Patient Access Specialist

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Job description

Patient Access Specialist, Patient Access Management, Days, 80 hrs/2 wks Hybrid and flexible work schedule opportunities available after probationary period Experience a rewarding and fulfilling career with Mercyhealth. Mercyhealth is committed to offering our partners a best place to work. Our unique workplace Culture of Excellence is built upon: Employee engagement, empowerment and growth Teamwork toward our common goal # providing exceptional health care services with a passion for making lives better An atmosphere of caring and quality that cascades throughout the organization Essential duties and Responsibilities Ensures all scheduled visits are pre-registered and accounts are appropriately certified / authorized in advance of the service date.# Initiates, obtains, and documents referrals/authorizations/pre-certifications in appropriate systems.# Answers incoming external/internal telephone calls, determines purpose of calls and schedules appropriately or routes to physician practices or other departments as appropriate. Registers new and returning patients via multiline phone lines, and various Mercy systems/applications for visits within the Mercyhealth System ensuring that all required elements are gathered to ensure payment for the service provided. Initiates outbound calls to external providers, patients, and/or payers based on referrals entered into the system and schedules appropriately.# Communicates with provider#s office as needed. Ensures compliance with Access and Revenue Cycle related policies and procedures. Manages waitlists, rescheduling/cancellation of appointments as necessary. Completes accounts in assigned WQ#s. Manages patient initiated scheduling requests through MyChart, Telehealth, or other self-scheduling applications. Maintains a high level of professionalism and provides a quality patient experience. Schedules appointments appropriately according to provider and clinic based protocols. Performs ancillary tasks by providing outreach to patients.# Must have excellent customer service skills. Answers questions about organization and provides callers with address, directions and other information about the site that they are scheduled for. Able to articulate information in a manner that patients, guarantors, and family members understand. Ensures compliance with reporting related to demographics and federal and state requirements. Has in depth knowledge of community based, state or federal government programs to provide assistance to patients who have limited or no ability to pay for their health care needs.# Screens patients and provides assistance with completion of applications, if necessary. Serves as a liaison to clinical staff by maintaining good communication regarding any problems and/or resolutions to patient issues or access concerns. Contacts insurance companies or employer groups via phone, web portals, electronic applications, or other appropriate means to determine eligibility and benefits for necessary services to obtain financial resolution and guarantee payment on account. Maintains current knowledge of payor payment provisions and regulations to ensure correct data is gathered and documented. Provides financial information to patients, which includes patient financial obligations, estimated costs of services, billing practices and establishing payment arrangements as necessary. Collects co-pays, deductible and other out of pocket expenses via phone and/or in person and ensures patients understand their financial obligation and arrange for payment at the time of visit. Must have a thorough understanding of patient payment options to be able to direct patients to appropriate resource for financial assistance programs.# These programs may include Medicaid, Mercy Community Care and other community assistance as appropriate. Advises department leadership of possible postponement or deferral of any elective/non-emergent service which have not been approved prior to service date. Documents activity within appropriate EMR or patient accounting systems. Complies with Mercyhealth Cash Handling and Collection Policies. Demonstrates an understanding and follows patient confidentiality policies and all HIPAA Regulations. Performs other clerical duties as needed such as faxing, filing and photocopying. Subject matter expert with regards to assigned responsibilities Provides training to new partners, as well as on an as-needed basis. Manages other duties as assigned. Education and Experience High school diploma or equivalent required. Two years of customer service experience preferred. Two #years of healthcare registration, scheduling, or physicians# office experience required. Certifications/Licensure Certification related to health care revenue cycle (Epic, AAHAM, NAHAM, HMFA, etc.) or an equivalently designated certification approved by management within 1 year of hire. Special Physical Demands The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations. Prolonged sitting Manual dexterity needed to operate telephone and keyboard. ######### ######################### #

* Patient Access Specialist, Patient Access Management, Days, 80 hrs/2 wks
* Hybrid and flexible work schedule opportunities available after probationary period

Experience a rewarding and fulfilling career with Mercyhealth. Mercyhealth is committed to offering our partners a best place to work. Our unique workplace Culture of Excellence is built upon:

* Employee engagement, empowerment and growth
* Teamwork toward our common goal - providing exceptional health care services with a passion for making lives better
* An atmosphere of caring and quality that cascades throughout the organization

Essential duties and Responsibilities

* Ensures all scheduled visits are pre-registered and accounts are appropriately certified / authorized in advance of the service date.
* Initiates, obtains, and documents referrals/authorizations/pre-certifications in appropriate systems.
* Answers incoming external/internal telephone calls, determines purpose of calls and schedules appropriately or routes to physician practices or other departments as appropriate.
* Registers new and returning patients via multiline phone lines, and various Mercy systems/applications for visits within the Mercyhealth System ensuring that all required elements are gathered to ensure payment for the service provided.
* Initiates outbound calls to external providers, patients, and/or payers based on referrals entered into the system and schedules appropriately. Communicates with provider's office as needed.
* Ensures compliance with Access and Revenue Cycle related policies and procedures.
* Manages waitlists, rescheduling/cancellation of appointments as necessary.
* Completes accounts in assigned WQ's.
* Manages patient initiated scheduling requests through MyChart, Telehealth, or other self-scheduling applications.
* Maintains a high level of professionalism and provides a quality patient experience.
* Schedules appointments appropriately according to provider and clinic based protocols.
* Performs ancillary tasks by providing outreach to patients. Must have excellent customer service skills.
* Answers questions about organization and provides callers with address, directions and other information about the site that they are scheduled for.
* Able to articulate information in a manner that patients, guarantors, and family members understand.
* Ensures compliance with reporting related to demographics and federal and state requirements.
* Has in depth knowledge of community based, state or federal government programs to provide assistance to patients who have limited or no ability to pay for their health care needs. Screens patients and provides assistance with completion of applications, if necessary.
* Serves as a liaison to clinical staff by maintaining good communication regarding any problems and/or resolutions to patient issues or access concerns. Contacts insurance companies or employer groups via phone, web portals, electronic applications, or other appropriate means to determine eligibility and benefits for necessary services to obtain financial resolution and guarantee payment on account.
* Maintains current knowledge of payor payment provisions and regulations to ensure correct data is gathered and documented.
* Provides financial information to patients, which includes patient financial obligations, estimated costs of services, billing practices and establishing payment arrangements as necessary.
* Collects co-pays, deductible and other out of pocket expenses via phone and/or in person and ensures patients understand their financial obligation and arrange for payment at the time of visit.
* Must have a thorough understanding of patient payment options to be able to direct patients to appropriate resource for financial assistance programs. These programs may include Medicaid, Mercy Community Care and other community assistance as appropriate.
* Advises department leadership of possible postponement or deferral of any elective/non-emergent service which have not been approved prior to service date.
* Documents activity within appropriate EMR or patient accounting systems.
* Complies with Mercyhealth Cash Handling and Collection Policies.
* Demonstrates an understanding and follows patient confidentiality policies and all HIPAA Regulations.
* Performs other clerical duties as needed such as faxing, filing and photocopying.
* Subject matter expert with regards to assigned responsibilities
* Provides training to new partners, as well as on an as-needed basis.
* Manages other duties as assigned.

Education and Experience
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