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Heywood Hospital Patient Access Authorization Specialist, 40 Hours, Days in Gardner, Massachusetts

Job Requirements Minimum Education * High School Diploma Minimum Work Experience * Formal training beyond high school preferred * Two years experience with insurance authorization requirements and process preferred. * Referral and/or third-party experience preferable Required Skills * Medical terminology, spelling competence and computer experience essential. * Excellent written and oral communication skills * Ability to perform multiple tasks with minimal supervision * Self-motivation with the ability to work as a team as well as independently * Use time management skills and deal effectively and courteoulsy with public, insurance representatives, case managers, physicians and all hospital personnel in a high-volume setting. Functional Demands * Physical Requirements: Exerts up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Frequently reaches (extending hands and arms in any direction), and handles (seizing, holding, grasping, turning, or working with hands). Organizational Expectations Behavioral Attributes: Conducts interactions with everyone in a friendly, courteous and respectful manner. Goes out of his/her way to offer assistance to others. If he/she cannot offer assistance, then finds someone who can. *Essential Functions * * Registers patients accurately, efficiently and professionally to ensure data integrity and facilitate timely claims processing. Collect and record accurate information. * Obtains and verifies all necessary demographic and billing information. * Uses system and regulatory compliance guidelines during the registration to assure proper patient identification, in support of patient safety. * Responsible for verifying and securing authorizations required by third party payer policies for inpatient and outpatient services in a timely manner and documenting in appropriate area in the EHR system. * Familiar with payer specific information, authorization guidelines, medical necessity and CPT/Diagnosis codes. * Communicate with insurance companies, provider office and patients in regards to status of authorization. Familiar with payer specific information, authorization guidelines, medical necessity and CPT/Diagnosis codes. * Prioritize workload and utilize system applications with a focus on completion of claim prior to filing. * Utilizes system programs for everyday work including follow up workflows to ensure authorizations are in place and valid * Refers uninsured patients to financial counselor * Communicates with other departments and providers to hold scheduling and service provision for non-emergent services until authorization is approved by insurance carrier * Assist in claim resolution and resolving payer problems by researching and verifying claim information * Scan documents to electronic medical record * Determines amount of patient payments, collects payments at point of service, or refers to appropriate party for follow up * Applies appropriate departmental guideline to ensure the financial security and handling of the patient accounts and sensitive material *Statement of Other Duties: This document describes the major duties and responsibilities for this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described. Facility: Heywood Hospital Department: HH. PATIENT REGIS.,2000.66550 Regular or Temporary Position: Regular Position Control #: 2000.66550.XXXX Position Hours: 40 Shift: Day Weekend Frequency: Every fourth Holiday Rotation: Every fourth Job Title: Patient Access Authorization Specialist, 40 Hours, Days Location: Gardner, Massachusetts Posted Date: 06/01/2021

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