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Patient Access Specialist

Company: MSCCN
Location: Janesville
Posted on: March 16, 2023

Job Description:

JOB REQUIREMENTS: Overview Patient Access Specialist, Days, Janesville, 80 Hrs / 2 wks Location: MercyCare Building, Janesville, WI Hybrid and flexible work 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... 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/C5575C65871A414A

Keywords: MSCCN, Janesville , Patient Access Specialist, Other , Janesville, Wisconsin

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