Lahey Health Patient Access Specialist in Burlington, Massachusetts
Welcome to Lahey Hospital & Medical Center, part of Beth Israel Lahey Health. Lahey Hospital & Medical Center is a world-renowned tertiary medical center known for its innovative technology, pioneering medical treatment and leading-edge research. A teaching hospital of Tufts University School of Medicine, the hospital provides quality health care in virtually every specialty and subspecialty, from primary care to cancer diagnosis and treatment to kidney and liver transplantation. It is a national leader in a number of health care areas, including stroke, weight management and lung screenings, among many others. Lahey also helps to advance medicine through research and the education of tomorrow's health care leaders.
About the Job
Responsible for ensuring that the patient experience in accessing healthcare at LHMC is efficient and welcoming, and that patient confidentiality is respected and patient safety is preserved. Ensures that all proper patient financial and demographic information is obtained and processed so LHMC is fully reimbursed for clinical services provided.
Essential Duties & Responsibilities including but not limited to:
Initiates patient scheduling activities by prioritizing and accessing a variety of sources, including patient phone calls, orders, recall lists, scheduled order work queues and MyChart.
Utilizes a variety of information sources to schedule, reschedule and cancel patient appointments. Information sources include online questionnaires, offline materials and subgroup searches.
Establishes working relationship with staff of assigned clinical departments. Understands and correctly applies unique clinical department scheduling protocols.
Remains current on scheduling protocols and applies judgment, or seeks management assistance, to ensure safe patient care when clinical department scheduling protocols do not meet patient needs.
Ensures all required key patient scheduling and registration information is captured and verified. Key information includes referring physician information, insurance coverage, demographics and contact information.
Identifies and communicates to Patient Access management issues that may impact the timeliness and accuracy of patient appointments and subsequent patient care.
Efficiently registers patients, capturing and verifying all required information in order to identify the patient, contact the patient, and receive proper reimbursement for services on initial claim submission.
Ascertains, creates and assigns the guarantor for each patient, including personal/family relations, workers compensation insurance, third parties, behavioral health or others as required.
Identifies, records and verifies patient insurance coverage using real time eligibility (RTE); reviews the insurer’s response to each verification request and takes appropriate action based on this response.
Applies the appropriate guarantor and insurance to each patient visit.
Communicates financial clearance status to patients. Advises patients of self-pay status and payment responsibility and schedules patients with Financial Counseling as needed.
Registers patients presenting for visits. Explains the registration process to patients and responds to patient questions.
Processes patient co-payments, co-insurance, deductibles and balances due. Safeguards cash, checks and receipts and reconciles cash drawer at end of each business day. Assists patients with Kiosk check-in as needed.
Completes the Medicare Secondary Payor Questionnaire for each patient and adjusts patient coverage based on results.
Instructs patients and obtains signatures on consent forms, financial forms and other documents required by the clinical department; distributes documents to patients; scans, processes and records receipt of all documents collected during registration encounter.
Counsels patients regarding non-covered services, obtaining signatures on Advance Notice Beneficiaries (ABNs) and waivers.
Monitors patient waiting area for a smooth, efficient registration flow. Advises patients of potential delays and takes steps to ensure a pleasant patient experience.
Completes registrations on inpatient units who may be missing information from their original registration.
Responds to patient concerns and potential patient safety issues accordingly. Recognizes health conditions that are a possible risk to others and adheres to appropriate established procedures to help contain risk.
Assures a neat, orderly registration desk and patient waiting area, securing all confidential patient information.
Maintain strict adherence to the Lahey Health Confidentiality policy.
Incorporate Lahey Health Standards of Behavior and Guiding Principles into daily activities.
Comply with all Lahey Health Policies.
Comply with behavioral expectations of the department and Lahey Health.
Maintain courteous and effective interactions with colleagues and patients.
Demonstrate an understanding of the job description, performance expectations, and competency assessment.
Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.
Participate in departmental and/or interdepartmental quality improvement activities.
Participate in and successfully completes Mandatory Education.
Perform all other duties as needed or directed to meet the needs of the department.
High school degree or equivalent
Licensure, Certification & Registration :
Prior experience in a business setting providing customer service, while processing and verifying electronic demographic, financial or other business-related information and data.
Skills, Knowledge & Abilities :
Able to work successfully in a fast-paced, multi-task environment, where some independent decision making is necessary. Able to process electronic information and data accurately and efficiently.
40 Hour / Day
Beth Israel Lahey Health is d edicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve. Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health. Beth Israel Lahey Health Performance Network is a unified joint contracting and population health management organization, jointly governed by participating physicians and hospitals.
Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.
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