With a greatly expanded, broader role, different expertise, including “people skills,” has become important for patient access. Patient access leaders share their must-have abilities:

Conflict management. How have you managed conflict with a patient, co-worker, or supervisor? Patient access applicants at St. Joseph’s Wayne Hospital and St. Joseph’s Regional Medical Center in Paterson, NJ, always field this question.

“This lets us know how the candidate views the work environment, and how they problem-solve,” says Sandra N. Rivera, RN, BSN, CHAM, director of patient access.

Candidates usually give an example of a conflict they experienced at their current job, such as handling a patient’s anger over a copay question. “We are looking for how they describe the issue,” Rivera notes.

A good response? The applicant listened carefully to the patient, did their best to help the patient, and involved a supervisor if needed. A concerning response? The applicant blamed the issue on staffing problems, or shifted the blame to someone else.

Managing conflict is a top priority for patient access leaders at Beaumont Hospital-Royal Oak (MI), too. “We look for examples that they took action to defuse the situation, that there was resolution, and that they learned from the experience,” says Suzanne Sharron, director of patient access and registration.


When searching for information about conflict management, hiring managers can ask questions such as:

  1. Tell me about a time with a customer that, looking back, you wished now you had handled differently. What happened and what was the outcome?
  2. Tell me about a time you had a conflict or difference of opinion with a co-worker or manager. How did it turn out?
  3. Please describe the most stressful work situation you have been involved in. How did it play out?
  4. What irritates you about other people? How do you deal with it?

“Good responses include situations with an angry patient where [the applicant was] able to hold their temper, focusing on key facts, empathizing, and remaining calm,” Sharron notes.

To improve conflict management skills in patient access staff, new hires participate in role-playing exercises. “Our educators act as angry patients or co-workers,” Sharron says. Common scenarios include: a hostile patient who has been waiting 10 minutes to register, a patient who works in the healthcare field telling hospital employees they’re not doing a good job or how to do things better, and an impatient family member complaining that parking was too far away.

People skills. “It is important that you have friendly, caring, personable staff that are not afraid or mean when speaking to patients about these difficult topics,” says Tracey Shetter, CHAM, manager of enterprise patient access call centers at WellSpan Health in York, PA.

Not everyone is cut out to interact with patients. “There are people who are best suited to work behind the scenes,” Shetter notes.

As the “face” of the organization, patient access needs “a strong passion for people and their care,” says Selena R. Wynn, MBA, CHAA, manager of revenue management at Emory Healthcare in Atlanta. Primary duties for patient access entail a great deal of in-person contact, including scheduling, registration, financial counseling, precertification, and collections.

“Working in this field can become very overwhelming from time to time,” Wynn laments. Patient access staff need to show empathy to people who often are ill, tense, or anxious about their health or their finances.

“My experience in leadership has changed my whole perception about the hiring process,” Wynn reports. Surprisingly, the best recruits are those with minimal healthcare experience. Much more important? An extensive customer service background and eagerness to learn.

“While you can train on a particular skill set, you want to make sure their character is a good fit for the position in such a diverse working environment,” Wynn adds.

Familiarity with legislative changes. “A great example is observation,” says Kim Horoski, MBA, department head of patient access at Brookhaven Memorial Hospital Medical Center in Patchogue, NY. It wasn’t enough for patient access staff to understand the process of classifying a patient as observation in the system; staff also needed to be familiar with the consent forms for observation.

“That was still not enough,” Horoski says. “They needed to be fluent in the reason for observation.” This becomes important to ensure the claim isn’t denied. Staff also needed to explain to patients what observation status means in terms of their coverage. “Patients will ask questions of that nature. That is inevitable,” Horoski adds.

Horoski has found patient access training in a quickly changing healthcare environment needs to be “more robust.”

You should be creating a manual that can be a living document, changing as the healthcare climate adapts,” she offers. Staff need to be familiar with the Patient’s Bill of Rights and any other hospital signage.

To address escalating training needs, Horoski created a mentor program. “It helps to build a bond with someone in the department who can be the shoulder to cry on during difficult times and a hand when help is needed,” she says.