Patient Access Specialist

OneOncology; Grand Rapids (MI); On-site; USD 36,000 - 54,000; Full time

Job summary

OneOncology in Grand Rapids seeks a patient access specialist to manage infusion center scheduling, verify insurance, collect co-pays, and coordinate with clinical staff to ensure timely care. The role requires at least 3 years in a medical office, knowledge of insurance benefits and authorizations, and strong organization and communication skills.

A high school diploma or GED is required; ICD-9/10 and CPT coding knowledge is a plus.

Qualifications

• Minimum of 3 years' experience in medical office required.
• Knowledge of insurance benefits, authorization process and contracting also required.
• Must be able to work independently, possess strong organizational and communication skills and to adhere to established goals and deadlines.
• High School Diploma or GED

Responsibilities

• Reception of patients to include arriving patient, collecting co-pay and deductibles due at time of service
• Schedules appointments, including follow-ups, diagnostics, treatments
• Management of incoming phone calls to the center
• Ensure authorizations obtained before treatment; responsible for communicating with clinical staff to ensure no authorizations are missed.
• Coordination of scheduling patients from outside physicians seeking to have their patient serviced at the infusion center for bloods, injections, and chemotherapy; to include pre-registering the patient, contacting patient's insurance company(ies) to obtain schedule of benefits, policy effective date and termination date, if applicable, verifying good authorization, and scheduling the 1st appointment with patient access and booking the infusion chair.
• For all patients scheduled in the infusion center the patient access specialist will provide assistance to the coordinator in checking pharmacy orders based on insurance authorization and communicate with the authorization specialist any discrepancies. The coordinator will also insure that the patient has a valid ONC6 number assigned to them and create one when needed.
• Working as a patient financial counselor as needed by advising patients of programs that we offer and directing the patient to the appropriate party such as the financial navigator for assistance.
• Informs patient of payment policy; Coordinates arrangements for patients needing financial assistance
• Completes summary of payment options for patients; refers patients to Patient Liaison who meet the eligibility requirements to apply for Medicaid.
• Meets with new patients before initial physician consult; obtains and verifies all demographic information, completes comprehensive summary of financial responsibility and payment options
• Responsible for follow-up with patients who need updated demographics, Insurance information, or have an outstanding financial responsibility
• Other duties as assigned by patient access manager
• Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer.

Skills

Medical office experience

Communication skills

Organizational skills

Customer service

Education

High School Diploma or GED

Tools

EHR systems

Job description

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology's mission and vision.

Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.

Job Description:

Role Summary:

Responsible for managing internal and external physician scheduling by providing the highest quality personalized care to all hose the employee encounters. In addition to, checking in infusion patients by following check-in policies and procedures; manages and directs incoming phone calls to the clinic; schedules follow-up appointments, diagnostics and treatments; assist as needed infusion desk coordinator and medical scheduler/Receptionist. The employee shall maintain positive work relationships with other members of the clinic staff and access team to facilitate clinical and financial patient care.

Responsibilities:

• Reception of patients to include arriving patient, collecting co-pay and deductibles due at time of service

• Schedules appointments, including follow-ups, diagnostics, treatments

• Management of incoming phone calls to the center

• Ensure authorizations obtained before treatment; responsible for communicating with clinical staff to ensure no authorizations are missed.

• Coordination of scheduling patients from outside physicians seeking to have their patient serviced at the infusion center for bloods, injections, and chemotherapy; to include pre-registering the patient, contacting patient's insurance company(ies) to obtain schedule of benefits, policy effective date and termination date, if applicable, verifying good authorization, and scheduling the 1st appointment with patient access and booking the infusion chair.

• For all patients scheduled in the infusion center the patient access specialist will provide assistance to the coordinator in checking pharmacy orders based on insurance authorization and communicate with the authorization specialist any discrepancies. The coordinator will also insure that the patient has a valid ONC6 number assigned to them and create one when needed.

• Working as a patient financial counselor as needed by advising patients of programs that we offer and directing the patient to the appropriate party such as the financial navigator for assistance.

• Informs patient of payment policy; Coordinates arrangements for patients needing financial assistance

• Completes summary of payment options for patients; refers patients to Patient Liaison who meet the eligibility requirements to apply for Medicaid.

• Meets with new patients before initial physician consult; obtains and verifies all demographic information, completes comprehensive summary of financial responsibility and payment options

• Responsible for follow-up with patients who need updated demographics, Insurance information, or have an outstanding financial responsibility

• Other duties as assigned by patient access manager

• Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer.

Required Qualifications:

• Minimum of 3 years' experience in medical office required

• Knowledge of insurance benefits, authorization process and contracting also required

• Must be able to work independently, possess strong organizational and communication skills and to adhere to established goals and deadlines

• High School Diploma or GED

Essential Competencies:

• Attendance is an essential job function.

• Manages incoming calls into the Infusion Center by answering the phone within 3 rings professionally and courteously.

• Communication with an Authorization specialist regarding any issues that arise in orders or with changes of orders.

• ICD-9/10 and CPT coding a plus

• Medicare, Medicaid and private-payer practices and regulations

The above job description is a general overview of the responsibilities and competencies for this role at OneOncology. Specific details may vary based on the needs of the organization.