EDUCATION & EXPERIENCE:

Minimum Qualifications:

• Associates degree and one year of clerical or customer service experience. An equivalent combination of education and experience relevant to the role may be considered for this position.

Preferred Qualifications:

• Insurance verification experience.
• EPIC experience.

LICENSES, REGISTRATIONS OR CERTIFICATIONS:

Required:

For departments reporting under Health System Ambulatory Operations, a valid Basic Life Support (BLS) certification must be obtained within 90 days of hire. Certification must be maintained for the duration of their employment in this position.

JOB SUMMARY:

The Patient Services Specialist II has advanced Patient Services Specialist skills and is proficient in independently maintaining a positive patient experience by consistently exceeding expectations in customer service and patient care, by coordinating clerical and medical activities of a healthcare team, patient registration activities and facilitating access to UTMB services for new and returning patients.

ESSENTIAL JOB FUNCTIONS:

Lead Responsibilities:

• Ability to function as a team leader.
• Provides peer guidance and leadership.
• Able to effectively triage problems.
• Understand clinic flow to maximize clinic usage to meet patient needs.

Customer Service:

• Provides high level customer service in all interactions with internal and external customers.
• Provides direct, professional, and knowledgeable interactions with patients, physicians, referral sources, and the treatment team.
• Answers calls accurately and with exceptional customer service at all times.
• Ensures callers needs are met and accurate information is obtained.
• Ensures calls are documented and triaged appropriately ensuring patient satisfaction and patient safety. Completes telephone encounter process if appropriate.
• Acts as patient advocate and liaisons with various departments to meet mutual goals.
• Maintains patient confidentiality regarding access to patient and other clinical information via email, computer, fax and mail.
• Addresses concerns of patients, provides service recovery, and escalates issues as needed.

Scheduling:

• Applies the policies of the clinical entity to schedule appointments.
• Coordinates financial counseling for day surgery.
• Completes reminder calls to patients for scheduled appointments.
• Educates patient/responsible parties regarding billing process and any additional financial responsibilities including third party benefits information.
• Provides out of pocket cost estimates to patients.
• Counsels patients about unpaid bills.
• Obtains future appointments at time of service for clinic follow-up, referrals, and ancillary services.

Arrival:

• Arrives patients and prepares paperwork/chart for visit.
• Appropriately receipts all monies collected, tokens distributed, and deferments authorized.

Registration:

• Verifies, ensures eligibility, and pre-registers patients by obtaining patient demographics and third-party coverage(s) at every encounter.
• Obtains and documents information required for third party reimbursement.
• Ensures compliance with Medicare and third-party coverage.
• Communicates with patient, referral source, UTMB physician and clinical staff regarding any obstacle to access or authorization.

Disposition:

• Fully dispositions each patient within the designated timeline.

Marginal or Periodic Functions:

• Performs related duties as required.
• Adheres to internal controls established for department.
• Reads all OSA Announcements and relevant communications relating to job duties.
• Successfully completes competency-based training and testing on an annual basis.
• Prioritizes and completes all work in an accurate, effective, and efficient manner.
• Locks office and secures files containing money or confidential information when away from workstation.
• Properly disposes of printed patient information, logs off computer when leaving workstation and keeps passwords confidential.
• Participates in team meetings/activities and supports the philosophy and goals of the team/department.

KNOWLEDGE/SKILLS/ABILITIES:

• Proficient in use of PC with experience in Excel, Word, and database management packages.
• Analytical and ability to collect and trend data.
• Knowledge of patient care and patient problems.
• Excellent human relations and written and oral communication skills.
• Ability to problem-solve.

WORKING ENVIRONMENT/EQUIPMENT:

• Standard hospital, clinical, and/or office environments.
• Standard office equipment.

SALARY RANGE:

Actual salary commensurate with experience.

WORK SCHEDULE:

On-site, full-time, 40 hours per week. Work location is Galveston with possibility to float to other sites as needed.