Senior Patient Access Specialist - St. Elizabeth Youngstown Hospital

Mercy Health•Youngstown, OH

About The Position

The Senior Patient Access Specialist performs admitting duties for patients receiving services at Mercy Health, while meeting the ministry’s mission, organizational goals, policies, processes, and regulatory requirements. Additional responsibilities include training, scheduling, quality auditing, reporting, and serving as the department’s SMART. The role provides compassionate customer service and may operate the telephone switchboard to relay incoming, outgoing, and inter-office calls. The specialist supports patient access and revenue-cycle operations by verifying insurance eligibility and benefits, collecting demographic and insurance information, processing physician orders, completing medical-necessity and compliance checks, and pre-registering patient accounts. The position also collects point-of-service payments, explains and obtains required consent and patient education forms, screens Medicare medical necessity using ABN software, and documents and audits accounts. The role has on-call responsibilities, including after-hours support and coming in at unscheduled times to cover staffing needs. This is a full-time collective bargaining unit position scheduled for 40 hours per week. All shifts may be scheduled, with primary shift times on days, and rotating weekends and holidays. Benefits may vary based on market and employment status.

Requirements

High school diploma or GED.
Two to three years of experience in patient access or a leadership role is preferred.
Typing speed of 45 words per minute.
Understanding of revenue cycle operations, including admissions, billing, payments, and denials.
Comprehensive knowledge of patient insurance processes for authorizations and benefits verification.
Knowledge of health insurance requirements.
Knowledge of medical terminology, CPT, or procedure codes.
Skills in data analysis, scheduling, attention to detail, critical thinking, communication, teamwork, conflict resolution, active listening, and relationship building.
Ability to work weekends, holidays, and on-call shifts.
English language.

Nice To Haves

CRCR (Certified Revenue Cycle Representative) certification from Healthcare Financial Management.
Associate degree in healthcare administration, business administration, or a related field.
Two to three years of experience in patient access or a leadership role.

Responsibilities

Perform admitting duties and accurately assign medical record numbers (MRNs) for patients receiving services.
Complete medical-necessity and compliance checks, provide patient instructions, collect insurance information, and receive and process physician orders using an overlay tool.
Provide excellent, compassionate customer service in accordance with Mercy Health policies and applicable standards.
Serve as the department’s SMART and operate the telephone switchboard to relay calls as applicable.
Use quality auditing and reporting systems to identify and ensure correction of accounts, including accounts involving other employees, departments, and facilities.
Develop training materials and programs for new department hires and provide continuing education to associates in revenue-cycle areas.
Develop patient access staff schedules and submit them to leadership for final approval.
Provide on-call and after-hours departmental support and come in at unscheduled times to cover staffing needs.
Collect point-of-service payments in emergency, outpatient, and inpatient settings, including past-due balances, and offer payment-plan options.
Audit accounts, ensure forms are completed accurately and on time, provide statistical data to Patient Access leadership, and meet assigned point-of-service goals.
Explain general consent-for-treatment forms, obtain required signatures and witness names, and distribute patient education documents and other required forms.
Review insurance eligibility responses, select the applicable insurance plan code, and enter benefit data to support collections and billing.
Pre-register patient accounts and make inbound or outbound calls to obtain demographic, insurance, and other patient information.
Screen Medicare medical necessity using ABN software, inform patients of possible non-payment, distribute ABNs when appropriate, and document distribution of designated forms and pamphlets.
Follow infection-control policies, use universal precautions and personal protective equipment, and perform other job-related duties as required, subject to reasonable accommodation.