Patient Access Specialist — Allen Hospital

Mercy Health•Oberlin, OH

5d•Onsite

About The Position

The Spec Patient Access LOR is responsible for performing admitting duties for all patients admitted for services at Mercy Health. They are responsible for performing these functions while meeting the mission and goals of Mercy Health ministry and all regulatory compliance requirements. The Spec Patient Access will work within the policies and processes as they are being performed across the entire organization.

Requirements

High School Diploma or GED
Typing
Patient Insurance
Obtaining Insurance Authorizations
Benefits Verification
Financial Acumen
Analyzing data or information
Health Insurance Requirements
Medical Terminology or CPT or procedure codes
Attention to detail
Acceptance of authority
Critical thinking
Communication with family members/patients
Teamwork
Conflict resolution
Active listening
Relationship building

Nice To Haves

CHAA (Certified Health Access Associate) – National Association of Healthcare Access Management
2 Year / Associates Degree
Combination of post-secondary education and experience in lieu of a degree
1-2 years of patient access experience
Medical terminology or CPT or procedure codes

Responsibilities

Assigning accurate MRNs
Completing medical necessity / compliance checks
Providing proper patient instructions
Collecting insurance information
Receiving, and processing physician orders
Utilizing an overlay tool while providing excellent customer service
Operating the telephone switchboard to relay incoming, outgoing, and inter-office calls
Adhering to Mercy Health policies and providing excellent customer service
Meeting point of service goals as assigned
Utilizing quality auditing and reporting systems to ensure accounts are corrected
Conducting audits of accounts and assuring that all forms are completed accurately and timely to meet audit standards
Providing statistical data to Patient Access leadership
Pre-registering patient accounts prior to patient visits
Inbound and outbound calling to obtain demographic, insurance, and other patient information
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 witness’s name
Explaining and distributing patient education documents
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
Accurately screening of medical necessity using the Advanced Beneficiary Notice (ABN) software
Informing Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate
Distribution and documentation of other designated forms and pamphlets
Performing all other duties as assigned including answering the phones at applicable facilities