Patient Service Specialist Prior Authorizations East OB GYN Mercy Health
3 weeks ago
At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.
**Job Title:**
Patient Services Specialist
Responsible for all aspects of scheduling, pre-registration and financial clearance functions associated with the respective specialty procedures. Responsibilities include collection and validation of accurate patient demographic and insurance information, obtaining pre-certification/authorization, scheduling the patient for outpatient and inpatient services, and entering information into multiple outpatient and inpatient systems. Other responsibilities include serving as the primary liaison with the patient, physician and hospital related to financial aspect of services.
Ensures that all pre-operative requirements have been completed, including scheduling surgeries, pre-admission testing, scheduling for outside medical evaluations related to surgery, and pre-operative teaching classes.
Initiates the insurance verification and pre-authorization process by contacting insurance carriers and providing proof of needed documentation.
Works closely with involved providers to pre-certify procedures and other necessary evaluations or processes; assists with denial and appeal process.
Reviews benefits, cost and coverage with patients and assesses their potential financial liability, and answers applicable questions. Completes all documentation for processes for both outpatient and inpatient services.
Proactively communicates issues or potential issues involving customer service and process improvement opportunities to management and providers.
Demonstrates a willingness and ability to work collaboratively with others for concise and timely flow of information. Maintains stable performance under pressure and handles stress in ways to maintain relationships with patients, customers and co-workers.
Required minimum education: High school diploma or GED
Experience: two years of experience in a similar health care role.
Many of our opportunities reward* your hard work with:
Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
Employer contributions to retirement savings plan when eligible
Paid time off
Educational Assistance
And much more
*Benefits offerings vary according to employment status
All 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 Employers, 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
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