Patient Access Specialist Resume Sample
Garland Cruickshank
349 Rowland Plains,
San Francisco,
CA
+1 (555) 373 3825
Work Experience
Patient Access Specialist
08/2017
-
PRESENT
Detroit, MI
- Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior
- Verifies insurance benefits, medical necessity, and obtains precertification/authorization as necessary. Determines and accepts payments, including co-pays and deductibles, or refers to financial counselors for follow-up
- Experience in front office and computer experience
- Possesses organizational, analytical and critical thinking skills with attention to detail
- Multi task and adapt to technology changes
- Retrieves reservation/notification of scheduled appointments and/or procedure from scheduling system
- Contacts patients with pending appointments and attempts to pre-register for encounter
- Ensures patient has appropriate authorization (if out of network/covered services) for pending services
Patient Access Specialist / Admitting Clerk
05/2011
-
07/2017
San Francisco, CA
- Provides patient accurate estimate of payment due at or before services are rendered
- Adheres to all quality and productivity standards defined by the department
- Collects prepayment for pending services (when applicable) and co-pays as defined by patient insurances for emergency services
- Reconciles the cash activity log
- Follows appropriate policies and procedures in production at each area
- Matches and retrieves appropriate patient from McKesson STAR MPI
- Establishes priorities, meets deadlines, and follows written and verbal instructions
- Follows downtime manual processes with little or no supervision
SSC Patient Access Specialist
03/2005
-
12/2010
Philadelphia, PA
- Interacts with local, state, and federal officers and inmates to identify appropriate payer sources
- Informs patient and/or family of the patient obligation policy
- Determines if reason for visit is work related (workers' compensation claim)
- Maintains accountability for accuracy of data collected and entered into systems and demonstrates the ability to maintain a passing grade on monthly audits
- Reviews daily Financial Counseling verification tickler to secure necessary documents
- Contacts patients by phone if due date is missed to continue to secure necessary documentation
- Assists patients with identifying potential payer sources including charity care
Education
Quinnipiac University
2000 - 2005
School's Degree in Secretarial Science Preferred
Professional Skills
- Cash handling and balancing. Demonstrated professionalism, effective communication skills and active listening skills
- Demonstrated professionalism, effective communication skills and active listening skills
- Demonstrated professionalism, effective communication skills, and active listening skills
- Demonstrate excellent verbal and action related customer service skills to our patients, physicians, visitors
- Proven excellent customer service, communication, verbal and written skills with an emphasis on organization and attention to detail required
- Demonstrates customer service skills, phone etiquette, and ability to meet productivity standards resulting in patient and family satisfaction
- Demonstrated basic telephone skills (transfer, conference, placing a patient on hold)
How to write Patient Access Specialist Resume
Patient Access Specialist role is responsible for customer, interpersonal, medical, insurance, health, technology, telephone, basic, patient, windows.
To write great resume for patient access specialist job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Patient Access Specialist Resume
The section contact information is important in your patient access specialist resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Patient Access Specialist Resume
The section work experience is an essential part of your patient access specialist resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous patient access specialist responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular patient access specialist position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Patient Access Specialist resume experience can include:
- Demonstrate knowledge and skills needed to operate specific equipment
- Excellent customer service skills and organizational management
- Self-motivate and multi-task in an effective manner that includes organizing and prioritizing the work in a timely manner
- Utilize critical thinking skills while working through complex situations
- Hospital admissions/ physicians office experience required or 1-2 years of professional work experience required
- Entry Level with prior work experience
Education on a Patient Access Specialist Resume
Make sure to make education a priority on your patient access specialist resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your patient access specialist experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Patient Access Specialist Resume
When listing skills on your patient access specialist resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical patient access specialist skills:
- Prior healthcare experience and prior experience working with patient eligibility and sponsorship. Registration scheduling experience
- Excellent telephone skills, critical analytical/investigative thinking skills, with an emphasis on exceptional customer service
- Experience with Windows based technology and keyboarding skills required
- Experience with Windows based technology and keyboarding skills
- Computer experience, accurate data entry skills, able to type at least 30 wpm
- Demonstrated basic medical terminology knowledge and/or customer service skill set gained through education/work experience
List of Typical Experience For a Patient Access Specialist Resume
1
Experience For Patient Access Specialist / Admitting Clerk Resume
- Possesses customer service and data entry skills to perform routine tasks
- Define problems, collect data, validate data, establish facts, and draw valid conclusions
- Explain processes and forms to patients prior to securing signatures and ensures that all documents are properly signed and witnessed as required
- Strong knowledge of Patient Access functions and front end billing systems (HMS, SSI, Passport, etc.)
