Operations Access Specialist Pathways Post Acute Brain Injury Program.

Operations Access Specialist

The Operations Access Specialist performs administrative services for an assigned program / location. This role ensures efficiencies, organization, and successful outcomes applicable to role and environment.

Job Responsibilities

• The Ops Access Specialist title is used in multiple departments within Shepherd Center and performs various duties in order to ensure proper functioning as applicable to role and assigned unit.
• Patient Financial Services Summary : Responsible for accurate and timely follow-up and collections of Patient Accounts as assigned. Follows through on assigned accounts until paid in full.
• Mild TBI / Concussion Clinic, Outpatient Registration, Pathways Summary : Performs administrative services for assigned unit to include maintaining efficient office organization; screening and handling incoming telephone calls; managing routine assignments; assisting with special events and projects; and managing patients visits.
• Calls carrier and completes follow-up on all assigned claims not paid within 30 days of initial claim submission.
• Print rebills as necessary to mail or fax in effort to expedite payment.
• Works closely with the PFS supervisor to assure feedback is routed to registration and billing areas as identified.
• Notes all activity in patient notes thoroughly.
• Reviews all EOBs on insurance payments received to assure accurate payment received, accurate charges processed, and contractual allowances posted accurately as time allows.
• Identifies bad debt and charity accounts and forwards to PFS Supervisor for approval.
• Assures all documentation and additional information requested by attorneys, physician offices, insurance carriers, patients, and other external sources, is provided in a timely manner.
• Responds to correspondence and phone messages in a timely manner.
• Keeps abreast of current billing requirements.
• Is proactive in developing solutions or improvements related to the position.
• Notifies management of any unresolved issues, problems related to the position. Resolves accounts per policy and procedure.
• Completes special projects and requests as assigned by management.
• Prints EOB's and Medical Records via ImpactMD as needed
• TBI / CC : -Effectively handles incoming / outgoing phone calls on multiple lines. Information needs of telephone callers are met when possible. If caller cannot be helped, caller is directed to correct source.
• Greets clients, families, and visitors in a friendly and considerate manner. Assists customers in receiving services from appropriate staff member. Assists clients in signing in / out
• Maintains appropriate office supplies. Supply room is kept clean and organized.
• Types all delegated material (graduation certificates, general correspondence, reports, memos, team reports, special assignments, etc.) within a reasonable time frame or by specified deadline.
• Responds promptly to changes in schedule and notifies appropriate parties of changes and assists staff as requested.
• Maintains cleanliness of reception and common areas. Notifies appropriate staff for any needed clean up or repairs in these areas.
• Distributes department mail promptly and accurately. Ensure outgoing mail is sent out daily
• Reviews messages from overnight answering service daily and notifies appropriate staff of client illness / tardiness / out of center.
• Places phone on night service at end of day.
• Ensures all doors to client building and garage are locked each day prior to end of shift.
• Performs special assignments and projects as instructed by supervisor in a timely and thorough manner.
• Organizes work / time effectively and prepares for coverage of Accountabilities during scheduled time off.
• Keeps track of client cancellations, compiles, and types Actual Versus Scheduled Report at the end of every month.
• Completes registration process of all new admissions.
• Maintains confidentiality in all interactions.
• Outpatient : -Schedule outpatient appointments with the appropriate service, professional or disciplines according to established guidelines.
• Schedule appointments for new evaluation, post discharges, follow-up visits, diagnostics, therapy, and counseling appointments.
• Confirm demographic and insurance data when patient is scheduled / registered.
• Return all phone calls regarding scheduling within 24 hours.
• Communicate with physicians and management regarding the changes in schedules, addressing problem / issues effectively.
• Proactive in the overall effective management of the schedules. (e.g. maintain patient wait-list, send confirmation letters, etc.)
• Monitor all computer software maintenance functions related to patient access.
• Collect complete referral intake information on New Patients.
• Complete all steps to schedule and prepare daily appointment packet accurately.
• Confirm, update and / or make copies of insurance cards and patient identification at each visit.
• Obtain "consent to treat" with the signature of responsible party, and ensure it is completed accurately.
• Notify clinical staff immediately, after patient completes registration process
• Follow check-in and check-out process according to policy.
• Complete MSPQ as required during registration.
• Notify Financial Counselors of any benefits that require pre-certification or referral authorization.
• Obtain complete referral information if required.
• Review and respond promptly to all intra and interdepartmental communications, (i.e., staff meetings minutes, attachments, e-mails, P&P, etc.)
• Proactively notify supervisor as appropriate regarding patient complaints, when registration is backed up, when tasks / expectations are not able to be met.
• Perform other duties as assigned by management.
• Accountabilities Pathways : -Maintain efficient office organization, taking inventory and ordering new supplies as needed.
• Greet clients, families and visitors in a friendly and considerate manner; assists customers in receiving services from appropriate staff member.
• Screen and handle incoming telephone calls.
• Assist with special events and projects.
• Complete registration process of all new admissions : obtain consent forms, obtain copy of client insurance card, and take a picture of client.
• Keep track of client cancellations, compiles and types Actual Versus Scheduled Report at the end of every month.
• Type all delegated material (graduation certificates, general correspondence, reports, memos, team reports, special assignments, etc.).
• Distribute department mail and ensure that outgoing mail is sent out daily.

Required Minimum Education

Required Minimum Certification

Required Licensure

Required Minimum Experience

Required Minimum Skills

Preferred Qualifications

Physical Demands

Working Conditions