Senior Patient Access Specialist - SS Revenue Cycle - Springfield Regional Medical Center

About the role

The Senior Patient Access Specialist is responsible for performing admitting duties for all patients receiving services at Mercy Health. Additional duties can include training, scheduling, and other leadership responsibilities. They are responsible for performing these functions while meeting the mission and goals of Mercy Health ministry and all regulatory compliance requirements. The Senior Patient Access Specialist will work within the policies and processes performed across the entire organization.

Responsibilities

• Assign accurate MRNs, complete medical necessity or compliance checks, provide proper patient instructions, collect insurance information, receive and process physician orders while utilizing an overlay tool, and provide excellent customer service as measured by Press Ganey.
• Serve as the SMART for the department and adhere to Mercy Health policies while providing excellent customer service with appropriate compassion.
• Operate the telephone switchboard to relay incoming, outgoing, and inter-office calls.
• Utilize quality auditing and reporting systems to ensure accounts are corrected, including accounts for other employees, departments, and facilities.
• Develop training materials and programs for new hires and provide continuing education to associates in all areas of revenue cycle.
• Develop staff schedules within the patient access department.
• Provide on-call support for the department, including after-hours support and leadership, and cover unscheduled shifts for staffing issues.
• Collect point of service payments in emergency, outpatient, and inpatient situations, including past due balances and offering payment plan options.
• Conduct audits of accounts and ensure all forms are completed accurately and timely to meet audit standards, providing statistical data to Patient Access leadership.
• Meet point of service goals as assigned.
• 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, Observation Forms, Consent forms, and all forms implemented for future services.
• Review eligibility responses in the insurance verification system, select applicable insurance plan codes, enter benefit data into the system to support POS collections and billing processes, and assist with clean claim rates including pre-registration of patient accounts prior to the patient visit.
• Accurately screen medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of tests by Medicare and distribute the ABN as appropriate.
• Distribute and document other designated forms and pamphlets.

Benefits

• Competitive pay, incentives, referral bonuses, and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources, and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development, and continuing education support