Access Specialist PRN Resume Examples & Samples
- Associate’s degree or 2 years of experience in lieu of degree preferred. Data entry skills required (45-60 keystrokes per minutes)
- Working knowledge of medical terminology desirable. Basic computer skills are required
- Must be comfortable operating in a collaborative, shared leadership environment
- Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior
- Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of check-in. In the collection of funds, documents payments/actions in the patient accounting system and provides the patient with a payment receipt
- Obtains signed physician orders for all tests and procedures from physicians/offices
22
Patient Access Specialist Resume Examples & Samples
- Answer and troubleshoot questions from reps
- Review PAW update requests and update pages as indicated
- 1 year of experience in Patient Access Representative role
23
Patient Access Specialist Resume Examples & Samples
- Responds to calls including patients, physicians, physicians’ office staff, peers, and determines the urgency of the situation and then suggests appropriate referrals
- Answers the Patient Access Services telephone lines for department, prioritizes, screens, and redirects calls. Answers questions, handles routine matters and takes messages
- Confirms patient appointments and gives appropriate instructions by telephone or by mailing each patient a letter providing information about the test(s) and any necessary preparation, if scheduled appointment is more than three (3) days out
- Maintains forms in all printers at all times, which may require lifting or carrying cases of forms
- Works with individual physician offices and their office managers/supervisors to obtain correct information for scheduling appointments
- Obtains information about patient’s health insurance electronically through the payer websites, and/or by information provided by the patient from the insurance issued identification card
- Secures payment for services, contracts for payment, as well as refer patients for financial counseling or collections of account balances
- Calculates patient liabilities and works with patients to set-up payment plans or secures other means of payment prior to scheduling
- Assist patients and their families with billing and payment plans, and pre-payment service collections in order to increase cash flow
- Utilizes Search America and US Bank Navigation databases for eligibility verification, pre-authorizations, quotes for services and to review/update accounts
- Collects co-payments and/or pre-payments from patients at time of appointment scheduling
- Performs other duties as assigned, but only after appropriate training
- One year data look-up/data entry experience
- One year experience in a call center with emphasis in a customer service/medical industry
- Knowledge of medical terminology and medical scheduling is preferred
- One year of post-secondary education
- Ability to type
- Time management and sound decision-making skills
- Basic knowledge of medical insurance theory
- Knowledge of all software and hardware computerized equipment used by the Patient Access Services Department
24
Patient Access Specialist Resume Examples & Samples
- High School Diploma or G.E.D
- An approved Medical Terminology certification or med term course completion with satisfactory scores
- Two years experience as a PAS 1 or equivalent with scheduling and/or registration and/or insurance verification in a healthcare setting
25
Patient Access Specialist Resume Examples & Samples
- High School diploma or equivalent required. ·
- Ability to type, spell, write or print legibly with general knowledge of personal computers required. ·
- Strong interpersonal communication, documentation and customer service skills required. ·
- 1-2 years of Hospital admissions
- Or physicians office experience required or 1-2 years professional work experience required
- Medical terminology preferred. ·
- Knowledge of health care insurance and managed care preferred. ·
- CPR- obtained within 30 days of hire
26
Patient Access Specialist Resume Examples & Samples
- 1-2 years of Hospital admissions or physicians office experience required
- Knowledge of health care insurance and managed care preferred
- CPR- required within 30 days of hire
27
Patient Access Specialist Lawrenceville & Duluth Resume Examples & Samples
- High School diploma or GED equivalent required
- Must have experience using keyboards with high degree of accuracy (minimum 25 WPM w/ 97% accuracy)
- Must have a sense of responsibility, professionalism, empathy, and a commitment to customer service
- Must have the ability to communicate effectively. Must have an aptitude for numeric and alpha filing and reading and sequencing numbers
- Must be proficient in navigating windows based systems
- Certified Patient Account Representative (CPAR) preferred
- Bi-lingual (Spanish) preferred
28
Patient Access Specialist Resume Examples & Samples
- Providing patients with documentation and printed materials related to their visit and treatment plan
