Senior Patient Access Specialist
O.N.E Purpose
Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
The Opportunity
Career Opportunity Offering: Bonus Incentives, Paid Certifications, Tuition Reimbursement, Comprehensive Benefits, Career Advancement
Pay: Between $18.65 - $19.90/hr. based on experience
Schedule: Full Time 8am-4:30pm (weekend rotation and on call required)
About the Role
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.
Responsibilities
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.
Operating the telephone switchboard to relay incoming, out-going and inter-office calls as applicable. Adhering to policies and providing excellent customer service in these interactions with the appropriate level of compassion.
Working within the policies and processes as they are being performed across the entire organization.
Pre-registering 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.
Explaining general consent for treatment forms to the patient/guarantor/legal guardian, obtaining necessary signatures and witnesses name. Distributing 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.
Reviewing eligibility responses in insurance verification system and appropriately selecting the applicable insurance plan code, entering benefit data into system to support POS (Point of Service Collections) and billing processes to assist with a clean claim rate.
Screening of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distributing the ABN as appropriate.
Distributing and documenting other designated forms and pamphlets.
Requirements
Minimum Education: 2 Year/ Associates Degree in Healthcare administration, business administration, or related field.
Minimum Years and Type of Experience: 2-3 years of experience in patient access or leadership role.
Preferred Knowledge, Skills, and Abilities: Certified Healthcare Access Associate (CHAA) and or CRCR, Certified Revenue Cycle Representative (Company Paid).
Qualifications
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.
Skills
Excellent communication skills.
Ability to multitask and prioritize tasks effectively.
Strong attention to detail.
Proficiency in Microsoft Office Suite.
Benefits
Comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
Professional certifications relevant to their field and tuition reimbursement.
Quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Pay
This position pays between $18.65 - $19.90/hr. based on experience.
Schedule
This position is an onsite role at Mercy - Lorain Hospital in Lorain, OH. The Senior Patient Access Specialist works full time from 8am-4:30pm with weekend rotations and on-call requirements.