Senior Patient Access Specialist

CAREER OPPORTUNITY OFFERING:

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement

• This position pays between $18.65 - $19.90/hr. based on experience

**This position is an onsite role at Mercy - St Rita's Medical Center in Lima, OH**

The Senior Patient Access Specialist is responsible for performing admitting duties for all patients admitted for services at the hospital. They are responsible for performing these functions while meeting the mission and goals of the organization and all regulatory compliance requirements. The Representative will work within the policies and processes as they are being performed across the entire organization.

• Patient Access staff are responsible for assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving and processing physician orders, and utilizing a overlay tool while providing excellent customer service as measured by Press Ganey. Operates the telephone switchboard to relay incoming, out-going and inter-office calls as applicable. They are to adhere to policies, and provide excellent customer service in these interactions with the appropriate level of compassion. Patient Access staff will be held accountable for point of service goals as assigned.

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• Senior Patient Access Specialist staff are responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities. Conducts audits of accounts and assures that all forms are completed accurate, timely to meet audit standards and provides statistical data to Patient Access leadership.

• Senior Patient Access Specialist Staff are responsible for the pre-registration of patient accounts prior to patient visits. This may include inbound and outbound calling to obtain demographic, insurance, and other patient information including the patient financial liabilities including collecting point of service collections as well as past due balances including payment plan options.

• The Senior Patient Access Specialist Staff explains general consent for treatment forms to the patient/guarantor/legal guardian, obtains necessary signatures and witnesses name. Explains and distributes patient education documents, such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and all forms implemented for future services.

• Reviews eligibility responses in insurance verification system and appropriately selects the applicable insurance plan code, enters benefit data into system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate.

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• Responsible for accurately screening of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate. Responsible for distribution and documentation of other designated forms and pamphlets.

Employment Qualifications:

• Certified Healthcare Access Associate (CHAA) and or CRCR, Certified Revenue Cycle Representative. (Company Paid)

Other Preferred Knowledge, Skills, and Abilities:

• 2 Year/ Associates Degree
• Preferred Minimum Education - Specialty/Major: Healthcare administration, business administration, or related field.
• Minimum Years and Type of Experience: 2-3 years of experience in patient access or leadership role.
• Other Knowledge, Skills and Abilities Required:
• Understanding of Revenue Cycle including admission, billing, payments and denials. Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits verification. Knowledge of Health Insurance requirements. Knowledge of medical terminology or CPT or procedure codes
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.