- Prioritizing patient flow including directing patients to other locations within the hospital or facilitating transportation services for patients if needed
- Referring patients to hospital services as needed (ie financial navigation)
- Collecting copays/payments and depositing all collections with hospital cashiers
- Verifying insurance and obtaining benefit information
- Facilitating scheduling and authorizations for urgent patient needs in conjunction with Practice Coordinators
- Addressing any patient concerns that remain after the end of the visit
- Providing back-up support to other staff as needed
- Providing exceptional customer service to all patients, visitors and customers
- Additional administrative responsibilities as directed by the physician, the supervisor or department leadership
- Superior oral communication skills
- Consistently displays professional appearance
- Consistently displays a positive attitude and friendly demeanor
- Ability to escalate issues appropriately
- Ability to effectively and accurately follow directions or instructions
- Ability to work collaboratively as part of a team; offers to help coworkers when needed
- Experience with Epic preferred; strong computer skills required
- Knowledge of healthcare and health insurance, preferred
- Familiarity with medical terminology, preferred
29
Patient Access Specialist Resume Examples & Samples
- Prioritize patient flow
- Verify insurance and obtain benefits
- Triage phone calls and schedule appointments
- Respond to patient, visitor, and customer inquiries
- Obtain patient demographics, personal information, and medical history by interviewing patients
- Other duties related duties incidential to the work described herein
- Ability to add, subtract, multiply, divide and calculate percentages
30
Patient Access Specialist Resume Examples & Samples
- Prioritize patient flow (includes bed planning for Admitting department)
- Admit patients
- Triage and respond to phone calls
- Verify insurance
- Pre Admissions
- Other duties as appropriate for role and as indicated
31
Patient Access Specialist Resume Examples & Samples
- Answer multi-line telephone system. The number of calls taken must be within 90% of the daily average calls per day per agent
- Compile and send new patient packets or flags patient if needs to be completed upon arrival
- Coordinate access to care for patients within own department or location
- Function at multiple sites as requested by supervisor
- Give basic information to patients (directions, parking information, and required preparation for appointment)
- Knowledgeable about various reasons for patient calls such as prescription refills, how to triage clinical issues, participating insurances, questions about physicians, etc
- Monitor patient wait list report
- Obtain chief complaints in order to schedule appropriately
- Review and verify the patient's insurance information
- Review, verify and enter the patient's demographic information to ensure data integrity
- Take incoming calls demonstrating the essential skills documented in the Telephone Courtesy Standards
- Take responsibility to escalate to appropriate clinical or supervisory personnel when needed, including thorough and accurate documentation of telephone encounter for messaging
- Treat all patients with respect and demonstrates the behaviors learned in the Patient Ambassador Program
- Work the overflow call list and Audiocare report
- Requires Associate's degree and six months of experience in a medical office, customer service, inbound call center, or other relevant health care setting
- In lieu of this, a High School Diploma or equivalent and one year of experience in a medical office, customer service, inbound call center, or other relevant health care setting will be considered
- Must have experience with personal computer based applications, including email and experience with other various office equipment
- Must be able to multitask at a high level
- Able to interact with a variety of external and internal constituents, including patients, patients families, internal physicians, referring physicians or their clinical/office staff, insurance companies, nurses
- Experience with/knowledge of medical terminology and multi-line telephone systems is preferred
- Electronic scheduling system experience is preferred
- Must be able to learn and apply third party payer guidelines and reimbursement practices
- Basic knowledge of health insurance preferred
- Must be able to maintain confidential information
- Must have strong interpersonal, organizational, and communication skills and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances
32
Patient Access Specialist Resume Examples & Samples
- Demonstrates exceptional customer service both for in-person and telephone activities
- Demonstrates expected behaviors applicable to the Medical Center and Revenue Cycle access systems and policies, procedures and guidelines
- Receives funds, issues receipts, balances cash journals, and makes deposits
- Maintains current working knowledge; adheres to Revenue Cycle policies and procedures; performs problem- solving activities
- Performs area-specific support activities