- Two year of experience in customer service or a health related field
- One year of experience in customer service or a health related field
- Medical Terminology with strong focus on Cardiovascular
- Works as a liaison with Centralized Referral Center or assigned entity to ensure prior-authorizations have been obtained to secure payment and prevent denials
- Hospital admissions or physician's office experience required
2
Experience For Senior Patient Access Specialist Resume
- Validates and enters prescription orders
- Perform in-depth research into patient's insurance, prior authorization and appeal requests on behalf of the provider
- Validates licensed practitioners
- Patient placement experience
- Demonstrate basic knowledge of English language in both verbal and written context
- Advanced customer service experience
- Ensuring the quality of patient registrations by obtaining thorough and accurate information in a timely and efficient manner
- Interacting and coordinating with other hospital departments and/or Physician staff to ensure quality care for all patients
- Serving as a patient resource in matters concerning up-front collections based upon covered benefits and in accordance with hospital policy
3
Experience For SSC Patient Access Specialist Resume
- Interviewing the patient/guarantor to obtain complete demographic, clinical, billing, insurance, and financial information
- Maintaining compliance with EMTALA and HIPAA rules and regulations
- Assume leadership role in recommending, implementing and
- Knowledge of payor plans, billing and working unbilled reports
- Ensures adequate staffing during peak times, lunch coverage and staff absences
- Assists with data entry for call quality reporting documentation, training assessments and report preparation
4
Experience For Rehab Patient Access Specialist Resume
- Monitors progress of applications to ensure processing timelines are adhered to via e-mail or Agency Portal to caseworkers/supervisors or Service Center
- Customer and personal service knowledge of principles and processes for providing GREAT customer and personal services
- This includes customer needs assessment, meeting quality, standards for services, and evaluation of customer satisfaction
- Other requirements: CPR required only for staff working in Off-site Rehab Facilities
- Determines and accepts required payments, including co-pays and deductibles, or refers to financial counselors for follow up
- Serves as primary source of information for physicians, patients, and others to the appropriate sites for appointments and cardiac testing requests
5
Experience For Patient Access Specialist PRN Resume
- Read and understand all screens related to complex scheduling
- Schedule appointments according to protocols
- Monitors scheduling activity, identifies workflow issues and makes recommendations to improve efficiencies
- Maintains and reviews scheduling reports for quality checks and correction of errors
- Perform registration for outside imaging
- Friendly and Outgoing
- Adjusts to changing situations and displays positive attitudes towards assignments
6
Experience For Patient Access Specialist Lawrenceville & Duluth Resume
- // Bi-Lingual (Spanish) speaking
- Starts the application process over the phone as part of the Pre-Access process
- Timely submits documentation and application to assigned caseworker, Service Center or uploads to State on-line application web site
- Documents and updates status on a regular basis in STAR and IndeApp
- Maintains confidentiality of patient health information in compliance with HIPAA regulations
7
Experience For Patient Access Specialist Mon-fri Resume
- Meets all productivity and quality requirements of the job
- Distributes and explains forms, documents, and educational handouts to patients or family members
- Verifies insurance benefits and obtains precertification/authorization as necessary
- Serves as a first point of contact for patients and physicians for MLHC, The Lankenau Heart Group and its satellite offices
- Manages a high volume and acuity of incoming phone calls; possesses the aptitude to assess and process a complex array of information which spans the cardiovascular continuum, and disseminates to relevant parties, both clinical and nonclinical
- Provides exceptional and compassionate customer service by developing an understanding of the callers’ needs and concerns
- Schedules physician office visits for new and existing patients, Cardiac Clearance and Cardiac Testing
- Assists in providing the appropriate solutions and scheduling options to meet both the patients’ and the facilities’ needs
- Demonstrates a working knowledge of the various tests, preps, protocols and procedures to efficiently process patients’ requests, and for the proper and timely scheduling of cardiac testing
8
