As one of the nation’s leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children – even those who may never enter our doors – through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own.
The Access Specialist II communicates with patients/providers via telephone to ensure accurate, prompt and courteous scheduling of specialty appointments according to established division guidelines. This position is responsible for obtaining and entering accurate demographic and insurance information for all encounters. The Access Specialist II is required to discuss financial obligations with patient families and collect when appropriate. The Access Specialist II is responsible for monitoring registration and insurance related items that fall into patient work queues to ensure timely claim filing. This role works collaboratively with medical secretaries and department managers to ensure all patients’ access needs are met. The Access Specialist II is required to provide superior customer service to both internal and external customers, and represent Nemours in a positive, professional manner. They are responsible for demonstrating a commitment to service, organization values, and professionalism through appropriate conduct and demeanor at all times.
Promptly answers incoming calls to schedule appointment for patients; makes outbound calls when follow-up is needed. Provide a smooth transition for all internal and external customers by utilizing excellent customer service skills and effective communication. Ensures efficient processing and documentation of all information required for insurance verification, registration and billing in the Electronic Medical Record (EMR) system. Schedule patient appointment according to established division guidelines and communicate updates and barriers in a timely manner. Ensure urgent diagnosis and appointments are handled with priority and escalation processes are utilized when necessary. Verify insurance eligibility and authorizations utilizing the available resource tools. Utilize the Managed Care Manual to verify participating insurances and their requirements. Inform the caller of their financial responsibility that is due at the time of service/offer to collect in advance at the time of scheduling and ensure accurate daily cash reconciliation. Adhere to the authorization process by informing the caller that an authorization is needed (if applicable) at the time the appointment is made. Refer patients to the Financial Advocates if financial assistance is needed. Educate the callers on the preparation for the appointment or requirements needed to ensure a productive visit. Accurately notate the patient’s accounts to communicate pertinent information to clinic, registration, authorization, family financial, and billing departments. Request medical records when necessary. Review work queues on a daily basis, make corrections and/or escalate to leadership if necessary. Respond to and complete staff message. Provide support for Cancelled Clinic requests. Review and take the necessary action to ensure patient scheduled appointments are accurate. Always offer specific directions to the clinic and location that they will be seen. Stay up-to-date of appointment scheduling changes and insurance requirements. Interact with coworkers and clinic personnel in a professional manner. Communicates effectively with patients, physicians and/or other departments regarding delays or any issues relating to patient appointments. Consistently achieve team metric standards and expectations. Maintains strict confidentiality at all times. Positively support mission, vision and values of Nemours. Brings forth any compliance/ethic issues and recommendations for operational improvement. Ensures successful adherence to policies, procedures and changes to the organization. Additional miscellaneous duties and responsibilities, as may be assigned from time to time by employee’s supervisor. Demonstrate reliability in daily work practices with a clear understanding of Nemours policies and procedures.
Education: High School Diploma, Associates Degree preferred
Experience: Customer service required, call center preferred
Insurance and scheduling experience preferred
EPIC or other EMR knowledge a plus
This position will be 12 hours a week or 24 hours a pay period, with hours alternating each week.
One week will be Monday & Tuesday 8 a.m. – 2 p.m. and the second week will be Monday 8 -2, Tuesday 11 – 2, and Wednesday 11 -2.
Individual must be flexible, as hours/days are subject to change based on business needs.
Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique “Bridge to a Healthy Future” pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.
Nemours is committed to improving the health of children. As a non-profit children’s health organization, we consider the health of every child to be a sacred trust. Through family-centered care in our children’s hospitals and clinics in Delaware, New Jersey, Pennsylvania and Florida, as well as world-changing research, education and advocacy, Nemours fulfills the promise of a healthier tomorrow for all children — even those who may never enter our doors. Nemours began more than 70 years ago with the vision of Alfred I. duPont to improve the lives of children and to do whatever it takes to prevent and treat even the most disabling childhood conditions. Today, through our children’s hospitals and health system, we directly care for 250,000 children annually in Delaware Valley and Florida, including families who travel from across the country and world to see our specialists — treating every child as we would our own. We also reach beyond the walls of our hospitals and clinics to be a voice for children on a national and international level, and to lead the way in prevention, intervention, education, and research. Nemours is growing to better serve the children and families in our ca...re. We have 1.1 million square feet of space currently devoted to providing children’s healthcare or under construction, all designed with significant input and advice from our patients and families.