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Sr. Patient Access Specialist
The Senior Patient Access Specialist is responsible for performing admitting duties for all patients receiving services at Mercy Health. As a Senior Patient Access Specialist, additional duties can include training, scheduling, and other leadership responsibilities. They are responsible for performing these functions while meeting the mission and goals of Mercy Health ministry and all regulatory compliance requirements. The Senior Patient Access Specialist will work within the policies and processes as that are being performed across the entire organization.
40%- Patient Access staff are 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. They will serve as the SMART for the department. They are to adhere to Mercy Health policies and provide excellent customer service in these interactions with the appropriate level of compassion. Operates the telephone switchboard to relay incoming, out- going and inter-office calls as applicable.
10%- Patient Access staff are responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected. These activities may include accounts for other employees, departments, and facilities.
10%- A Senior Patient Access Specialist is responsible for the development of training materials and programs for new hires to the department, as well as providing continuing education to associates in all areas of revenue cycle.
5%- A Senior Patient Access Specialist is responsible for the development of staff schedules within the patient access department.
Responsible for the development of training materials and programs for new hires to the department, as well as providing continuing education to associates in all areas of revenue cycle.
Responsible for the development of staff schedules within the patient access department.
Will have on-call responsibilities for the department, including providing after-hours support and leadership. As part of on-call responsibilities, the Senior Patient Access Specialist may be responsible to come in to work at unscheduled times to cover for staffing issues.
5%- Senior Patient Access Specialist are responsible for the collection of point of service payments. These activities may be conducted in emergency, outpatient, and inpatient situations including past due balances and offering payment plan options. Conducts audits of accounts and assures that all forms are completed accurate, timely to meet audit standards and provides statistical data to Patient Access leadership. Sr. Patient Access Specialists will be held accountable for point of service goals as assigned.
5%- 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.
5%- Reviews eligibility responses in insurance verification system and appropriately selects the applicable insurance plan code, enters benefit data into system to support POS (Point of Service Collections) and billing processes to assist 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.
5%- 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.
5%- Perform other assigned duties as assigned
Education / Certifications:
Required Minimum Education: High School Diploma or GED
Preferred Education: 2 year / Associates Degree, Specialty: Healthcare Administration, Business Administration, or related field
Combination of post- secondary education and experience will be considered in lieu of degree.
2-3 Years of experience in Patient access of Leadership role
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.
Performs repetitive tasks/ motions
Hears alarm bells, telephone, and other sounds
Hears normal conversations
Have good manual dexterity
Have good eye-hand-foot coordination
Please indicate the activity’s level of frequency that applies to this position using the following frequency scale:
1 = Not at all within shift (0%),
2 = Occasionally within shift (1-33%),
3 = Frequently within shift (34-66%),
4 = Continuously within shift (67-100%);
Standing - 4
Walking - 4
Sitting - 3
Balancing - 3
Reaching above head - 2
Lift above shoulder - 2
Climbing - 1
Bending - 3
Twist at waist - 3
Push/Pull with force <50lbs - 3
Reaching above shoulder - 2
Lift from floor level up - 2
Lift above head - 2
Crouching/Squatting - 2
Crawling - 1
Push/Pull with force >50 lbs - 1
Lift/Carry up to 50 lbs - 2
Lift from waist level up- 2
Reads and interprets written/oral instructions.
Sets and meets deadlines, prioritizes work and works independently.
Identifies and understands issues and problems.
Examines data and draws logical conclusions demonstrating the ability to apply high levels of critical thinking and understanding.
Expresses or exchanges ideas by means of oral or written communications.
Makes decisions which have significant impact on the immediate work unit and monitor impact outside immediate work unit.
Organize thoughts and ideas into understandable terminology.
Must be flexible and able to adapt to change.
Periods of high stress and fluctuating workloads may occur.
May be exposed to physical altercations and verbal abuse.
Required to car travel to off-site locations, occasionally in adverse weather conditions.
May be exposed to high noise levels and bright lights.
May be exposed to limited hazardous substances or body fluids.
Potential exposure to infectious organisms.
May be constantly interrupted; requiring changing from one task to another of different nature without loss of efficiency or composure.
May have periods of constant interruptions.
Prolonged periods of working alone may occur.
Full Time- 40 hours/ week
6a - 230p - rotating weekends & rotating holidays
Mercy Health is an equal opportunity employer.
We’ll also reward your hard work with:
Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
An employer-matched 403(b) for those who qualify.
Paid time off
And much more
Scheduled Weekly Hours:
Days (United States of America)
SS Revenue Cycle - Administration
All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Ashland, Kentucky, which is an Affirmative Action and Equal Opportunity Employer, please email firstname.lastname@example.org. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at email@example.com