- Demonstrates engagement in the work, team, and goals of the Revenue Cycle
- Ability to provide excellent customer service while meeting registration turnaround time guidelines
- Ability to think quickly, demonstrate resourcefulness under pressure, and thrive in a fast-paced environment
33
Patient Access Specialist Resume Examples & Samples
- Possesses basic computer skills and a typing minimum of 26 wpm
- Excellent customer service skills required; experience in management of team concepts
- Physician office or outpatient and Electronic Medical Record (EMR) experience, preferably EPIC, a plus
- Willing to give input in the development of a new clinic while remaining flexible
- Ability to work independently while being a valuable contributing member of the team
- Ability to work interdepartmentally among varied disciplines and levels
- Bilingual- Spanish preferred but not required
34
Patient Access Specialist Resume Examples & Samples
- Answer multi-line telephone system and schedule appointments, contact or page physicians according to department questionnaires, protocols and templates
- Demonstrate ability to understand reason for patient visit and apply decision making ability to schedule an appointment with the correct sub-specialist by obtaining medical information/diagnosis in order to adequately meet the patient's needs and allow for appropriate scheduling to a specific physician or specialty
- Demonstrate the ability to understand the reason for a consumer referral call. Use decision making ability to appropriately refer a physician, class or program to meet the consumer's needs
- Demonstrate the ability to understand the reason/needs for the patient or clinicians call and apply the decision making ability to page or contact the appropriate physician to meet the patient's needs
- Ensure effective communication and call escalation to appropriate personnel; includes thorough and accurate documentation of telephone encounter
- Ensure effective communication to patients regarding scheduling and call details, give basic information to patients (directions, parking information, and required preparation for appointment)
- Maintain performance at or above established benchmarks for: Quality Assurance. Average Call Handling Time, Schedule Adherence and Telephone Aux usage
- Make decisions independently and take initiative to find answers to questions. Appropriately triage phone calls to or from clinical and other areas
- Provide support to supervisor/manager in the instruction of training new staff in order to maintain a high quality of service to the patient and the department
- Research, resolve and respond to email, web and telephone billing inquiries from patients and insurance carriers in accordance with departmental protocols
- Review, verify and enter the patient's demographic and insurance information to ensure data integrity
- Understand UPMC 72-hour appointment requirement and work to ensure guidelines are met while still placing the patient with the right sub-specialist whenever possible to avoid return visit to see the correct sub-specialist
- Completion of high school diploma or equivalent and 2 years of medical office, customer service, inbound call center (preferred) or other relevant health care experience required
- Associates degree and 1 year of medical office, customer service, inbound call center (preferred) or other relevant health care experience preferred
- Must have working knowledge of Word and Outlook. Working knowledge of Excel is preferred
- Advanced knowledge of health insurance preferred
- Initiative to work productively in a team setting with minimal supervision
- Must be able to learn new concepts quickly and apply them in a medical setting. Experience with/knowledge of medical terminology and multi-line telephone systems is preferred
- Ability to interact with a variety of external and internal constituents, including patients, patients families, internal physicians, referring physicians or their clinical/office staff, insurance companies, nurses
- Must be able to make appropriate decisions based on the circumstances as well as established protocols
- Must be able to learn and apply third party payer guidelines and reimbursement practices and available financial resources for the funding of medical care
- Must demonstrate the ability to effectively problem solve and make independent decisions
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Patient Access Specialist Resume Examples & Samples
- Ability to work well under pressure in a fast paced contact center environment
- Excellent critical thinking skills with ability to independently resolve problems
- Demonstrates a functional and technical understanding of applicable scheduling software and use of medical record technology
- Works with primary care and specialty provider offices to best coordinate transfer of required information and generate the best possible patient experience
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Patient Access Specialist Resume Examples & Samples
- Levelevel of knowledge normally acquired through completion of high school
