Patient Access Associate Specialist

About the Role

We are searching for the next Patient Access Specialist champion. This role 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.

Responsibilities

• Assign accurate MRNs, complete medical necessity / compliance checks, provide proper patient instructions, collect insurance information, receive and process physician orders, and utilize an overlay tool while providing excellent customer service as measured by Press Ganey.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable, adhering to policies and providing excellent customer service with the appropriate level of compassion.
• Be held accountable for point of service goals as assigned.
• Utilize quality auditing and reporting systems to ensure accounts are corrected, including accounts for other employees, departments, and facilities; conduct audits of accounts and assure that all forms are completed accurately and timely to meet audit standards; provide statistical data to Patient Access leadership.
• Pre-register patient accounts prior to patient visits, including inbound and outbound calling to obtain demographic, insurance, and other patient information, including patient financial liabilities, point of service collections, and past due balances with payment plan options.
• Explain general consent for treatment forms to the patient/guarantor/legal guardian, obtain necessary signatures and witness names; explain and distribute 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.
• Review eligibility responses in insurance verification system, appropriately select applicable insurance plan code, and enter benefit data to support POS (Point of Service Collections) and billing processes for a clean claim rate.
• Accurately screen medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of tests and distribute the ABN as appropriate; distribute and document other designated forms and pamphlets.

Qualifications

• High School Diploma/GED required.
• 1+ years of customer service experience.
• 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.
• CRCR certification required within 9 months of hire (company paid).

Pay and Schedule

This position pays between $17.00 - $18.15/hr based on experience. This is a part-time onsite role at Mercy - Clermont Hospital in Batavia, OH, with a schedule of 7pm-7am and 1pm-1am (3 weekends on, then one off; during the off week, hours scheduled would be during the week).

Benefits

• Bonus incentives
• Paid certifications
• Tuition reimbursement
• Comprehensive benefits package designed to support physical, emotional, and financial health, including healthcare, time off, retirement, and well-being programs
• Quarterly and annual incentive programs for employees who go beyond expectations
• Professional development with certification and tuition reimbursement