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Scheduled Weekly Hours:

Work Shift:

Senior Patient Access Specialist - St. Elizabeth Youngstown Hospital

THIS IS A COLLECTIVE BARGAINING UNIT POSITION

Shift/Schedule

• Full Time - Scheduled for 40 Weekly Hours
• Shift Times - All Shifts. Primary Shift Times - Days
• Rotating Weekends and Holidays

Primary Function/General Purpose of Position

The Sr Spec Patient Access is responsible for performing admitting duties for all patients receiving services at Mercy Health. Additional duties can include training and scheduling.  This position is responsible for performing these functions while meeting the mission and goals of Mercy Health ministry and all regulatory compliance requirements.  The Sr Spec Patient Access will work within the policies and processes as that are being performed across the entire organization.  

Essential Job Functions

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, outgoing, and inter-office calls as applicable.

• 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.
• 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.
• Responsible for the development of staff schedules within the patient access department and submits to leadership for final approval.
• Will have on-call responsibilities for the department, including providing after-hours support.  As part of on-call responsibilities, be responsible to come in to work at unscheduled times to cover for staffing issues. 
• 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. 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. 
• 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

• CRCR, Certified Revenue Cycle Representative - Healthcare Financial Management (preferred)

Education

• High School Diploma or GED (required)
• 2 Year/ Associates Degree - Healthcare administration, business administration, or related field (preferred)

Work Experience

• 2-3 years of experience in patient access or leadership role (preferred)

Training

Language

• English

Patient Population

• Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.
• Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.​
• Not applicable to this position

Working Conditions

• Periods of high stress and fluctuating workloads may occur.
• May be exposed to high noise levels and bright lights.
• May be exposed to physical altercations and verbal abuse.
• May be exposed to limited hazardous substances or body fluids.*
• May be exposed to adverse weather conditions; cold, hot, dust, wind, etc.
• May have periods of constant interruptions.
• Prolonged periods of working alone.
• Other: Must be able to work weekends, holidays, and on-call.                                    

* Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.

Skills

Hard/Tech/Clinical Skills:

• 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
• Typing speed of 45 words per minute required
• Analyzing data or information
• Scheduling

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Soft/Interpersonal Skills:

• Attention to detail
• Acceptance of authority
• Critical thinking
• Communication with family members
• Teamwork
• Conflict resolution
• Active listening
• Relationship building

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:

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.