Patient Access Specialist

JOB REQUIREMENTS: Overview Job Profile Summary Responsible for correctly
prioritizing and completing all steps of the scheduling, referral
management, authorization, verification and registration process prior
to patients receiving services. Identifies scheduling needs, reviews
schedules, follows scheduling protocols and enters visit information for
appropriate scheduling. Identifies, verifies, and captures appropriate
patient demographic information and health insurance benefit eligibility
information. Performs payer coverage investigation, as necessary,
utilizing both internal and external tools and resources, to obtain
reimbursement verification. Utilizes knowledge including, but not
limited to, managed care, commercial, government, and work comp
insurance billing requirements, as well as current coding guidelines and
standards, to ensure resolution of pre-service edits, appropriate
management of claims, initiation and direction of accounts for
pre-authorization as required, prevention of timely filing claim
denials, and procurement of appropriate reimbursement. This position
requires understanding of healthcare Revenue Cycle and the importance of
evaluating and securing all appropriate financial resources to maximize
reimbursement to the health system. This position assumes clinical and
financial risk of the organization when collecting and documenting
information on behalf of the patient. 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 providers 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 WQs. 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… For
full info follow application link. EOE&AA/M/F/Vet/Disabled. Mercy is an
equal employment opportunity employer functioning under Affirmative
Action Plans. APPLICATION INSTRUCTIONS: Apply Online:
ipc.us/t/53381EF7A02F44A8