Experience For Patient Access Specialist Per Diem Resume
- Two to three years of patient registration, appointment scheduling, unit clerk, financial counseling or customer service experience in a fast-paced, high volume, high acuity environment required
- Medical Terminology with strong focus on Cardiovascular Human
- Knowledge of insurance payers and Navinet procedures
- Identifies all emergent/urgent admission accounts by pulling standard admission/census reports. Verifies patient demographics, obtains signatures on incomplete consent forms and inquires about other insurance and accident details for urgent/emergent admissions
- Verifies insurance eligibility and benefits on all emergent/urgent admissions to inpatient and observation and determines if an authorization or referral is needed for type of service
- Contacts patient’s family or physician offices to obtain missing insurance information which can include policy number, group number, date of birth and insurance phone number if patient does not have insurance cards during emergent/urgent admission
- Notifies payer of all emergent/urgent admissions to inpatient or observation, communicates clinical requirements and contact information to Care Management department in a timely fashion
9
Experience For Patient Access Specialist Days Thurs Resume
- Documents all communication with patient, payer and Care Management in Meditech notes Identifies all scheduled patient accounts by pulling standard scheduling reports and initiates pre-registration/registration process 4 days prior to service
- Collaborates with Central Scheduling, Ancillary Department Scheduling and Surgery Scheduling to identify add on patients (patient’s scheduled for services less than 2 days from booking date)
- Previous experience with HMS, SSI, Passport or other billing systems highly desired
- Hospital patient accounting systems and billing systems
- Register and activate walk-in, add-on, and emergency room patients by gathering all patient demographic financial and pertinent information
- Refers patients with questions regarding financial liability to appropriate resource(s)
- Processes key documents to facilitate obtaining insurance information
- Accesses information and translates data into information acceptable to the claims processing system
- Maintains all appropriate claim files and follows up on suspended or outstanding claims
10
Experience For Patient Access Specialist Project Based Resume
- Gains a deep knowledge of insurance benefits and understands fully intricacies of third party liability and workers' compensation
- Calculates patient liability and provides estimates, as per state regulations
- Register and activate scheduled patients by gathering all demographic, financial, and pertinent information necessary to meet all regulatory andbilling requirements
- Verify insurance eligibility and benefits for scheduled outpatient and
- Proficiency in Microsoft Office tools (Word, Excel, Outlook, etc.)
- Comprehensive Pre-Registration process for specified departments/modalities due to sensitive nature of patient clinical and/or financial needs and complication of required processes
- Responsible for all patient and claim edits for accuracy and compliance with all government and commercial carriers to ensure a clean claim submission
- Verifies patient identification, demographic information, and insurance coverage
- Accepts point of service payments
List of Typical Skills For a Patient Access Specialist Resume
1
Skills For Patient Access Specialist / Admitting Clerk Resume
- Review prior bad debts and request payment of outstanding prior bad
- Experience: 2-3 years related experience in patient access, registration, patient accounting, or revenue cycle equivalent educational course work
- Experience: 2-3 years related experience in patient acces, registration, patient accounting, or revenue cycle equivalent educational course work
- Experience:2-3 years related experience in patient acces, registration, patient accounting, or revenue cycle equivalent educational course work
- Experience in an office setting requiring customer service responsibilities
- Demonstrates willingness to achieve personal and professional growth resulting in staff development
2
Skills For Senior Patient Access Specialist Resume
- Experience working in a high-volume healthcare environment
- Related experience, in a healthcare or institutional work setting
- Higher education, or equivalent 2 years work experience in healthcare or a professional office setting
- Previous experience working in a Shared Services Model
- Prior authorization assistance and tracking
- One to Two years’ experience in a hospital customer service setting
- Related experience in a healthcare or institutional work setting
- Patient registration or acute care billing experience
- Strong knowledge of MS Office products.
