Job Summary: The Front Desk and Eligibility serve as the first point of contact for patients and play a key role in ensuring a positive patient experience. This position is responsible for performing front desk functions, including new patient registration, patient check-in/check-out, scheduling, insurance verification, and payment collection, while also managing eligibility services such as sliding fee applications, insurance enrollment assistance, and discount program determinations. This role works collaboratively with clinical and administrative teams to maintain efficient patient flow and accurate patient records. The Patient Access & Eligibility Specialist may work at multiple clinic locations as needed and must demonstrate dedication to the mission, vision, and core values of the organization. Essential Job Duties and Functions: - Greet patients and visitors in a professional and courteous manner, serving as the first and last point of contact for the Center.
- Facilitate new patient registration, including collecting and entering complete demographic, insurance, guarantor, and consent information into the electronic health record system.
- Educate new patients on required documentation, office policies, sliding fee program availability, and appointment expectations prior to or at the time of the visit.
- Check patients in and out in a timely manner while maintaining efficient patient flow.
- Schedule appointments and follow-up visits according to provider and clinic protocols.
- Verify and update patient demographic and insurance information in the electronic health record system.
- Determine patient financial responsibility and collect required fees; process and print payment receipts.
- Answer incoming phone calls, assess caller needs, take messages, and route calls to appropriate staff.
- Work closely with clinical staff and triage nurses to ensure patient needs are addressed.
- Operate electronic health record systems and other databases to register patients, update accounts, and perform other patient access functions using two patient identifiers.
- Assist with maintaining accurate patient account records and documentation.
- Support the training of new Patient Access staff as needed.
- Maintain an organized and professional front desk environment.
Eligibility and Enrollment Services - Counsel patients or responsible parties by phone, mail, or in person regarding the Center’s sliding fee discount program, eligibility guidelines, and required documentation.
- Process sliding fee applications and renewals, ensuring completeness and accuracy.
- Communicate with patients regarding missing documentation and follow up on pending applications.
- Notify patients of eligibility determinations by issuing approval or denial letters and membership cards when applicable.
- Enter sliding fee determinations and maintain accurate eligibility information in the electronic health record system.
- Obtain and maintain Certified Application Counselor (CAC) status to assist patients with Marketplace and Medicaid enrollment.
- Provide enrollment assistance for eligible patients applying for Medicaid or Marketplace coverage.
- Manage the Vision Assistance Program, including voucher or coupon distribution when available.
- Maintain strict confidentiality in accordance with HIPAA regulations and organizational policies.
Additional Responsibilities - Maintain professional communication with patients, families, and staff from diverse cultural and socioeconomic backgrounds.
- Demonstrate flexibility to support operations at multiple clinic locations as assigned.
- Perform additional duties as assigned to support Patient Access operations and patient care.
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