Patient Access Intake Specialist Sr

Work for One of the World's Best Health Systems!

For Five Consecutive Years, Newsweek named Southcoast Health among the World's Best Hospitals (Charlton Memorial, St. Luke's, and Tobey). In addition, since 2018, Southcoast Health has been voted by readers as South Coast Media Group's Best Place to Work. Why? Because we have some of the most talented people in the world!

• Hours: 40hrs
• Shift: Day shift
• Location: Charlton Memorial Hospital - Fall River, MA

We are searching for a Patient Access Intake Specialist Sr to 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

Education and/or Experience Requirements:

• 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, HER
• Exceptional customer service skills are required
• Over three years of related medical office work experience is required
• Associates degree preferred. 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.

* Office is set up in a Cube environment - Social Distancing is observed. There is no face to face patient contact - all communication with Patients and Providers is over the phone.

Southcoast Physicians Group (SPG) is a multi-specialty integrated network of more than 450 providers in southeastern Massachusetts and Rhode Island. We are focused on bringing together high-quality to deliver exceptional health care services.

Southcoast Health is a community healthcare system with multiple access points, offering an integrated continuum of health services throughout Southeastern Massachusetts and Rhode Island. By uniting a single purpose and building an integrated system of services and resources, we have become one of the largest and fastest-growing health systems in Massachusetts.

Together We Are More.

• With more than 7,500 employees, Southcoast Health is the largest employer in Southeastern Mass., and the 18th largest employer in the Commonwealth, according to the Boston Business Journal.
• We strive for a culture of health and well-being that recognizes, respects, and celebrates the rich diversity of one another and the communities we serve.

We are committed to providing our employees in Massachusetts and Rhode Island with optimal benefits that promote a healthy work/life balance and add value to our employees' lives.

• Generous Earned Time Off Package**
• Health, Dental and Vision Insurance*
• Tuition Assistance**
• Short Term and Long-Term Disability Insurance*
• Life & AD&D insurance*
• Flexible Spending Accounts*
• 403B Retirement Plan with match
• HealthQuest Wellness Program
• Employee Assistance Program
• Employee Discount Program
• Career Development Opportunities
• Diversity, Equity and Inclusion Council

*Available to regular status employees who are scheduled to work a minimum of 24 hours.

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

Are you ready to make a difference in your community? Join us to be More than medicine!

Southcoast Health is an Equal Opportunity Employer