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Sr. Patient Access Intake Specialist

2 months ago

Fall River, United States Southcoast Health System Full time

Overview:

Find out for yourself why Southcoast Health has been voted Best Place to Work for 6 years in a row

Join Southcoast Health, where your future is as promising as the care we provide. Our commitment to each other, our patients, and our community is more than a mission - its our way of life, and youll be at the heart of it.

Southcoast Health is a not-for-profit, charitable, health system with multiple hospitals, clinics and facilities throughout Southeastern Massachusetts and Rhode Island.

Nestled in local communities, Southcoast Health provides inclusive, ethical workplaces where our highly skilled caregivers offer world-class, comprehensive healthcare close to home.

We are searching for a talented Sr. Patient Access Intake Representative (Rehab)

* $1,200 New Hire Sign-On Bonus (Rehires Termed More than 1 year also eligible)*

Hours: 32hrs

Shift: Day Shift Mon, Tues, Thurs 9am-430pm and Wed, Fri 9am-1pm

Location: Charlton Memorial Hospital Fall River, MA

A career at Southcoast Health offers you:

  • A culture of well-being that embraces, respects, and celebrates the rich diversity of one another and the communities we serve.
  • Competitive pay and comprehensive benefits package
  • Generous Earned Time Off Package**
  • Employee Wellbeing Program
  • 403B Retirement Plan with company match
  • Tuition assistance / Federal Loan Forgiveness programs
  • Professional growth opportunities and customized leadership training

**Available to regular status employees who are scheduled to work a minimum of 20 hours.

Southcoast Health is an Equal Opportunity Employer.

Responsibilities:

Position reports to the Operations Team Leader of Rehab Services. Perform a wide variety of duties to secure optimal revenue for all services performed at Southcoast Health Rehab Services. Determine patient liability prior to service by creating an estimate based on individual payer, notifies patient of their potential liability in accordance with the Federal and State regulations. Initiate contact with patients, clinicians, and third party payers to obtain pre-certification and authorization for evaluations and diagnostic tests. Use critical thinking skills to ensure CPT codes are documented and authorized for the appropriate service. Navigate multiple payer portals to determine requirements for authorization and submit electronic requests. Follow up with payer denials by researching clinical data to support an appeal. Verify coverage and initiate authorizations for new evaluations and treatments

Qualifications:
  • Equal to completion of four years of high school plus additional specialized courses or training, secretarial school, diploma, or medical office certification.
  • Duties require comprehensive understanding of medical terminology and managed care plans and experience in obtaining and processing insurance referrals and authorizations.
  • Knowledge of Healthcare and Managed Care preferred.
  • Proficient keyboarding skills are essential.
  • Must possess strong reasoning and critical thinking skills.
  • Proficient in use of software applications such as e-mail, Work, Excel, EHR.
  • Exceptional customer service skills are required.
  • Over three years of related medical office work experience is required.
  • Experience in obtaining and processing insurance referrals and authorizations. Knowledge of Healthcare and Managed Care preferred.
  • Must be fully vaccinated against seasonal Influenza and the COVID 19 virus or to be exempt from the requirement for medical or personal reasons by signing a statement certifying you are choosing to be exempt from vaccination once hired.


Pay Range:
USD $16.88 - USD $28.00 /Hr.