- Three to Six months of on-the-job training to become familiar with registration,scheduling and computer procedures
- Basic medical terminology class, keyboarding, and prior insurance and/or business office experience preferred
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Patient Access Specialist Resume Examples & Samples
- Assume leadership role in recommending, implementing and monitoring sound financial counseling guidelines for Radiation Oncology, and Satellite facilities
- Interact with patients and family members (if necessary) in the most courteous, respectful and empathetic manners in discussing all aspects of their financial situation
- Work with other departments including XRT satellite operations and the multidisciplinary clinics (MCCs) to provide patients with the most accurate estimate in an integrated and expeditious manner
- Strengthen the integrity and confidentiality of patient financial information by sharing that information only for reasons as stipulated by the institutional guidelines
- Maximize the functionality of various institution and Radiation Oncology information systems software/platforms such as ONE CONNECT and MOSAIQ to accomplish duties promptly
- Responsible for complete assurance that patients and family members (if necessary) understand all aspects of their financial relationship with the institution and the Division of Radiation Oncology
- Assume leadership role in managing patient data update, financial clearance status, and expeditious appointment scheduling
- Ensure timely, proper and efficient collection of patient demographic information and also update patients’ files regularly
- Following institutional and departmental guidelines, work closely with MCCs, New Patient Referral, XRT satellites, and Proton Therapy partnership to ensure expeditious triaging and scheduling of patients
- Responsible for ensuring that there is understanding between clinical teams, referring parties and others concerned regarding patient appointments
- Asserts complete oversight in assuring Verification, pre-certification and terms of various insurance plans and benefits
- Implement established institutional and departmental guidelines to achieve standards for verifying insurance, performing pre-certifications, and assuring insurance updates for all patients
- Establish functional and productive working relations with third-party payor agencies such as Managed Care Office and outside insurance companies
- Responsible for interpreting and implementing regular contract summaries, provisions and restrictions as they apply to various patient population for Radiation Oncology, its outreach and satellite facilities
- Obtain and document verification of patient eligibility (and applicable effective dates) using the available institutional and/or payor systems, including real-time web portals and tools, within the applicable timeframes as outlined by department policies and procedures. Promptly notify Patient Access and the patient, when eligibility information is invalid and/or cannot be verified
- Work collaboratively with Patient Access to document updated and/or corrected insurance information into the system in accordance with applicable department policies and procedures
- Obtain and document verification of patient benefits, including information regarding the product type, in-network or out-of-network status, all applicable co-payment, deductible, and co-insurance amounts or percentages, pre-existing indicator and time period, and any lifetime or annual maximums into CARE and/or designated future state systems in a timely manner
- Timely manage work lists for cases requiring pre-authorization and work directly with the payor or assigned third party vendor to obtain all required pre-authorizations. Seek to obtain pre-authorization through on-line web portals and tools, when available. Accurately document all reference and pre-authorization numbers, along with payor contact information, into CARE and/or designated future state systems in a timely manner
- For patients participating in a clinical trial, appropriately document and review with patients and the payors services being covered by the clinical trial sponsor and those designated for coverage under the patient’s insurance
- Provides financial counseling to patients which includes reviewing cost estimates, assistance with calculating expected patient liability, discussions regarding payment requirements, collection of financial amounts dues, provide information regarding available payment plan options, and provide information regarding patient financial assistance opportunities when applicable. Financial counseling also includes reviewing ABN, MSPQ, account review and any other barriers to financial clearance with patients as needed
- Complete and timely submit all documents (PFA, COBRA, etc,) requiring Supervisor approval for financial clearance
- Promptly escalate any issues with financial clearance and/or counseling to the Financial Clearance Supervisor or seek assistance as appropriate from the Financial Clearance Coordinator, when needed
