Preferred Access Specialist - Ambulatory Admin - Med Ops

Preferred Access Specialist - Ambulatory Admin - Med Ops

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Job Description

The Preferred Access Specialist reports to the Operations Project Manager and is responsible for coordinating all aspects of key referring physician and priority referrals for Tufts Medical Center and Wellforce affiliates, including NEQCA. Utilizing tools such as the web-based Crimson Medical Referrals, the Specialist will be responsible for improving the process of Physician-to-Physician referrals and ultimately closing the referral loop by improving the coordination of patient care and the exchange of health data. The Preferred Access Specialist will act as a liaison between the referring physicians and the Tufts Medical Center physicians and staff to schedule patient appointments. As Tufts Medical Center continues to develop the network with other community physician groups and hospitals, the Preferred Access Specialist maintains the ‘high touch’ style of customer service. The Preferred Access Specialist must exhibit exemplary communication skills, both written and verbal and have excellent phone etiquette. The Preferred Access Specialist must possess the ability to carry out various tasks and duties under pressure, while demonstrating exemplary patient customer service skills. The Physician Access Specialist must exhibit a willingness to learn and carry out new tasks and projects when required. The Preferred Access Specialist must have the ability to maintain complete confidentiality and privacy with sensitive information.

• Receives, tracks, and closes the loop on patient referrals from referring physicians and key referring stakeholders. Coordinates all aspects of incoming referral requests from tools such as Crimson Medical Referrals for patients needing specialty care and services, including triaging appointment requests, patient intake information, direct and indirect scheduling of appointments with specialists according to established scripting and scheduling protocols, and coordinating multiple, complex needs as requested to make the experience for the patient as easy as possible.
• Facilitates new patient pre-registration and maintains accurate patient demographic data, insurance and eligibility information, and referral data in our scheduling systems.
• Demonstrates working knowledge of insurance concepts and coverage and provides appropriate information to patients on participating and non-participating payors.
• Utilizes information systems/tools, such as Invision/RCO, eClinicalWorks, NEHEN, DaVincian, EMDEON and others to assist with the scheduling and registration processes.
• Instructs patients in preparation of visit by providing any preparation, location and other general information in a professional and courteous manner.
• Maintains in-depth knowledge of all Tufts MC departments’ specialty and subspecialty services and departments. Maintains current and accurate information for each provider in Tufts Medical Center and its community based satellite practices and locations.
• Interacts with Tufts Medical Center physicians, community physicians, community hospitals, nurse liaisons and support staff to resolve problems, ensuring prompt and excellent customer service and customer relations. Maintains excellent working relationships with all parties.
• Communicates issues related to access and customer service with management in order to expedite resolution appointments to requesting referring physicians.
• Exhibits a willingness to solve problems constructively and seeks excellence in the performance of his/her job.
• Participates in the achievement of personal and departmental goals and initiatives.
• Actively contributes to positive morale and teamwork; stays informed and supports changes and initiatives; demonstrates good communication skills, keeps coworkers informed.
• Performs other similar and related duties as required or directed.

Qualifications

• Basic computer literacy including familiarity with word processing, spreadsheet, and database software packages. Experience with Microsoft Office applications (Word, Excel, and Access) required.
• Demonstrates professionalism and excellent ‘high touch’ style customer service skills by going above and beyond for patient care.
• Excellent verbal and written communication skills and possesses excellent phone etiquette.
• Strong understanding of medical terminology; knowledge and familiarity with physical symptoms, diagnoses and procedure coding.
• Strong understanding of health insurance market in the Boston metro area as well as the State of Massachusetts; knowledge of the payers contracted for services for Tufts MC and the PO providers.
• Solid understanding of insurance referral processes.
• Strong ability to work in a self-directed manner with excellent organizational skills.
• Attention to detail.

• Associates Degree or higher preferred, or equivalent work experience in a health care setting.

• Two to three years related experience in insurance, managed care referral processes, private physician’s office practice or hospital registration setting.

An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements.

• Normal office setting.
• Minimal exposure to hazardous waste, blood born pathogens and bodily fluids

Additional Information

All your information will be kept confidential according to EEO guidelines.

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.