Patient Access Specialist - Allen Hospital (PRN)

This is a PRN As Needed Position

Shift/Schedule/Training:

• Full Time Training
• Shift Times - All (Availability on 1st 2nd or 3rd shift as needed)
• Weekend and holiday availability is required

Primary Function/General Purpose of Position

The Spec Patient Access LOR 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 Spec Patient Access will work within the policies and processes as they are being performed across the entire organization.

Essential Job Functions

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 an overlay tool while providing excellent customer service as measured by Press Ganey. Operates the telephone switchboard to relay incoming outgoing 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. Spec Patient Access 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.

Patient Access staff are responsible for the pre-registration of patient accounts prior to patient visits. This may include inbound and outbound calling to obtain demographic insurance and other patient information including the patient financial liabilities including collecting point of service collections as well as past due balances including payment plan options.

The Patient Access staff explains general consent for treatment forms to the patient/guarantor/legal guardian obtains necessary signatures and witnesss 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.

Perform all other duties as assigned including answering the phones at applicable facilities.

This document is not an exhaustive list of all responsibilities skills duties requirements or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor subject to reasonable accommodation.

Licensing/Certification

CHAA (Certified Health Access Associate) National Association of Healthcare Access Management preferred

Education

High School Diploma or GED required

2 Year / Associates Degree preferred

Combination of post-secondary education and experience in lieu of a degree

Work Experience

1-2 years of patient access experience highly preferred.

Training

Medical terminology or CPT or procedure codes - preferred