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

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

Key

Perks and Benefits :

* 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 (PTO) program beginning day one, designed to support work-life balance, rest, and time with family.

* Medical Insurance:
Choose from two High Deductible Health Plan (HDHP) options or a PPO plan, along with Dental and Vision coverage. Benefits begin on the first of the month following your hire date.

* HSA with employer contribution for eligible health plans; FSA for medical and dependent care expenses.

* Company-paid Life Insurance 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 with no waiting period for participation.

* Tuition Assistance Program

* Free access to an on-site gym, available 24/7, making it easy to prioritize your health and wellness before or after your shift.

* Employees receive a 10% discount on food and beverages at the Wilson Cafeteria, Coffee Bar and Micro Mart.

Who We Are:

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.

Employment Status: PART TIME

Working Hours:

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

Shift: 1st Shift - 48 hours per pay period, 3 days per week.

Every other weekend and every other holiday REQUIRED.

Must have EXCELLENT attendance

Incentives:

Shift differentials and holiday pay

Position

Reports to:

Director of Patient Access

SUMMARY:

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.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

* 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 Registration 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 responsibilities may be required for lead roles such as providing recommendations for process improvement and maintaining quality aspects within Patient Access.

* Aware of the functions within the scope of the hospital policy/procedure.

* Aware of and responds to Disaster/Fire Plan per policy.

* Maintains patient confidentiality at all times.

* Performs other duties within scope of responsibility as assigned.

EDUCATION AND/OR

EXPERIENCE:

High School…