- Completely and accurately document conversations and communication with Patient Access, payors, third party vendors, patients, and any other representative in and outside of the institution
- Answer emails and phone calls in a timely manner, and respond to voicemails and myMDAnderson messages within one business day
- Conducts all financial clearance activities in a courteous and professional manner and maintains a positive working relationships with patients, physicians, payors, third party vendors and any other identified business partners
- Seeks to improve job performance and personal growth by participating in available educational, training and mentoring opportunities
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Patient Access Specialist Resume Examples & Samples
- Performs complete and accurate registration and/or admission functions to provide information to maximize reimbursement, and ensures timely and thorough information to all other providers and users of patient data. Verifies insurance requirements, obtains and understands insurance benefits. Collects non-covered fees. Registers and pre-registers outpatients in one or more clinical and diagnostic locations within their primary area of responsibility and at least one access area outside hiring location. Access areas include but may not be limited to Busse Center, Emergency/Admitting Department, Immediate Care Centers, Laboratory and Ambulatory Infusion Center
- Interacts with patients and their representatives to collect and interpret all required demographic, insurance, financial, and clinical data necessary to facilitate patient check in and registration at point of service. Offers and/or schedules interpreter services for patients when necessary. Obtains and scans general consent for treatment, identification and insurance cards, Coordination of Benefits and other appropriate documents. Obtain and submit National Provider Information (NPI) for providers not on staff ordering outpatient diagnostic tests. Interprets physician orders for completeness and compliance with regulatory agencies and NCH policies. Informs patients of registration processes and privacy notification, establishes financial responsibility to meet internal, regulatory or payer requirements. When applicable, completes the Medicare Secondary Payer (MSP) questionnaire and discusses potential deferral of services according to NCH policy. Initiates the Medicare Advance Beneficiary Notice (ABN), as appropriate, and explains payer policies to patients. Streamlines check in process for patient previously pre-registered and appropriately updates the account for changes identified upon arrival. Reviews physician’s orders for compliance with the Illinois Department of Public Health (IDPH), and the Center for Medicare & Medicaid Services (CMS) regulations and NCH and medical staff office policies
- Ensures financial protocols and requirements are met. Refers patients to Financial Counselors for identification of financial assistance options. Minimizes third party payer denials by verifying authorization of service prior to forwarding patients to service delivery areas. Maintains current knowledge of insurance requirements communicated by email, memorandum, educational matrices and in-services. Communicates effectively with service delivery areas when unresolved financial issues impact appointment schedules
- Identify clinical and financial criteria that requires involvement of Case Management team. Utilizes price estimator to determine financial responsibility and attempt to secure all financial responsibility prior to the date of service. Meet monthly cash collection goals as determined collaboratively by Department Director/Manager. Log cash collected receipts and maintain balanced cash at all times
- Maintain registration accuracy by meeting or exceeding expectations with 97% or higher accuracy score. Resolve all work queues within Department standards determined time period to release bill holds to ensure timely reimbursement. Research and conduct outreach via phone/fax to obtain additional information to process coverage requests and complete all necessary actions to close cases
- Electronically records all required and updated information on patient accounts in multiple hospital information systems according to Emergency Medical Treatment and Active Labor Act (EMTALA), the Health Insurance Portability and Accountability Act (HIPAA), payer, and other applicable regulations and standards
- Prepares all required patient registration forms, documents, charts and reports, labels, patient plates, identification bands, medical records forms, and other related documents for distribution to appropriate departments, physicians and clinical staff. Notifies clinical department of patient’s arrival
- May perform as a patient receptionist/greeter. Assists patients with way finding and transport needs. Contacts clinical departments and scheduling staff as needed to assist in promoting the efficient flow of patients and prioritization of service scheduling and admissions. Assists with other tasks to support the clinical department as determined by the Manager of Patient Access
