Patient Access Specialist I/II - Dental, Echo Cliffs Health Center

Navajo Preference Employment Act

In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.
Overview

POSITION SUMMARY

The primary purpose of the patient access specialist is to schedule and register patients by accurately collecting and analyzing all patients’ demographic, third party coverage (i.e., insurance), and clinical data elements. Incumbent interviews patients and assists them in completing required forms to process medical, dental and pharmacy billing claims. Incumbent is responsible for data integrity to further expedite third party reimbursement and optimize customer satisfaction. This position requires the ability to work under conditions of frequent interruptions and willingness to work flexible schedule. Incumbent also initiates and carries out a variety of clerical duties such as scheduling, changing, cancelling patient appointments, building of provider schedules.

Qualifications

NECESSARY QUALIFICATIONS Education:

High School diploma or GED

Experience:

Patient Access Specialist I:

• Must have six (6) months of experience working in a fast-paced office environment

Patient Access Specialist II:

• Must have two (2) years of experience working in a fast-paced office environment. Experience with electronic patient registration software, or similar patient financial services

Certification:

• Must maintain a current valid certification of the following throughout employment:
  • Basic Life Support (BLS) from the American Heart Association

Other Skills and Abilities:

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate achievement in each one of the following areas:

• Must have excellent customer service skills, personal and telephone communication skills
• Ability to manage multiple priorities and deadlines.
• Proficient knowledge and ability to use computer software
• Demonstrate through work history the ability to complete special projects; the ability to meet departmental deadlines, analyze, research, and troubleshoot.
• Demonstrates the ability to solve problems following chain of command
• Experience with special projects to meet department demands, must work independently, analyze, research, troubleshoot and resolve issues
• Positive communication and working relationships with others
• Possession of high ethical standards and no history of complaints
• Reliable and dependable; reports to work as scheduled without excessive absences
• Ability to handle sensitive and confidential information
• Must be proficient with typing and accurate spelling and grammar
• Ability to work independently with minimal to no supervision
• Ability to work under conditions of frequent interruptions and availability to work a flexible schedule
• Possesses and employs an ability to communicate with patients and families during time of emotional and physical
• Responds positively to supervision to enhance and improve work performance
• Completion of above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
• Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading, or incomplete information, as determined by TCRHCC.

Responsibilities

ESSENTIAL FUNCTIONS:

1. Review, update and maintain all patient data in multiple patient accounting, registration, and scheduling systems by initiating the completion of forms required for billing and
2. Interview patients to obtain pertinent registration information, assure document scanning, retrieving, and editing, and patient identification to determine patient’s insurance coverage, limitations and communicates to patients any co-pays or deductibles for collection.
3. Identify patient’s potential financial liability for a specific service and identify patients at risk for inability to meet financial liability. Make a referral to an appropriate agency or department. Provide an overview of options available to patients/families by assessing patient understanding of registration process to determine appropriate response to patient’s questions and applications and communicate appropriate information needed to complete patient’s eligibility
4. Collect cash payments for pharmacy and medical services and complete necessary reconciliation in accordance with fiscal policy, including the issuance of a transaction receipt.
5. Perform insurance verification and prior authorization for patients prior to patient’s schedule appointment or
6. Assist patients in completing and updating forms required for medical records, third party insurer and the
7. Identify and pre-authorize patients whose health benefits are subject to prior approval to determine the extent of health care for both inpatient and outpatient
8. Collaborate with various departments to expedite patient services and improve patient
9. Serve patients and visitors by welcoming and greeting them in person and on the telephone; answering or referring to inquiries; directing patients and
10. Work rotational shifts (call back schedule is only for Emergency and Inpatient).
11. Intake and coordinate motor vehicle accidents/worker’s compensation claims visits that are encountered during shift to appropriate
12. Follow established guidelines regarding patient identification and income screening for the non-eligible Medicaid patients according to technical training information provided.
13. Work with software systems for clinical, medical, dental, pharmacy and other office healthcare
14. Assure required requisitions for various departments are completed and timely routed as appropriate. Ensure the unit is stocked with appropriate forms and supplies. Retrieve and print laboratory reports, health summaries, medication lists, and other patient records as
15. Responsible for electronic health records data entry pertinent to patient service
16. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
17. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (See CDC website for most current updates)
18. Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction.
19. Perform other duties as