Senior Patient Access Specialist

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 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
• Utilizing a overlay tool while providing excellent customer service as measured by Press Ganey
• Operating the telephone switchboard to relay incoming, outgoing, and inter-office calls
• Conducting audits of accounts and ensuring all forms are completed accurately, timely to meet audit standards
• Pre-registering patient accounts prior to patient visits
• 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
• Screens of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of tests by Medicare and distributing the ABN as appropriate
• Distributing and documenting other designated forms and pamphlets

Requirements

• Certified Healthcare Access Associate (CHAA) and/or Certified Revenue Cycle Representative (CRRC)
• Minimum of 2-3 years of experience in patient access or leadership role
• 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

Qualifications

• 2 Year/Associates Degree preferred
• Specialty/Major: Healthcare administration, business administration, or related field

Skills

• 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

Benefits

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

Pay

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

Schedule

This position is an onsite role at Mercy - The Jewish Hospital in Cincinnati, OH.