The Spec Patient Access LOR is responsible for performing admitting duties for all patients admitted for services at Mercy Health. They are responsible for performing these functions while meeting the mission and goals of Mercy Health ministry and all regulatory compliance requirements. The Spec Patient Access will work within the policies and processes as they are being performed across the entire organization. Essential Job Functions?Patient Access staff are responsible for assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician orders, and utilizing an overlay tool while providing excellent customer service as measured by Press Ganey. Operates the telephone switchboard to relay incoming, outgoing, and inter-office calls as applicable. They are to adhere to Mercy Health policies and provide excellent customer service in these interactions with the appropriate level of compassion. Spec Patient Access will be held accountable for point of service goals as assigned. 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. 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. Patient Access staff are responsible for the pre-registration of patient accounts prior to patient visits. This may include inbound and outbound calling to obtain demographic, insurance, and other patient information including the patient financial liabilities including collecting point of service collections as well as past due balances including payment plan options. The Patient Access staff explains general consent for treatment forms to the patient/guarantor/legal guardian, obtains necessary signatures and witness’s name. Explains and distributes patient education documents, such as Important Message from Medicare, Important Message from Tricare, Observation Forms, MOON form, 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. 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 all other duties as assigned including answering the phones at applicable facilities. 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. CHAA (Certified Health Access Associate) – National Association of Healthcare Access Management, preferred. Education. High School Diploma or GED – required 2 Year / Associates Degree – preferred. Combination of post-secondary education and experience in lieu of a degree. Work Experience 1-2 years of patient access experience highly preferred. Training. Medical terminology or CPT or procedure codes - preferred. Working Conditions. Periods of high stress and fluctuating workloads may occur. General office environment. 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 human blood and other potentially infectious materials. May have periods of constant interruptions. Prolonged periods of working alone. Skills. Typing. Patient Insurance. Obtaining Insurance Authorizations. Benefits Verification. Financial Acumen. Analyzing data or information. Health Insurance Requirements. Medical Terminology. CPT or Procedure Codes. Attention to detail. Acceptance of authority. Critical thinking. Communication with family members/patients. Teamwork. Conflict resolution. Active listening. Relationship building.