Senior Patient Access Intake Spec-Rehab

Southcoast Health System•Fall River, MA

8d•Onsite

About The Position

Southcoast Health is seeking a Senior Patient Access Intake Specialist for Rehab Services at Charlton Memorial Hospital in Fall River, Massachusetts. This 40-hour-per-week role works a day shift from 8:45 a.m. to 5:15 p.m. The position performs a variety of duties to secure optimal revenue for Southcoast Health Rehab Services. It determines and communicates patients’ potential financial liability before services, in accordance with applicable federal and state regulations, and helps secure the required certifications and authorizations for evaluations, diagnostic tests, and treatments.

Requirements

Education equivalent to completion of four years of high school plus additional specialized courses or training, secretarial school, a diploma, or medical office certification.
Over three years of related medical office work experience.
Comprehensive understanding of medical terminology and managed care plans.
Experience obtaining and processing insurance referrals and authorizations.
Proficient keyboarding skills.
Strong reasoning and critical-thinking skills.
Proficiency with software applications such as email, Word, Excel, and EHR.
Exceptional customer service skills.
Must be fully vaccinated against seasonal influenza and COVID-19, or qualify for an exemption for medical or personal reasons by signing a statement certifying the choice to be exempt from vaccination once hired.

Nice To Haves

Associate degree preferred.
Knowledge of healthcare and managed care preferred.

Responsibilities

Determine patient liability before service by creating an estimate based on the individual payer and notify the patient of potential liability in accordance with federal and state regulations.
Initiate contact with patients, clinicians, and third-party payers to obtain pre-certification and authorization for evaluations and diagnostic tests.
Use critical-thinking skills to ensure CPT codes are documented and authorized for the appropriate service.
Navigate multiple payer portals to determine authorization requirements and submit electronic requests.
Research clinical data to support appeals of payer denials.
Verify coverage and initiate authorizations for new evaluations and treatments.
Perform duties to secure optimal revenue for Southcoast Health Rehab Services.