Patient Access Liaison

Esperanza Health Center, Inc.; Philadelphia (Philadelphia County); In loco; USD 38.000 - 48.000; Tempo pieno

Descrizione del lavoro

Esperanza Health Center, Inc. seeks a Patient Access Liaison to help uninsured individuals enroll in the Health Insurance Marketplace and educate them on ACA and Healthy PA options. The PAL schedules appointments, guides online applications, and coordinates with the social services team for referrals and pre-certifications.

Responsibilities include ensuring HIPAA and HRSA compliance, maintaining records, and supporting front desk tasks during peak hours. Bilingual English/Spanish preferred.

Competenze

• High school diploma or GED is required.
• Experience with Centricity and EHC clerical processes is essential.
• Strong analytical and multi-tasking abilities.
• Completion of ACA online training and certification.
• Ability to communicate professionally in English and Spanish.

Mansioni

• Assist uninsured individuals with Health Insurance Marketplace enrollment and ACA/Healthy PA education.
• Schedule appointments and help patients/community members complete online applications.
• Coordinate with social services to complete referral pre-certifications and on-site applications.
• Ensure HIPAA, HRSA, and ACA compliance; maintain accurate records and reports.
• Provide front desk support during peak hours and assist with scripting and outreach.

Conoscenze

Spanish language

English language

Analytical skills

Communication skills

Formazione

High school diploma or GED

ACA online training certification

Strumenti

Centricity

Descrizione del lavoro

SUMMARY:The Patient Access Liaison (PAL) works directly with uninsured persons to help enroll them in the Health Insurance Marketplace and educate them about their options under the Affordable Care Act and Healthy PA. The PAL schedules appointments to personally help patients and non-patients, contacts patients who do not have scheduled visits or unfinished online applications, works directly with uninsured patients and staff to complete referral pre-certifications at designated site, and assures compliance with HRSA regulations, insurance requirements, and HIPAA law. The PAL makes recommendations to Practice Administrator and Director of Social Services based on findings.

ESSENTIAL FUNCTIONS

Customer Service

• Display a customer service attitude and the love of Christ in all interactions. Treat all patients with courtesy, respect and patience even when patient is demanding or rude.
• Answer phone professionally within 4 rings. Document nature of call and route to appropriate party if needed. Verify phone numbers and insurance information every time.
• Return calls to patients who leave phone messages.
• Explain the EHC uninsured program and the Insurance options to patients; assist patients with low literacy level to complete EHC self-pay paperwork or on-line application.
• Offer support, hope and comfort to patients using listening skills, prayer and scripture
• Interview patients or interested members of the community, review required documentation, discuss Health Marketplace options, and assist with on-line insurance applications.
• Follow-up with individuals who have incomplete applications.
• Keep records, according to instructions provided, of all persons educated and/or enrolled under the ACA.
• If individual is ineligible for insurance coverage under ACA and would like to receive medical/dental care at EHC, proceed with the EHC sliding fee/discount process by reviewing proof of income documentation, and assigning correct self-pay sliding fee or discounted level at assigned site
• Work with social services team to complete on-site applications
• Notify patients in advance of expiration date so that updated documentation can be obtained and reviewed prior to appointments
• Utilize EMR messaging and pop-up notes effectively to communicate with clerical team and billing team
• Assist patients/EHC staff in finding/pricing diagnostic studies as needed

Referral Pre-certification Specialist:

• Submit all referral pre-certifications for designated site on time; submit all relevant supporting information such as coding, test results, vital signs.
• Handle stat requests immediately and see through to conclusion
• Communicate with providers when additional information is needed
• Document pre-certification status in chart.
• Support hub clericals with difficult referrals as needed

Clinical and Organizational Support

• Train "floaters" and other staff for adequate clinic coverage
• Ensure compliance with HRSA regulations, ACA and HIPAA law.
• Oversee all additions/edits to referral spreadsheet.
• Submit monthly reports to Director of Social Services (number of person assisted in ACA sign ups} and Practice Administrator (Self-pay and pre-certification statistics}
• Provide front desk help as needed for lunch coverage, start-up, or peak call hours
• Cover CA positions within department if needed
• Recognize critical situations and respond effectively; maintain personal boundaries, taking on responsibility or tasks within limits of personal ability.
• Other duties as directed by supervisor

EDUCATION, KNOWLEDGE, SKILLS, AND QUALIFICATIONS:

• High school diploma or GED
• Extensive experience with Centricity and with the EHC clerical role, insurances, pre-certification program and other EHC clerical department knowledge bases
• Strong analytical skills, with proven ability to problem-solve; proven ability to multi-task well and prioritize well.
• Completion of on-line training for the ACA, achieving certification.
• Ability to track projects and maintain accurate records.
• Ability to communicate professionally in written and verbal form; in Spanish and English.
• Demonstrated ability to maintain confidentiality, trust, and honesty in all transactions
• Solid record of timeliness and reliability in a work setting.
• Demonstrated ability to train others in clerical skills
• Must be able to work during hours when EHC experiences peak phone volume.
• Solid Christian faith; ability to share personal faith in Christ and pray with others in need.
• Able to integrate personal faith in Jesus Christ with work at EHC.

WORKING CONDITIONS

• Must be able to sit at a desk for long periods of time.
• Must be able to read fine print on paper, type and use computer extensively, and use databases.
• Must be able to hear and speak on the phone using a headset and other equipment.