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Pre-Access Specialist II Mercy Health St Elizabeth

Company: Mercy Health
Location: Youngstown
Posted on: January 13, 2021

Job Description:

Thank you for considering a career at Mercy HealthMISSIONIt is expected that all of the duties and responsibilities of this position will be performed in a manner that reflects the values of Mercy Health. The mission of Mercy Health is to extend the healing ministry of Jesus by improving the health of our communities with emphasis on people who are poor and under-served.SUMMARY OF JOB RESPONSIBILITIES:Under minimal supervision of the lead Pre-Access Specialist and Department Manager, the Specialist Il is responsible for performing revenue cycle tasks necessary to ensure compliance, patient safety, and excellent customer service. This position is fast-paced, requiring multitasking and effective problem solving skills. The following tasks must be performed timely and accurately: assign appropriate MRNs, schedule correct procedure appointments based on verbal requests or written orders (knowledge of medical terms and human anatomy preferred), demonstrate knowledge of Mercy Health system and services offered, validate patient demographic and insurance information, screen for medical necessity to ensure Medicare compliance, document necessary pre-certifications / authorization for service, verify and accurately document patient insurance eligibility and benefits, calculate and collect patient liabilities (money) and provide exceptional customer service. The Specialist Il has many customers, including patients, insurance payers, clinical department staff and physician offices. It is expected that the Specialist Il will foster positive relationships with all customers in an effort to provide quality patient care. The Specialist Il will act as an example to other teammates and serve as a shift lead in the absence of supervisory personnel. The Specialist Il should remain in full compliance with all departmental, institutional and regulatory policies and procedures. The roles and responsibilities of this job support the mission, vision, values and strategies of Mercy Health.QUALIFICATIONSEDUCATION:High School graduate or GED required.Graduate of business school or 1 year of college preferred.Medical terminology and knowledge of insurance preferred.EXPERIENCE:1-2 years of healthcare experience preferred.I -2 years of extensive customer service experience preferred.Experience in multiple areas of pre-access (scheduling, pre-registration, financial clearance) preferred.Effective in fast-paced environment and demonstrates strong problem-solving skills.Excellent communication skills, computer proficiency, typing, phone etiquette and customer service skills required.Knowledge of healthcare terms and revenue cycle processes, including insurance regulations, preferable.KNOWLEDGE AND SKILLS:Strong data entry skills required, as well as demonstrated ability to work in multiple systems accurately and efficiently, such as scheduling and registration systems, document imaging, scanning, medical necessity and data quality monitoring.CHAA (Certified Healthcare Access Associate) certification preferred.PRNCIPAL JOB ACCOUNTABILITIES:Schedules the correct procedure at the appropriate facility and appropriate time, while also ensuring assignment of proper patient types Accurately obtains / validates / documents patient demographic, insurance and clinical information and assigns correct payer plan codeAccurately pre-registers patients, including selection of proper medical record number for patient safetyCompletes insurance verification and eligibility checksCalculates patient liabilities and actively collects and processes patient paymentsCorrects registration errors identified during pre-registrationReceives and processes physician orders received via fax, Order Facilitator, or any other method available for receiving pre-service orders Follows up on missing orders, ensures that requested orders are received and on file prior to services being renderedCollects and accurately documents initial pre-certification / authorization information if available when schedulingPerforms medical necessity / compliance checks to ensure services meet medical necessity based on Medicare Local Coverage Determination (LCD) and communicates ABN requirements to physician offices if scheduled service(s) is not medically necessaryRefers patients to financial counselors when additional financial counseling or payment arrangements are neededAccurately cancels and/or reschedules appointments as requestedMeets productivity requirements to ensure excellent service is provided to customers Demonstrates knowledge of entire Mercy Health system and services offeredDemonstrates problem solving skills related to scheduling, financial clearance and patient liabilityOrganizes work / resources to accomplish objectives and meet deadlinesProactively communicates issues or potential issues involving customer service and process improvement opportunities to managementMaintains excellent public relations with patients, families, physicians and hospital staffEnsures that patients, their families, visitors, customers and staff members are treated with kindness and respectMaintains the privacy and security of all confidential and protected health information. Uses and discloses only that information which is necessary to perform the function of the job.Interfaces with other key internal and external staff to obtain necessary information to address PreAccess accounts.Demonstrates the willingness and ability to work collaboratively with others for concise and timely flow of information.Reports issues and trends to appropriate management personnel and works collaboratively to develop solutions.Participates in all educational activities, and demonstrates personal responsibility for job performance.Takes initiative for learning new skills and willingness to participate and share expertise on projects, committees and other activities, as deemed appropriate.Uses supplies and equipment effectively and efficiently.Consistently demonstrates a positive and professional attitude at work.Maintains stable performance under pressure. Handles stress in ways to maintain relationships with patients, customers and co-workers.Maintains compliance with established corporate and departmental policies and procedures. Meets or exceeds expectations for data quality, POS collections, customer service and productivity.Maintains satisfactory attendance record and punctuality record as set forth by Mercy Health corporate and department.The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.Mercy Health is an equal opportunity employer.We'll also reward your hard work with:* Comprehensive, affordable medical, dental and vision plans* Prescription drug coverage* Flexible spending accounts* Life insurance w/AD&D* An employer-matched 403(b) for those who qualify.* Paid time off* Educational Assistance* And much moreScheduled Weekly Hours:0.1Work Shift: Other Department: Women's Imaging Center - St. Elizabeth - ABDU Breast Care CenterAll 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

Keywords: Mercy Health, Youngstown , Pre-Access Specialist II Mercy Health St Elizabeth, Healthcare , Youngstown, Ohio

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