Patient Access - Patient Access Rep - PART TIME

Wilson Health•Sidney, OH

23h

About The Position

Wilson Health is looking for a Part-time - Patient Access Prior Authorization Specialist for our location in Sidney, Ohio (North Dayton, Ohio) area. Key Perks and Benefits: Access to Employer Direct Care Clinic. Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan. Generous paid time off program beginning day one Medical Insurance: Your Choice of Two High Deductible Health Plan Options or a PPO, Dental and Vision Insurance H S A with employer contribution for eligible health plans, FSA for medical and dependent care expenses Company Paid Life, Short Term and Long-Term Disability Insurance Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance Industry leading retirement plan- employer contributions begin day one, no waiting period for participation Tuition Assistance Program Who We Are: At Wilson Health, our mission is to improve the health and wellness of our communities by delivering compassionate, quality care. We are committed to making a difference for our neighbors, friends, and family and our vision is to be a trusted, nationally-recognized leader of innovative, collaborative community health. Employment Status: PART TIME Working Hours: 7AM - 3:00PM (Monday - Friday) Shift: 1 st Shift - 48 hours per pay period, 3 days per week. Every other weekend and every other holiday REQUIRED. Must have EXCELLENT attendance Incentives: Shift differentials and holiday pay Position Reports to: Director of Patient Access SUMMARY: This position is responsible for the verification and documentation of insurance benefits and timely submission of initial prior authorization requests for outpatient and surgical procedures. Responsible for review and preparation of chart documents to accompany complex authorization requests. The Prior Authorization Specialist will provide appropriate information to third party payers and communicate with department clinicians when additional information is required to assure prior authorization is completed appropriately.

Requirements

High School diploma or general education degree (GED); one to three years related experience and/or training; or equivalent combination of education and experience.
Must have excellent typing skills and basic knowledge of personal computers.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
Abilty to walk from patient to patient
Work envirnoment can be fast paced at times.
Must have a sense of urgency with all patient situations

Nice To Haves

Prior Healthcare Registration preferred

Responsibilities

Registers and interviews patient or patient’s representative to obtain and record name, address, age, persons to notify in case of emergency, attending Physician, and individual or insurance company responsible for payment of bill and other demographic and financial information deemed necessary to complete patient record. ER Registration, Labor and Delivery Registartion as needed. Prior Knowledge of Electronic Health Records (EHR) - EPIC
Answers telephone, schedules appointment(s) for outpatient testing and pre-registers patient for same in an accurate and efficient manner. Maintains proper phone etiquette and responds to all inquiries or routes call to the appropriate area. Appointments scheduled per department guidelines and policy.
Enters pre-registration information in the HIS system on scheduled appointments in an accurate manner per department policy.
Enters patient information into computer and routes printed copies to designated department.
Prepares ID bracelets for Same Day Surgery patients and routes appropriately.
Obtains necessary signatures of consent from the patient/representative and explains patient’s rights to the patient/representative.
Reviews computer print outs for correct information, separates and distributes copies to appropriate departments.
Maintains files and keeps forms current.
Effectively present information and respond to questions from managers, staff members, patient, patient’s family, and the general public. These would include the pediatric client, the adolescent client, the young-middle aged client, and the geriatric client.
Demonstrates a comprehensive knowledge in changing government regulations. Must maintain local and national medical review policies and precertification of outpatients. Will screen diagnosis on patients with Medicare Health Insurance for procedures that have LMRP’s in place and request additional information from Dr offices as needed or present patient with an Advanced Beneficiary Notice if needed for non-compliant diagnosis.
Additional responsibilities may be required for lead roles such as providing recommendations for process improvement and maintaining quality aspects within Patient Access.
Aware of the functions within the scope of the hospital policy/procedure.
Aware of and responds to Disaster/Fire Plan per policy.
Maintains patient confidentiality at all times.
Performs other duties within scope of responsibility as assigned.

Benefits

Access to Employer Direct Care Clinic
Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan
Generous paid time off program beginning day one
Medical Insurance: Your Choice of Two High Deductible Health Plan Options or a PPO, Dental and Vision Insurance
H S A with employer contribution for eligible health plans, FSA for medical and dependent care expenses
Company Paid Life, Short Term and Long-Term Disability Insurance
Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance
Industry leading retirement plan- employer contributions begin day one, no waiting period for participation
Tuition Assistance Program
Shift differentials and holiday pay