Senior Patient Access Specialist - St. Elizabeth Youngstown Hospital

Mercy Health • Youngstown, OH

1d • Onsite

About The Position

The Sr Spec Patient Access is responsible for performing admitting duties for all patients receiving services at Mercy Health. Additional duties can include training and scheduling. This position is responsible for performing these functions while meeting the mission and goals of Mercy Health ministry and all regulatory compliance requirements. The Sr Spec Patient Access will work within the policies and processes as that are being performed across the entire organization.

Requirements

• High School Diploma or GED (required)
• 2-3 years of experience in patient access or leadership role (required)
• Typing speed of 45 words per minute required
• Understanding of Revenue Cycle including admission, billing, payments and denials
• Comprehensive knowledge of patient insurance process for obtaining authorizations and benefits verification
• Knowledge of Health Insurance requirements
• Knowledge of medical terminology or CPT or procedure codes
• Analyzing data or information
• Scheduling
• Attention to detail
• Acceptance of authority
• Critical thinking
• Communication with family members
• Teamwork
• Conflict resolution
• Active listening
• Relationship building
• Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.
• Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.
• Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.

Nice To Haves

• CRCR, Certified Revenue Cycle Representative - Healthcare Financial Management (preferred)
• 2 Year/ Associates Degree - Healthcare administration, business administration, or related field (preferred)

Responsibilities

• Responsible for assigning accurate MRNs, completing medical necessity or compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician order while utilizing an overlay tool and providing excellent customer service as measured by Press Ganey.
• Serves as the SMART for the department and adheres to Mercy Health policies, providing excellent customer service with compassion.
• Operates the telephone switchboard to relay incoming, outgoing, and inter-office calls.
• Responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected, including accounts for other employees, departments, and facilities.
• Responsible for the development of training materials and programs for new hires and providing continuing education to associates in all areas of revenue cycle.
• Responsible for the development of staff schedules within the patient access department and submits to leadership for final approval.
• Has on-call responsibilities for the department, including providing after-hours support and coming in to work at unscheduled times to cover for staffing issues.
• Responsible for the collection of point of service payments in emergency, outpatient, and inpatient situations, including past due balances and offering payment plan options.
• Conducts audits of accounts, assures all forms are completed accurately and timely to meet audit standards, and provides statistical data to Patient Access leadership.
• Held accountable for point of service goals as assigned.
• Explains general consent for treatment forms to the patient/guarantor/legal guardian, obtains necessary signatures and witnesses’ name.
• Explains and distributes patient education documents, such as Important Message from Medicare, Observation Forms, Consent forms, and all forms implemented for future services.
• Reviews eligibility responses in insurance verification system, appropriately selects the applicable insurance plan code, and enters benefit data into the system to support POS (Point of Service Collections) and billing processes.
• Assists with a clean claim rate including pre-registration of patient accounts prior to the patient visit, which may include inbound and outbound calls to obtain demographic information, insurance information, and all other patient information.
• Responsible for accurately screening of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate.
• Responsible for distribution and documentation of other designated forms and pamphlets.

Benefits

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED