Patient Access Specialist

JOB REQUIREMENTS: Overview Patient Access Specialist, Days, 80 Hrs / 2

wks Location: Rockton Ave Campus; Rockford, IL. Hybrid schedule

opportunities available after probationary period. 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 provider's 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 WQ's. 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

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/0EE8C94F16354F2A