Access Specialist I

Albany Medical Center; City of Albany (NY); On-site; USD 46,215 - 60,080; Part time

Job summary

Albany Medical Center is seeking a Pre-Service Specialist I to be the first touchpoint for patients, handling appointment scheduling and insurance verification in a high-volume setting.

You will interpret payer benefits, collect financial obligations, and navigate multiple systems to ensure accurate registration and optimal patient experience. Prior customer service and medical terminology knowledge are preferred, with room for career ladder advancement.

Qualifications

• High School Diploma or GED required.
• 1–2 years winning customer service personality with ability to engage patients and customers via telephone.

Responsibilities

• Schedule appointments and services for assigned service line via scheduling system.
• Triage calls by identifying trigger words and directing to the appropriate Clinic Nursing team.
• Collect and verify demographics and insurance information for accurate registration.
• Interpret payer information regarding eligibility and financial responsibility.
• Discuss and collect patient financial obligation pre-services.
• Interpret referrals/physician orders to schedule correctly.
• Scan or manage online forms to maintain the EHR.
• Comply with Federal, State, and Third-Party payer regulations.
• Use multiple systems during calls to complete registration and support workflow.
• Review services to ensure correct setting of care.

Skills

Customer service

Scheduling

Insurance knowledge

Communication

Multitasking

Pressure management

Learning attitude

Attention to detail

Problem solving

Teamwork

Insurance benefits interpretation

Education

High School Diploma/G.E.D.

Job description

Department/Unit: Patient Access Work Shift: Per Diem (United States of America) Salary Range: $46,215.00 - $60,080.00

The Pre-Service Specialist I is responsible for the initial touchpoint of our patient population to provide an exceptional patient experience assisting in scheduling services for our Hospital and Practice. This requires ability to work in a high-volume contact center and fast paced environment. Understanding complex scheduling needs of our patients in an empathetic, compassionate manner is critical. Position is required to use eligibility application to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. The position requires ability to understand and apply contractual benefits to the service being rendered, with ability to collect patient financial obligation pre-services.

The Pre-Service Specialist I, after one year in the position and based on performance and success in position, has ability to be promoted to Pre-Service Specialist II as Career Ladder requirements indicate.

Essential Duties And Responsibilities

• Responsible for scheduling appointments and services for assigned service line (POD) via the scheduling system following established scripting and protocols promoting physician satisfaction and scheduling efficiencies on behalf of our patients.
• Ability to identify trigger words, symptoms and patient concerns, assuring calls are triaged to the respective Clinic Nursing team per protocol.
• Responsible for discerning demographic and insurance information to ensure accurate registration
• Responsible to interpret information received from Insurance Payer regarding patient’s eligibility and financial responsibility
• Responsible for discussing financial obligation of patient and collect via cash, credit card or check
• Ability to accurately interpret referral/physician order to meet the patient and/or provider need for scheduling of services correctly.
• Responsible for scanning or managing online form template to maintain the Electronic Health Record
• Comprehend Federal, State, Third Party Payer regulations as it pertains to a hospital and practice pre-registration.
• Ability to work in multiple systems during a telephone call or patient facing interaction to complete an accurate registration and support clinical workflow.
• Responsible for review of services being rendered to ensure the appropriate setting of care has been assigned by the physician’s office
• Obtains all insurance information from patient and verifies insurance to ensure active coverage for services being scheduling.
• Provides thorough comments, where applicable for all conversations with patients or providers.

Qualifications

• High School Diploma/G.E.D. - required
• 1 – 2 years Winning customer service personality with ability to engage patients and customers via telephone with superior patient experience.
• Medical Terminology and Insurance Knowledge - preferred
• Proven customer service skill with ability to exceed expectations
• Ability to multi-task in stressful and high patient volume unit
• Must be able to manage pressure of very tight timeframes to execute task
• Ability to learn in classroom, utilizing resources
• Ability to maintain composure under pressure
• Ability to review information and draw appropriate conclusion
• Good judgement and ability to be resourceful to problem solve; elevate issues as needed
• Team minded worth ethic
• Demonstrated ability interpret patient’s insurance benefits and apply the applicable contractual obligations

Equivalent combination of relevant education and experience may be substituted as appropriate.

Physical Demands

• Standing - Occasionally
• Walking - Occasionally
• Sitting - Constantly
• Talking - Constantly
• Hearing - Constantly
• Repetitive Motions - Constantly
• Eye/Hand/Foot Coordination - Frequently

Working Conditions

• Extreme cold - Rarely
• Extreme heat - Rarely
• Humidity - Rarely
• Wet - Rarely
• Noise - Occasionally
• Hazards - Rarely
• Temperature Change - Rarely
• Atmospheric Conditions - Rarely
• Vibration - Rarely

Thank you for your interest in Albany Medical Center!

Albany Medical Center is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

Thank you for your interest in Albany Med Health System!

Albany Med Health System is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.