Patient Access Specialist

Mercy Health • Rockford, IL

451d

About The Position

The Patient Access Specialist at Mercyhealth is responsible for managing the scheduling, referral management, authorization, verification, and registration processes for patients prior to receiving services. This role ensures that all necessary patient information is collected and verified, facilitating a smooth and efficient patient experience while maximizing reimbursement for the health system. The specialist acts as a liaison between patients, providers, and insurance companies, ensuring compliance with healthcare regulations and policies.

Requirements

• High school diploma or equivalent required.
• Two years of healthcare registration, scheduling, or physicians' office experience required.
• Two years of customer service experience preferred.
• Certification related to health care revenue cycle (Epic, AAHAM, NAHAM, HMFA, etc.) or equivalent certification within 1 year of hire.
• Excellent oral communication and organizational skills.
• Ability to handle stress and problem solve effectively.
• Computer experience preferred, knowledge of EPIC desirable.
• Ability to multi-task and work independently.

Nice To Haves

• Experience with healthcare billing and coding guidelines.
• Knowledge of community-based, state, or federal government programs for patient assistance.

Responsibilities

• Ensure all scheduled visits are pre-registered and accounts are certified/authorized in advance of service dates.
• Initiate, obtain, and document referrals/authorizations/pre-certifications in appropriate systems.
• Answer incoming calls, determine the purpose, and schedule or route appropriately.
• Register new and returning patients via multiline phone lines and various Mercy systems.
• Initiate outbound calls to external providers, patients, and/or payers based on referrals.
• Communicate with provider's offices as needed.
• Manage waitlists and reschedule/cancel appointments as necessary.
• Complete accounts in assigned work queues.
• Manage patient-initiated scheduling requests through MyChart and other applications.
• Provide a quality patient experience and maintain professionalism.
• Ensure compliance with Access and Revenue Cycle policies and procedures.
• Contact insurance companies to determine eligibility and benefits for services.
• Provide financial information to patients regarding their obligations and payment arrangements.
• Collect co-pays and other out-of-pocket expenses and ensure patients understand their financial obligations.
• Document activity within appropriate EMR or patient accounting systems.
• Participate in workgroups related to access and scheduling improvements.

Benefits

• Full-time position with competitive salary.
• Opportunities for professional development and training.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED