Mercy Health Patient Access Specialist in Youngstown, Ohio
Patient Access Specialist
Job ID: 4660498
Updated: March 13, 2018
Geographic Location: Youngstown
Location: Youngstown, OH, United States
Department: Patient Access Registratn
Full/Part Time: Full-Time
Standard Hours: 40
The Patient Access Specialist is responsible for performing admitting duties for all patients admitted for services at Mercy Health. They are responsible for performing these functions while meeting the mission and goals of Mercy Health ministry and all regulatory compliance requirements. The Patient Access Specialist will work within the policies and processes as they are being performed across the entire organization
- Patient Access staff are responsible for assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving and processing physician orders, and utilizing a overlay tool while providing excellent customer service as measured by Press Ganey. Operates the telephone switchboard to relay incoming, out-going and inter-office calls as applicable. They are to adhere to Mercy Health policies, and provide excellent customer service in these interactions with the appropriate level of compassion. Patient Access Specialists will be held accountable for point of service goals as assigned.
- 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. 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.
- The Patient Access Specialist 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, Important Message from Tricare, Observation Forms, MOON form, Consent forms, and all forms implemented for future services.
- 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.
- 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.
Qualifications - Minimum
Education / Certifications:
- Required Minimum Education: High School Diploma or GED
- Preferred Education: 2 year / Associates Degree
- Preferred Certification: CHAA (Certified Health Access Associate)
- 1-2 Years of Experience Preferred
- 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.
- Patient Access experience highly preferred. Typing speed of 45 words per minute required if applicable.
Shift and Job Schedule
Full-time, 40 hours per week, days / afternoons, 6:30 a.m. to 3:00 p.m.
work days afternoons weekends and holidays as needed
Equal Employment Opportunity
It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.