Patient Access - Patient Access Rep - PART TIME

Position

Patient Access - Patient Access Rep - PART TIME - 1st Shift

Sydney, OH

1518

1

Wilson Health is looking for a Part-time
- Patient Access Prior Authorization Specialist
for our location in Sidney, Ohio (North Dayton, Ohio) area.

• Access to Employer Direct Care Clinic. Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan.
• Generous paid time off program beginning day one
• Medical Insurance:
  Your Choice of Two High Deductible Health Plan Options or a PPO, Dental and Vision Insurance
• H S A with employer contribution for eligible health plans, FSA for medical and dependent care expenses
• Company Paid Life, Short Term and Long-Term Disability Insurance
• Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance
• Industry leading retirement plan- employer contributions begin day one, no waiting period for participation
• Tuition Assistance Program

At Wilson Health, our mission is to improve the health and wellness of our communities by delivering compassionate, quality care. We are committed to making a difference for our neighbors, friends, and family and our vision is to be a trusted, nationally-recognized leader of innovative, collaborative community health.

PART TIME

7AM - 3:00PM (Monday - Friday)

Must have EXCELLENT attendance

Every other weekend and every other holiday REQUIRED.

Shift differentials and holiday pay

Director of Patient Access

This position is responsible for the verification and documentation of insurance benefits and timely submission of initial prior authorization requests for outpatient and surgical procedures. Responsible for review and preparation of chart documents to accompany complex authorization requests. The Prior Authorization Specialist will provide appropriate information to third party payers and communicate with department clinicians when additional information is required to assure prior authorization is completed appropriately.

• Registers and interviews patient or patient’s representative to obtain and record name, address, age, persons to notify in case of emergency, attending Physician, and individual or insurance company responsible for payment of bill and other demographic and financial information deemed necessary to complete patient record.
• ER Registration, Labor and Delivery Registartion as needed.
• Prior Knowledge of Electronic Health Records (EHR) - EPIC
• Answers telephone, schedules appointment(s) for outpatient testing and pre-registers patient for same in an accurate and efficient manner.
• Maintains proper phone etiquette and responds to all inquiries or routes call to the appropriate area.
• Appointments scheduled per department guidelines and policy.
• Enters pre-registration information in the HIS system on scheduled appointments in an accurate manner per department policy.
• Enters patient information into computer and routes printed copies to designated department.
• Prepares  for Same Day Surgery patients and routes appropriately.
• Obtains necessary signatures of consent from the patient/representative and explains patient’s rights to the patient/representative.
• Reviews computer print outs for correct information, separates and distributes copies to appropriate departments.
• Maintains files and keeps forms current.
• Effectively present information and respond to questions from managers, staff members, patient, patient’s family, and the general public. These would include the pediatric client, the adolescent client, the young-middle aged client, and the geriatric client.
• Demonstrates a comprehensive knowledge in changing government regulations. Must maintain local and national medical review policies and precertification of outpatients. Will screen diagnosis on patients with Medicare Health Insurance for procedures that have LMRP’s in place and request additional information from Dr offices as needed or present patient with an Advanced Beneficiary Notice if needed for non-compliant diagnosis.
• Additional…