3
Skills For SSC Patient Access Specialist Resume
- Relevant biologics healthcare/ insurance experience
- Six months of office and/or call center, customer service or healthcare experience is required
- Experience with insurance verification and eligibility required
- Two years of recent customer service experience required
- One year of recent healthcare or professional clerical experience required
- Patient access service or patient financial service work experience
- 6+ months related experience, preferably in a healthcare organization
- Perform in-depth research into patient’s insurance, prior authorization and appeal requests on behalf of the provider
- Coordination of patient access experience
4
Skills For Rehab Patient Access Specialist Resume
- Researching and processing insurance claims, including resolving any claim denials or underpayment of claims
- Working with payor plans, billing and unbilled reports in Medhost/HMS
- Typing or data entry competency of at least 40 words/minute
- Verifying patient insurance benefit information
- Working knowledge of health insurance eligibility and liability
- Typing or data entry competency of at least 40 words/ minute
5
Skills For Patient Access Specialist PRN Resume
- Responsible for making, confirming and cancelling appointments for both new and existing patients
- Schedules incoming calls, outgoing calls, and community physician referrals to facilitate scheduling is done in a timely fashion
- Ensures demographic information is updated and registration is completed during scheduling to prevent errors for check-in or back end billing
- Work with Physician, Physician office staff, hospital staff in obtaining and supplying information relative to patient’s admission
- Work independently while realizing limitations of decision-making capabilities
6
Skills For Patient Access Specialist Lawrenceville & Duluth Resume
- Performs cashier functions; obtaining and processing patient payments, co-pays, and deductibles, phone and television charges, and patient remittances
- Knowledge of scheduling templates, insurance verification, hospital billing practices, HIPPA regulations
- Counsels patients regarding non-covered services, obtaining signatures on Advance
- Acts as liaison for patients with staff in the Patient Accounting Office. Answers any question posed by a patient related to a billing or financial issue
- Cash handling and balancing
- JH Community Physicians Central Scheduling Keswick - Baltimore, Maryland
- Monitor Medicaid Pending accounts and provide correct coverage on any accounts
- Knowledge of medical terminology and billing processes
7
Skills For Patient Access Specialist Mon-fri Resume
- Schedules and pre-registers following established policies and procedures to assure accuracy
- Adheres to department policies and procedures and utilizes approved tools in order to provide consistent call handling processes
- Problem solve and multi-task; keep confidences; knowledge of scheduling parameters, insurance concepts and patient registration software
- JHCP Central Scheduling - Keswick
- JHCP Central Scheduling - Keswick - Baltimore, MD
- JHCP Central Scheduling - Keswick location - Baltimore, MD
- Provide site-training to staff
- Responds to and handles all professional calls (MD’s, Pharmacists, Nursing Homes, etc) internally and externally
8
Skills For Patient Access Specialist Per Diem Resume
- Collects demographic and financial data and enters it into the patient’s electronic medical record, meeting regulatory and compliance requirements
- Prepare daily work assignments and staffing
- Modify, update, and maintain the scheduling template for the unit and/or department
- Identifies and evaluates the appropriate funding programs, qualifies the patient, or utilizes outsource eligibility resources
- Transfers patients between facilities, receiving facility transfer information and up/downgrades
- Communicate with physician offices regarding status of authorizations
- Claims assistance, tracking and submission
9
Skills For Patient Access Specialist Days Thurs Resume
- Interaction with Healthcare facilities and facilitate the processing of bulk product orders
- Review billing accounts to verify bills are routed appropriately
- Serve as point of contact for referring physicians and patients
- De-escalate basic situations including patient complaints
- Knowledge of federal, state, local and intermediary specific billing requirements
10
Skills For Patient Access Specialist Project Based Resume
- Manages patient expectations for all scheduled appointments and provides information to patients regarding their visit
- Assists with Onboarding of new associates
- Cross training of current associates
- Understands and adheres to state and federal regulations and system policies regarding compliance, integrity and ethical registration practices
- Completes clinical screening for specified modalities to ensure patient safety
- Complete and/or process patient payments for account posting accuracy
- Responsible for practicing AIDET and all customer/patient related encounters
List of Typical Responsibilities For a Patient Access Specialist Resume
1
Responsibilities For Patient Access Specialist / Admitting Clerk Resume
- Hospital admissions or physicians office experience required or 1-2 years professional work experience required. ·
- Provides a standard registration process across Allina Health System that our customers view as a positive experience
- Establishes working relationship with staff of assigned clinical departments. Understands and correctly applies unique clinical department scheduling protocols
- Coordinate/scheduling complex appointments
- Recognize patient’s level of care needed upon arrival
- Expert knowledge of specialty products, reimbursement for medical and pharmacy benefits, patient access processes and patient assistance programs: operational policies and processes
- Responds to calls including patients, physicians, physicians’ office staff, peers, and determines the urgency of the situation and then suggests appropriate referrals
- Obtains information about patient’s health insurance electronically through the payer websites, and/or by information provided by the patient from the insurance issued identification card
2
Responsibilities For Senior Patient Access Specialist Resume
- Ensure timely, proper and efficient collection of patient demographic information and also update patients’ files regularly
- For patients participating in a clinical trial, appropriately document and review with patients and the payors services being covered by the clinical trial sponsor and those designated for coverage under the patient’s insurance
- Prepares all required patient registration forms, documents, charts and reports, labels, patient plates, identification bands, medical records forms, and other related documents for distribution to appropriate departments, physicians and clinical staff. Notifies clinical department of patient’s arrival
- 8 Ability to work independently, exercising good judgment, and multi-task in a high stress, fast paced service environment with patients, patient’s family and physician’s
- Collects copies of necessary supporting documentation for inclusion in patient’s financial file
- Fluency in Spanish needed!