- Perform customer service standards by adhering to the AIDET principles. Investigate and direct inquires or complaints to appropriate medical staff members and follow up to ensure satisfactory resolution. Consistently demonstrate premier customer service and communication skills with all internal and external customers/contacts and ensure the patient and their family members have the best hospital encounter possible. May do basic precepting for new hires and acts as a resource team member for performance improvement activities and a super user for various registration and scheduling related systems
- Adheres to all Northwest Community Hospital standards, policies, and procedures and reports compliance concerns to management staff
- High school diploma required. College degree preferred
- Minimum 2 years of customer service work experience using computers required
- Prior working knowledge of medical terminology preferred
- Previous healthcare experience with regulatory compliance requirements, payer requirements, HIPAA privacy and security requirements, and general revenue cycle procedures preferred
- Epic Registration and/or Scheduling experience preferred
- Ability to functionally navigate multiple computer software systems with accurate keyboard skills following computer security protocols
- The interpersonal communication skills necessary to interview and interact with customers and physicians and to project a professional and compassionate concierge style of service to patients, patient families, physician’s and staff in person and on the telephone
- Ability to work independently, exercising good judgment, and multi-task in a high stress, fast paced service environment with patients, patient’s family and physician’s
- Detail oriented with good analytical problem-solving skills to appropriately register patients and schedule patient procedures
- Ability to operate routine office equipment (facsimile, copiers, plate production, scanners, printers)
- Ability to ask patient or responsible party for payment at time of service and maintain a cash drawer
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Patient Access Specialist Resume Examples & Samples
- Performs complete and accurate registration and/or admission functions across multiple access services areas or sites to provide information to maximize reimbursement, and ensures timely and thorough information to all other providers and users of patient data. Verifies insurance requirements, obtains and understands insurance benefits. Collects non-covered fees. Registers and pre-registers outpatients in more than one clinical and diagnostic location within their primary area of responsibility and multiple access areas outside hiring location. Access areas include but may not be limited to Busse Center, Emergency/Admitting Department, Immediate Care Centers, Laboratory and Cancer Services
- Interacts with patients and their representatives to collect and interpret all required demographic, insurance, financial, and clinical data necessary to facilitate patient check in and registration at point of service. Offers and/or schedules interpreter services for patients when necessary. Obtains and scans general consent for treatment, identification and insurance cards, Coordination of Benefits and other appropriate documents. Obtain and submit National Provider Identification (NPI) for providers not on staff ordering outpatient diagnostic tests. Interpret physician orders for completeness and compliance with regulatory agencies and NCH policies. Informs patients of registration processes and privacy notification, establishes financial responsibility to meet internal, regulatory or payer requirements. When applicable, completes the Medicare Secondary Payer (MSP) questionnaire and discusses potential deferral of services according to NCH policy. Initiates the Medicare Advance Beneficiary Notice (ABN), as appropriate, and explains payer policies to patients. Streamlines check in process for patient previously pre registered and appropriately updates the account for changes identified upon arrival. Reviews physician’s orders for compliance with the Illinois Department of Public Health (IDPH), and the Center for Medicare & Medicaid Services (CMS) regulations and NCH and medical staff office policies
- Ensures financial protocols and requirements are met. Refers patients to Financial Counselors for identification of financial assistance options. Identify clinical and financial criteria that require involvement of Case Management team or Financial Counseling. Collaborate with internal and external customers to provide timely resolution to third party payer requirements prior to date of service. Minimizes third party payer denials by verifying authorization of service prior to forwarding patients to service delivery areas. Maintains current knowledge of insurance requirements communicated by email, memorandum, educational matrices and in-services. Provides support to primary care practices and specialty care providers regarding utilization, authorization and referral activities. Communicates effectively with service delivery areas when unresolved financial issues impact appointment schedules
