Job Description

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 medical terminology or CPT or procedure codes.

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.

Mercy Health is an equal opportunity employer.

As a Mercy Health associate, you’re part of a Misson that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What we offer
• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.

Department:

SS Revenue Cycle - Legacy MH Acute

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). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email recruitment@mercy.com If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com