Patient Access Coordinator
Steward Health Care System LLC ("Steward") is a fully integrated, physician-led national health care services organization committed to providing the highest quality of care in the most cost-efficient manner in the communities where our patients live.
Steward - the largest privately held health care company in the U.S. - owns and operates 35 community hospitals across nine states, serves over 1,000 distinct communities and employs approximately 40,000 health care professionals. In addition to our hospitals, the Steward provider network includes 4,800 providers, 25 urgent care centers, 87 preferred skilled nursing facilities, substantial behavioral health offerings, over 7,300 hospital beds under management, and approximately 1.5 million full risk covered lives through the company's managed care and health insurance services.
Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, New Jersey, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.
Under the direction of the Program Manager, the Patient Access Coordinator will serve as a patient advocate, liaison, and educator to assist patients with understanding the cost of care and navigating the continuum of care. The candidate will provide services in areas of financial need to patients, families, and the health care team as appropriate. Patients will be provided with health care team education, links to resources and data in support of easing the financial hardship on patients and their families seeking oncological services.
The Coordinator will serve as an expert in insurance verification and eligibility, medical necessity and the attainment of drug authorizations when required by insurance carrier for all medications ordered and administered in the Oncology Program. This applies to all scheduled and emergent patients for any given day. This person serves as a liaison between physicians, clinical team, patients, pharmacies, and contracted insurance plans. This position is responsible for the research of patient eligibility and access to patient assistance programs and community resources to mitigate potential fiscal risk to patient and organization. He/she will work with health insurance providers to determine coverage, benefit limits, and financial responsibility and conveys this information to the clinical team, patient, and family. The Coordinator will be instrumental in obtaining written documentation, tracking, and reporting outcomes of each authorization request. The Coordinator will also be in a position to interface directly with medical staff, pharmacy, financial counselors and billers to ensure a seamless process to the patients receiving outpatient treatments.
The incumbent may have access to highly confidential patient, employee and/or SMG proprietary information, and must handle & protect the information in accordance with SMG and GSMC policies, HIPAA requirements and the highest level of ethical standards. The incumbent is responsible for reporting all security events, potential events, or other security risks to the organization. The incumbent is responsible for participation in and completion of all patient safety initiatives appropriate to the position, and conducts all job responsibilities according to the Mission and Values of Steward Medical Group.
Required Skill, Knowledge and Abilities:
- Listens well and devotes full attention to patients and medical professionals alike
- Is compassionate and caring, as the job involves dealing with people who are critically ill and in active treatment
- Has the ability to remain calm, even under the most stressful of situations
- Communicates well, both orally and in writing
- Is able to switch priorities based upon patient need
- Possesses a basic understanding of medical terminology and procedures
- Is able to maintain confidentiality
- Has a professional appearance and demeanor in order to make others feel more at ease
- Keeps paper and electronic medical records, and updates these records as needed
- Provides information to insurance companies in order to assist with billing
- Refers patients to Infusion Scheduler for checkout, and ensures they have post-treatment instructions if required
- Refers individuals to outside agencies when unable to meet their needs
- Calculates payment information, accepts funds, and credits accounts accordingly
- Strong communication skills, attention to detail, and a high level of organization are critical qualities.
- Possesses a high level of customer service experience and commitment to providing customer service excellence.
- Medical Terminology and experience specific to Oncology and Infusion Services is required.
- Awareness of philosophy of care as it relates to patient financial services.
- Knowledge of commercial and State/Federal insurance preferred. Must be able to operate independently to complete all tasks with minimal supervision.
- Must have good interpersonal skills to interact with individuals in all levels of the practice and the public.
- Must have good organizational skills and be able to manage multiple tasks at the same time.
- Must be accountable for accuracy and timeliness of work.
- Must be trustworthy and committed to confidentiality. Incumbent has access to confidential hospital, patient, and employee financial information.
Job Status: Full Time
Job Reference #: 11943