Patient Service Specialist - Call Center
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About The Position
Everyone who works with Mercy Health is united under one purpose: to help our patients be well in mind, body and spirit. This drive, along with our history of faith, is a powerful combination. It gives us a shared calling to work toward every day. Join our exceptional team and help us continue to provide the highest quality of health care possible to our communities. Responsible for answering all incoming calls, schedule appointments, take messages for clinics, provide triage for any Red Flag 'urgent call', work referral work queues and assist when possible clinics with online requests. Job Title: Patient Services Specialist Responsible for all aspects of scheduling, pre-registration and financial clearance functions associated with the respective specialty procedures. Responsibilities include collection and validation of accurate patient demographic and insurance information, obtaining pre-certification/authorization, scheduling the patient for outpatient and inpatient services, and entering information into multiple outpatient and inpatient systems. Other responsibilities include serving as the primary liaison with the patient, physician and hospital related to financial aspect of services. Ensures that all pre-operative requirements have been completed, including scheduling surgeries, pre-admission testing, scheduling for outside medical evaluations related to surgery, and pre-operative teaching classes. Initiates the insurance verification and pre-authorization process by contacting insurance carriers and providing proof of needed documentation. Works closely with involved providers to pre-certify procedures and other necessary evaluations or processes; assists with denial and appeal process. Reviews benefits, cost and coverage with patients and assesses their potential financial liability, and answers applicable questions. Completes all documentation for processes for both outpatient and inpatient services. Proactively communicates issues or potential issues involving customer service and process improvement opportunities to management and providers. Demonstrates a willingness and ability to work collaboratively with others for concise and timely flow of information. Maintains stable performance under pressure and handles stress in ways to maintain relationships with patients, customers and co-workers.
