Senior Patient Access Specialist – St. Vincent Medical Center

Thank you for considering a career at Mercy Health!

Scheduled Weekly Hours:

40

Work Shift:

All Work Shifts (United States of America)

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.  

ESSENTIAL FUNCTIONS

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.

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.

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.

A Senior Patient Access Specialist is responsible for the development of staff schedules within the patient access department.

A Senior Patient Access Specialist 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.  

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 The Patient Access Specialist is expected to adhere to Mercy Health policies, and provide excellent customer service in these interactions. 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.

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. 

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. 

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 other assigned duties as assigned 

MINIMUM EDUCATION

Required Minimum Education: High School Diploma / GED

Preferred Education: 2 year/Associates Degree - Specialty/Major: Healthcare administration, business administration, or related field.

MINIMUM QUALIFICATIONS

Minimum Years and Type of Experience:  2-3 years of experience in patient access or leadership role.

Other Knowledge, Skills and Abilities Required: 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 medic