The Access Center Specialist communicates with the patients/providers via telephone to ensure accurate, prompt, and courteous scheduling of specialty appointments according to established division guidelines. this position is responsible for obtaining and entering accurate demographic and insurance information for all encounters. The access Center Specialist is required to discuss financial obligations with patient families and collect payments or escalate to Financial Advocates when appropriate.
The Access Specialist is responsible for monitoring registration and insurance related items that fall into patient work queues to ensure timely claim filing. This role works collaboratively with other Nemours departments to ensure all patient access needs are met. The Access Center Specialist is required to provide superior customer service to both internal and external customers, and represent Nemours in a positive, professional manner. They are responsible for demonstrating a commitment to service, organization values, and professionalism.
Answers calls for assigned clinic specialties in an efficient manner, using standardized greeting, content, and closure of call.
Accurately captures and verifies patient demographic, guarantor, legal guardian, and insurance information in the EMR system. Utilizes quality review work queue to identify and correct discrepancies.
Schedules appointments in the EMR system, following scheduling and insurances guidelines. Provides all necessary appointment information at time of scheduling, and all necessary directions and paperwork via mail or email following closure of the scheduling call.
Actively reviews electronic communications and process documentation to stay abreast of correct department processes and notifies leadership immediately of any questions.
Ensures accuracy in answering questions and assisting customers with requests. Utilizes escalation guideline criteria to prioritize patients' health concerns, and follows reliable methods to document and escalate calls as instructed in guidelines.
Collects copays, outstanding balances, and any applicable prepayments at time of scheduling. Partners with Financial Advocate when appropriate.
Identifies and attempts to resolve complaints. When unable to resolve complaints, utilizes escalation guidelines to route callers to the appropriate Nemours associate.
All other duties as assigned by supervisor.
Job Requirements
High School Diploma required.
More than one (1) year of customer service, medical office, or call center experience required.
NAHAM certificate (National Association of Healthcare Access Management) - CHAA preferred.
