Patient Access Quality Specialist

Patient Access Quality Specialist

Health Partners of Western Ohio

Schedule: Monday - Friday 8:00am-4:30pm, No weekends

POSITION PURPOSE

The Patient Access Quality Specialist ensures high-quality performance and compliance within patient access operations. The Patient Access Quality Specialist focuses on auditing, monitoring, and improving patient access processes, including registration accuracy, insurance verification, scheduling, information services, and patient experience. The specialist provides data-driven insights, collaborates with teams to implement improvements, and ensures adherence to organizational and regulatory standards.

BENEFIT OFFERED:

• Paid Time Off (PTO)
• Insurance (Medical, Dental, and Vision)
• Paid Holidays
• 403b Retirement with up to 8% match (starts at 3% and increases with time of service at HPWO)
• Tuition Reimbursement
• Training Opportunities
• Eligible to apply for the Emerging Leaders Program after 1 year of Employment
• Annual Raises
• Employee Assistance Program

QUALIFICATIONS

EDUCATION/CERTIFICATION: Associate's Degree and at least three years of previous experience with healthcare scheduling protocols and/or billing practices.

REQUIRED KNOWLEDGE: Successful completion of in-house training.

EXPERIENCE REQUIRED: Three years of previous experience with billing practices and healthcare scheduling protocols.

SKILLS/ABILITIES:

• Strong organizational skills.
• Sharp critical thinking skills.
• Analytical capabilities.
• Strong and effective leadership skills.
• Proven capability to make decisive and effective decisions.
• Presentation and educational skills.

ESSENTIAL FUNCTIONS AND BASIC DUTIES:

• Conducts regular audits of patient access functions such as registration, scheduling and insurance verification.
• Reviews documentation for accuracy, compliance, and completeness.
• Generates quality performance reports and metrics.
• Analyzes data on patient access functions.
• Evaluates patient and provider feedback related to patient access services.
• Identifies errors and inefficiencies and implements performance improvement methodology to address identified issues.
• Develops and delivers targeted training based on quality reports and audit findings.
• Works with teams to address and resolve patient concerns regarding registration, scheduling, or insurance issues.
• Trains new Center Receptionists on workflow and Electronic Health Record.
• Collaborates with staff to implement process changes that enhance efficiency and patient satisfaction.
• Partners with cross-functional teams, including patient access, revenue cycle, and clinical, nursing, and quality to streamline workflows.
• Collaborates with external customers, including payers, to maintain relationships, analyze provided data to identify areas for improvement, gather feedback, and implement actions to enhance performance.
• Recognize and advocate for the critical role of patient access team members, emphasizing its' impact on relationships with both internal and external customers.
• Acts as a resource and advocate for quality improvement initiatives.
• Committed to patient advocacy and dedicated to promoting equitable access to care
• Communicates effectively with others on issues, data, procedures, and resolutions related to patient access.
• Maintains knowledge base in coding, billing, and Federally Qualified Health Center billing procedures.
• Meets patient experience goals and expectations related to patient access.
• Maintains strictest confidentiality.
• Travels to all Health Partners' locations, as necessary.
• Demonstrates ability to manage change and assists others within the organization to navigate changes.
• Performs other duties as assigned.

WORK ENVIRONMENT

Work is primarily sedentary, demanding sitting, walking, lifting, and bending. Those physical movements and the degree of mobility, manual dexterity, and hand-eye coordination commonly associated with duties in an office setting will be performed repetitively. This also includes bending, twisting, reaching, lifting, pulling, pushing, and walking. The ability to distinguish letters and symbols and utilize telephones, computer terminals, fax machines, and copiers is required. The work environment characteristics described here represent those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions. Working under stressful conditions, as well as irregular hours, may be required.