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USA

Access Center Specialist II- Ortho

Wilmington - Delaware (DE), 19801

Nemours

Job Description:

As one of the nation’s leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children – even those who may never enter our doors – through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own.

The Access Specialist II communicates with patients/providers via telephone to ensure accurate, prompt and courteous scheduling of specialty appointments according to established division guidelines. This position is responsible for obtaining and entering accurate demographic and insurance information for all encounters. The Access Specialist II is required to discuss financial obligations with patient families and collect when appropriate. The Access Specialist II is responsible for monitoring registration and insurance related items that fall into patient work queues to ensure timely claim filing. This role works collaboratively with medical secretaries and department managers to ensure all patients’ access needs are met. The Access Specialist II is required to provide superior customer service to both internal and external customers, and represent Nemours in a positive, professional manner. They are responsible for demonstrating a commitment to service, organization values, and professionalism through appropriate conduct and demeanor at all times.

This is a Part-Time 20 hours a week posting.

Essential Functions:

The Access Specialist II communicates with patients/providers via telephone to ensure accurate, prompt and courteous scheduling of specialty appointments according to established division guidelines. This position is responsible for obtaining and entering accurate demographic and insurance information for all encounters. The Access Specialist II is required to discuss financial obligations with patient families and collect when appropriate. The Access Specialist II is responsible for monitoring registration and insurance related items that fall into patient work queues to ensure timely claim filing. This role works collaboratively with medical secretaries and department managers to ensure all patients’ access needs are met. The Access Specialist II is required to provide superior customer service to both internal and external customers, and represent Nemours in a positive, professional manner. They are responsible for demonstrating a commitment to service, organization values, and professionalism through appropriate conduct and demeanor at all times.


Promptly answers incoming calls to schedule appointment for patients; makes outbound calls when follow-up is needed. Provide a smooth transition for all internal and external customers by utilizing excellent customer service skills and effective communication. Ensures efficient processing and documentation of all information required for insurance verification, registration and billing in the Electronic Medical Record (EMR) system. Schedule patient appointment according to established division guidelines and communicate updates and barriers in a timely manner. Ensure urgent diagnosis and appointments are handled with priority and escalation processes are utilized when necessary. Verify insurance eligibility and authorizations utilizing the available resource tools. Utilize the Managed Care Manual to verify participating insurances and their requirements. Inform the caller of their financial responsibility that is due at the time of service/offer to collect in advance at the time of scheduling and ensure accurate daily cash reconciliation. Adhere to the authorization process by informing the caller that an authorization is needed (if applicable) at the time the appointment is made. Refer patients to the Financial Advocates if financial assistance is needed. Educate the callers on the preparation for the appointment or requirements needed to ensure a productive visit. Accurately notate the patient’s accounts to communicate pertinent information to clinic, registration, authorization, family financial, and billing departments. Request medical records when necessary. Review work queues on a daily basis, make corrections and/or escalate to leadership if necessary. Respond to and complete staff message. Provide support for Cancelled Clinic requests. Review and take the necessary action to ensure patient scheduled appointments are accurate. Always offer specific directions to the clinic and location that they will be seen. Stay up-to-date of appointment scheduling changes and insurance requirements. Interact with coworkers and clinic personnel in a professional manner. Communicates effectively with patients, physicians and/or other departments regarding delays or any issues relating to patient appointments. Consistently achieve team metric standards and expectations. Maintains strict confidentiality at all times. Positively support mission, vision and values of Nemours. Brings forth any compliance/ethic issues and recommendations for operational improvement. Ensures successful adherence to policies, procedures and changes to the organization. Additional miscellaneous duties and responsibilities, as may be assigned from time to time by employee’s supervisor. Demonstrate reliability in daily work practices with a clear understanding of Nemours policies and procedures. Other duties as assigned.

Offer process improvement suggestions and participate in Daily Management Systems (DMS). Special projects and CI activities. Participate in engagement and team activities. Assist with training new associates. Cross train and provide support to other access areas.

Excellent customer service skills. Proficient computer software skills in the MS Office Suite. Must be familiar with personal computers and have excellent and accurate typing skills. Must be able to work in multiple applications/screens. Excellent telephone etiquette and communication skills. Strong knowledge of Health Care Plans and verification methods preferred. Attention to detail. Sets priorities; makes constructive suggestions and thinks proactively; recognize the importance of process and systems and strives to improve them employing the Continuous Process Improvement methodology. Ability to communicate and document accurate and complete information both verbally and written. Meets deadlines and completes work in a timely manner. Builds and fosters professional relationships with internal and external customers. Communicates effectively with providers, patient families, and other team members. Maintain strict confidentiality. Demonstrate reliability through work performance and attendance. Demonstrate ability to organize and prioritize responsibilities. Demonstrate positive attitude and ability to get along with others. Ability to be a pro-active thinker. Accepts and gives feedback and asks clarifying questions when uncertain. Ability to work independently with little supervision while meeting performance standards. Facilitates team approach and shows willingness to adapt and accept on-going change.

Additional Requirements:

High School Diploma

1-3 years of job related experience.

Position hours:

Monday required

Tuesday preferred

Other days negotiable

Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique “Bridge to a Healthy Future” pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.

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