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Patient Access Specialist

Job Description - Patient Access Specialist






Job Summary and Responsibilities






As a Patient Access Representative, you will manage administrative duties for the patient intake process in our clinic, adhering to established guidelines.

Every day you will interact with patients in person and by phone, facilitating check-in/out, collecting data and payments, validating insurance, scheduling appointments, and processing referrals and authorizations.

To be successful, you will demonstrate critical thinking, strong customer service, and knowledge of insurance, billing, and medical terminology, ensuring a seamless, high-quality patient intake experience.

  • Maintains up-to-date knowledge of specific admission, registration, and pre-registration requirements for all areas, including but not limited to: Main Admitting, OP Registration, Maternity, and Rehabilitation Units
  • Ensures the pre-registration process is complete for all assigned accounts at least 5-days prior to the scheduled date of service whenever possible
  • Verifies insurance eligibility and benefits on all assigned accounts using electronic verification systems or by contacting payers directly to determine level of insurance coverage. When contacting payers directly, utilizes approved scripting
  • Obtains referral, authorization and precertification information and documents this information in the ADT system
  • When appropriate, ensures the payer receives a Notice of Admission on all admissions, scheduled and non-scheduled, with 24-hours or the next business day
  • Meets CMS billing requirements for the completion of the MSP, issuance of the Important Message from Medicare, issuance of the Observation Notice, and other requirements applicable and documenting completion within the hospital's information system for regulatory compliance and audit purposes








Job Requirements






  • High School Graduate General Studies or GED 
  • Minimum 2 years of experience working in a hospital Patient Registration department, physician office setting, healthcare insurance company, revenue cycle vendor, and/or other revenue cycle-related role
  • Minimum 1 year of experience in customer service, preferably in a healthcare environment
  • Experience in requesting and processing financial payments
  • Applicable education and/or training can be used to balance a lack of experience

Preferred

  • 3 years experience








Where You’ll Work






Mercy Medical Center Redding offers comprehensive health care to nearly 300,000 residents in a six-county region. It is one of only two Level II trauma centers, the only Level III Neonatal Intensive Care Unit (NICU) and the only Joint Commission-certified Advanced Thrombectomy-Capable Stroke Center north of Sacramento north of Sacramento. Mercy Medical Center Redding is a 266-bed regional medical center providing inpatient and outpatient services as well as specialized cardiovascular care, stroke care, orthopedics, neurological surgery, comprehensive cancer care, maternity care, and a robust robotic surgery program. In addition, the hospital’s network of care includes Mercy Home Health and Hospice and Dignity Health Connected Living. 

One Community. One Mission. One California 





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