- Assist in Emergency Room Admission and Front Desk Registration when required
3
Responsibilities For SSC Patient Access Specialist Resume
- Identify department workflow issues and opportunities
- Obtain authorizations for services
- Two or more years in a healthcare role; two or more years in a role equivalent to Patient Service Specialist I or equivalent
- BLS Healthcare Provider certification recommended, not required
- Responsible for completing the entire patient ‘account’ and serve as the patient’s advocate to ensure patient access to appropriate clinical services
4
Responsibilities For Rehab Patient Access Specialist Resume
- Maintain patient access database
- Use departmental policies, procedures and protocols to evaluate and determine the best alternative for the patient as it pertains to all aspects of registration and pre-registration
- Read and understand requisitions, referral and insurance requirements, patient related data and other forms
- Read and understand departmental protocols
- Read and understand written product directions
- 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
- 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
5
Responsibilities For Patient Access Specialist PRN Resume
- 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
- Obtains and verifies patient demographic, insurance and financial information from patient or guarantor including review of patient search functions in database
- Ensures medical necessity compliance by obtaining necessary data, reviewing compliance systems, and communicating information to patient or guarantor prior to service and/or emergent cases date of services
- Ensures that all related scheduling applications are complete and updated through functional design team
- Prepares reports for multidisciplinary team and management including referral information, insurance reimbursements, charges and patient financial disposition
- Registers patients presenting for visits. Explains the registration process to patients and responds to patient questions
- Ensures all notifications and authorizations are completed within the required time frames
- Consults with health care payor plans for authorizations
6
Responsibilities For Patient Access Specialist Lawrenceville & Duluth Resume
- Screens and qualifies patients for charity care
- Communicates insurance eligibility and benefits to patient or guarantor
- Prepares for scheduled, emergent, urgent and add-on outpatient services, surgical services and procedures by ensuring that necessary demographic information, physician admit orders, equipment, instruments and supplies are captured/available and ready for use
- Handles unexpected scheduling events
- Ensures changes are made to the system to include communication to management and appropriate staff
- Serves as the financial representative on the multidisciplinary team
- Participates in patient discharge process
- Performs completion of registration, to include financial summary counseling and patient education as it relates to insurance/third party payer information, applicable funding, or charity programs
- Manages and facilitates complex change management activities using change readiness and change management processes including organizational assessment, communication, training, hand-offs and implementation
7
Responsibilities For Patient Access Specialist Mon-fri Resume
- 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
- 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
- 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
- Perform in-depth research into patient’s insurance, prior authorizations and appeals requests on behalf of the provider
8
Responsibilities For Patient Access Specialist Per Diem Resume
- Assures a neat, orderly registration desk and patient waiting area, securing all confidential patient information
- Ensure timely processing and resolution of complex cases
- CPR- required- within 30 days of hire
- Provides advanced services to patients, providers and caregivers. Services could include but not limited to
- Manage day to day activities of health care provider support requests across multiple communication channels (Phone, Fax, Chat, e-mail, etc.)
9
Responsibilities For Patient Access Specialist Days Thurs Resume
- Serve as a resource for Health Care Providers and patients and use regional reimbursement, distribution and payer policy expertise to provide solutions for patient access situations
- Master of all standard and advanced services and willing to perform them as needed for the good of our patients
- Healthcare or healthcare reimbursement experience and possess a high level of proficiency in all aspects of reimbursement and access (i.e. benefits investigations, specialty pharmacy distribution, private and public payer reimbursement policies and procedures, etc.)
- Expert knowledge of specialty products and reimbursement for medical and pharmacy benefits
- Obtain authorizations for surgical and radiology procedures
- Collect payments for inpatient and ambulatory procedures
- Two years in a healthcare or related customer service field
- Benefit verification result call
- Advanced alternate coverage research
10
Responsibilities For Patient Access Specialist Project Based Resume
- Establishes themselves as regional experts regarding payer trends and reports any reimbursement trends/delays to management team (e.g. billing denials, claim denials, pricing errors, payments, etc.)
- Processes any necessary correspondence
- Work is routine and requires moderate problem resolution
- Completes work with limited autonomy
- Works under supervision or under defined procedures
- Accurately enters application data for approval, denial or rejection
- Communicates with patients, HCPs, and healthcare professionals in a professional manner
- Communicates with internal and external departments to facilitate coordination of care
- Completes calls in a timely and quality driven manner
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