Representative-Patient Access I-PRN

Trinity Health•Dubuque, IA

About The Position

MercyOne is seeking a Representative I in Patient Access to provide patient-focused customer service. The role performs outpatient and/or inpatient registration and insurance verification, collects patient financial liability payments, and helps ensure patients meet financial requirements, including Medicare medical necessity, payer pre-certifications, and referrals. It also provides general information to hospital users, patients, families, and physician offices. The schedule is PRN, as needed. The position supports operational projects through research, data collection, analysis, reporting, and performance-improvement activities. It uses multiple system applications to analyze information, create reports, and develop educational materials while prioritizing quality, confidentiality, and safety. The role may also involve specialized Patient Access Account Specialist work, including processing and editing items for correctness under payer guidelines, resolving items to ensure accurate claims, and timely payment processing.

Requirements

High school diploma or equivalent.
Minimum of one year of customer service experience for the entry-level PAR I position.
HFMA CRCR or NAHAM CHAA certification required within one year of hire.
For the Patient Access Account Specialist role, at least two years of hospital registration or insurance verification experience.

Nice To Haves

Patient Access experience is preferred.

Responsibilities

Provide patient-focused customer service.
Perform outpatient and/or inpatient registration and insurance verification.
Collect patient financial liability payments and ensure financial requirements are met, including Medicare medical necessity, payer pre-certifications, and referrals.
Provide general information to hospital users, patients, families, and physician offices.
Research, collect, compile, synthesize, and analyze information for operational projects and initiatives.
Prepare detailed summaries and analytical reports, including graphical presentations of trends and practical options or solutions.
Collaborate on performance-improvement activities focused on program efficiency and patient experience.
Use multiple system applications to perform analysis, create reports, and develop educational materials.
Leverage program and operational data and measurements to demonstrate progress, return on investment, and impacts.
For Patient Access Account Specialist duties, analyze, process, and edit items for correctness based on payer guidelines, resolve items, ensure claims are billed accurately, and process payments timely.
Maintain knowledge of applicable laws, regulations, compliance requirements, policies, procedures, and guidelines, and follow safe, honest, ethical, and professional work practices.