- Proficient in the use of CPT and ICD codes, and utilizes online payer resources. Utilize estimator to determine financial responsibility and attempt to secure all financial responsibility prior to the date of service. Meet monthly cash collection goals as determined collaboratively by Department Director/Manager. Maintain registration accuracy by meeting or exceeding expectations with 97% or higher accuracy score. Resolve all work queues within Department standards determined time period to release bill holds to ensure timely reimbursement. Log cash collected receipts and maintain balanced cash at all times
- Coordinates scheduling of service areas for patients requiring multiple tests. Identify and assign electronic educational programs for scheduled services. Explains patient prep and way finding instructions to patient. Collaborates with physician offices to check-in appointments and schedule tests post-physician office visits at offsite NCH locations
- May do basic precepting for new hires and acts as a resource team member for performance improvement activities and a super user for various registration and scheduling related systems
- Performs customer service standards by adhering to the AIDET principles. Investigate and direct patient inquiries or complaints to appropriate medical staff members and follow up to ensure satisfactory resolution. Consistently demonstrate premier customer service and communication skills with all internal and external customers/contacts and ensure the patient and their family members have the best hospital encounter possible
- Minimum 2 years of customer service work experience required
- Minimum of 1 year experience in a healthcare patient access department or hospital required
- Computer experience in a windows environment required
- Previous healthcare experience with regulatory compliance requirements, payer requirements, HIPAA privacy and security requirements, and general revenue cycle procedures required
- Successful on-the-job completion of NCH Patient Access Specialist I competencies required
- Ability to transact payments at time of service and maintain a cash drawer
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Patient Access Specialist Resume Examples & Samples
- 8 Ability to work independently, exercising good judgment, and multi-task in a high stress, fast paced service environment with patients, patient’s family and physician’s
- 10 Ability to operate routine office equipment (facsimile, copiers, plate production, scanners, printers)
- 11 Ability to ask patient or responsible party for payment at time of service and maintain a cash drawer
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Patient Access Specialist Per Diem Resume Examples & Samples
- Provide exceptional customer service to all patients, visitors, and customers
- Collect payments
- Knowledge of healthcare and health insurance
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Patient Access Specialist / Admitting Clerk Resume Examples & Samples
- Coordinates pre-admissions
- Establishes electronic accounts on patients
- Interviews the patient, or a family member, to obtain necessary information
- Verifies insurance and assists patient to pre-certify with insurance company and sign admitting documents
- Provides patient with financial understanding of their responsibilities toward their hospitalization
- Collects copies of necessary supporting documentation for inclusion in patient’s financial file
- Financially evaluates patients, and directs patient toward financial assistance programs
- Determines and collects appropriate deposits, coinsurance, co-payments and deductibles
- Serves as information resources for patients, physicians, nurses, and other health care professionals
- Visits patients and their families within the assigned Nursing Unit to complete interview process inclusive of explaining hospital policies
- Safeguards the confidentiality of all patient information
- Assist in Emergency Room Admission when required
- Assists with PBX when required
- Attends and participates in department and hospital meetings
- Ability to operate a personal computer. Knowledge of computerized data entry and information processing systems
- Knowledge of medical terminology and abbreviations
- Ability to work cooperatively with peers to contribute to the overall productivity of the team
- Ability to communicate effectively both verbally and in writing
- Ability to maintain accurate, current reports and records
- Repetitive use of hands
- Ability to transport/move up to ten pounds of files, books, documents at a time on a regular basis
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Patient Access Specialist Resume Examples & Samples
- Maintain compliance with EMTALA, DNV, HIPAA and all other hospital and government regulations applicable to the Admissions settings
- Provide excellent customer service at all times by effectively meeting customer needs, understanding who the customers are, and building quality relationships
- Answer telephone in a professional and courteous manner, record messages and communicate to appropriate medical staff
