Senior Patient Access Intake Spec-Rehab

Southcoast Health System•Fall River, MA

14d•Onsite

About The Position

Join Southcoast Health, a not-for-profit, charitable, health system with multiple hospitals, clinics and facilities throughout Southeastern Massachusetts and Rhode Island. Southcoast Health provides inclusive, ethical workplaces where highly skilled caregivers offer world-class, comprehensive healthcare close to home. This role is located at Charlton Memorial Hospital in Fall River, MA.

Requirements

Equal to completion of four years of high school plus additional specialized courses or training, secretarial school, diploma, or medical office certification.
Duties require comprehensive understanding of medical terminology and managed care plans and experience in obtaining and processing insurance referrals and authorizations.
Proficient keyboarding skills are essential.
Must possess strong reasoning and critical thinking skills.
Proficient in use of software applications such as e-mail, Work, Excel, EHR.
Exceptional customer service skills are required.
Over three years of related medical office work experience is required.
Experience in obtaining and processing insurance referrals and authorizations.
Must be fully vaccinated against seasonal Influenza and the COVID 19 virus or to be exempt from the requirement for medical or personal reasons by signing a statement certifying you are choosing to be exempt from vaccination once hired.

Nice To Haves

Knowledge of Healthcare and Managed Care preferred.
Associates degree preferred.
Knowledge of Healthcare and Managed Care preferred.

Responsibilities

Perform a wide variety of duties to secure optimal revenue for all services performed at Southcoast Health Rehab Services.
Determine patient liability prior to service by creating an estimate based on individual payer, notifies patient of their potential liability in accordance with the 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 requirements for authorization and submit electronic requests.
Follow up with payer denials by researching clinical data to support an appeal.
Verify coverage and initiate authorizations for new evaluations and treatments.