- Provide and obtain signatures on required forms and consents
- Obtain, verify, and enter complete and accurate demographic information on all accounts to facilitate smooth processing through the revenue cycle
- Verify insurance benefits for all plans associated with patient, confirming the correct payor and plan is entered into the patient accounting system
- Obtain insurance authorizations as required by individual insurance plans, documenting authorization numbers in the appropriate fields for accurate billing
- Maximize the efficiency and accuracy of the collection process by pursuing collections at the time of service in a customer service oriented fashion
- Scan all registration and clinical documentation into the system and maintain all medical records
- Obtain patient satisfaction surveys from all patients upon discharge
- Coordinate the transfer of patients to other hospitals when necessary
- Respond to medical record requests from patients, physicians and hospitals
- Maintain cash drawer according to policies
- Maintain log of all patients, payments received, transfers and hospital admissions
- Maintain visitor log
- Maintain a clean working environment for the facility. This includes the front desk, restroom, waiting room, break area and patient rooms when assistance is needed by medical staff
- Receive deliveries including mail from various carriers and forward to appropriate departments
- Notify appropriate contact of any malfunctioning equipment or maintenance needs
- Assist medical staff as needed
- 1 year patient registration and insurance verification experience in a health care setting, strongly preferred
- Knowledge of various insurance plans (HMO, PPO, POS, Medicare, Medicaid) and payors, strongly preferred
- Working knowledge of MS Office (MS Word, Excel and Outlook)
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Patient Access Specialist Resume Examples & Samples
- Great Customer Service
- Greet and welcome patients
- Access account
- Direct patient to appointment/procedure or give instructions
- Perform other job-related duties as assigned
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Rehab Patient Access Specialist Resume Examples & Samples
- The Patient Access Insurance Specialist must be detail oriented, personable, calm, flexible, honest, and capable of handling difficult situations with tact and diplomacy
- Incumbent must posses skills to effectively communicate in a professional manner with various internal and external providers
- Ability to type, spell, write or print legibly with general knowledge of personal computers required
- Strong interpersonal communication, documentation and customer service skills required
- 1-2 years of Hospital admissions or physicians' office experience required or 1-2 years professional work experience required
- Knowledge of health care insurance and managed care required. Medical terminology preferred
- Bilingual preferred
- BLS Healthcare Provider certification recommended, not required. Annual CPR certification recommended, not required
- Fluency in Spanish needed!*
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Patient Access Specialist Resume Examples & Samples
- High School Diploma or G.E.D.,
- AND an approved medical terminology certification or med term course completion with satisfactory scores
- AND minimum (3) three years experience as a PAS 2 or equivalent with scheduling and/or registration and/or insurance verification in a healthcare setting
- Moderate expertise with computer programs including but not limited to Microsoft Office and Database programs
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Patient Access Specialist Mon-fri Resume Examples & Samples
- High school diploma or equivalent required. Associate’s degree or 2 years of experience in lieu of degree preferred
- Validates medical necessity (LCD/NCD review) to ensure clinical and financial clearance. Contacts scheduling and/or ancillary department associates for clarification, on diagnosis and/or test(s)/procedure(s) as necessary
- Prepares identification bracelets and patient ID labels/plates for Inpatients and selected Outpatients. Obtains/scans patient/guarantor signatures on required forms (ID cards, insurance cards, consent to treatment, assignment of benefits, release of information, waivers, ABNs, advance directives, etc.). May audit & record the patient's valuables, securing appropriate authorizations, if needed. Disseminates patient information, including patient guidebooks and other required documents
- Provides information, directions, transportation, and assistance to patients, family members and visitors, ensuring timely, customer-centric service delivery in an effective and efficient manner. Communicates with various ancillary departments to ensure smooth patient flow and high data integrity
- May perform cross-functional duties, including but not limited, to patient placement. While performing reservation duties, the position is primarily responsible for making bed assignments and transfers, providing functional guidance as necessary and scheduling patients to be admitted
