Patient Access - Eligibility Screening Specialist

Welcome to Ovation Healthcare!
At Ovation Healthcare, we?ve been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating... excellence, we help rural healthcare providers fulfill their missions.
The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare's vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior.
We?re looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork.
Ovation Healthcare's corporate headquarters is located in Brentwood, TN. For more information, visit https://ovationhc.com.
Description
Amplify, an Ovation Healthcare company is seeking Certified Professional and/or Facility Coders with a minimum of three years' experience in a hospital and/or clinic setting coding, prefer Critical Access Hospital and Rural Health but not necessary. Seeking knowledge in the following areas, Inpatient, Observations, Emergency, Same Day Surgery, Ancillary, Recurring therapies, Provider-based and Free standing clinics/offices. Must be able to pass testing on proficiency and knowledge. Must be proficient in excel, can multi-task, excellent communication skills both verbally and in writing. Must be able to maintain a 95% QA accuracy rate as well as productivity standards. Must be able to follow official coding guidelines.
Summary
The ESS Analyst, reflects the mission, vision, and values of Amplify RCM, adheres to the organization?s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards. This position reports to the Patient Access Manager.
The position requires a resourceful, self-directed team player capable of handling multiple tasks, including research, meeting with, and communicating with clients via email/phone, collecting required application materials and drafting documents. This position is responsible for navigating the complexities of Medicaid eligibility, application processes, and compliance for patients. This position acts as a liaison between patients, healthcare providers and government agencies, ensuring that individuals receive the benefits they are entitled to and that applications are processed efficiently and accurately.
The ESS Analyst should possess strong interpersonal skills, communication skills, telephone etiquette, and excellent customer service skills. The ESS Analyst will verify the patient demographical and health insurance information. A successful ESS Analyst will practice courtesy when answering or making telephone calls and will build a good rapport with scheduling staff, insurance/benefit verification staff and ancillary department staff. The ESS Analyst will also satisfactorily achieve and maintain all productivity and QA standards according to department requirements and policies.
Responsibilities
? Run census daily to review for correction insurance and financial class assignments.
? Visits all self pay emergency room, inpatients, observation, and families of newborns within 24 hours of admission.
? Conducting phone calls to patients to thoroughly verify and determine if eligibility requirements for Medicaid have been met or would be met by the patient based on federal and state guidelines.
? Provides guidance and support to applicants and accurately submits and investigates/reviews and processes application submission, resolves discrepancies and ensures compliance by the patient.
? Assists Financial Counselor and Patient Access Manager to obtain pertinent information as needed through in room patient visits and phones calls pre and post service delivery.
? Conducting themselves in a courteous and professional manner.
? Verifying and communicate any monies owed by patient.
? Attends all required department meetings and hospital-wide meetings as assigned.
? Completes all required education and training for hospital employees and department specific requirements.
? Embraces new processes, procedures, and applications, which can enhance processes.
? Communicates and builds relationship with physician clinics and ancillary departments to ensure patients are screened appropriately for all services.
? Completes other duties assigned by Patient Access Manager and/or Revenue Cycle Director, including assisting with other functions in registration when volumes dictate.
Required Skills And Experience
? Minimum one (1) year of experience in insurance verification and/or Medicaid eligibility processing/determination experience.
? Minimum two (2) years of experience in a medical office or hospital patient access related environment.
? Strong oral, and written communication skills as well as computer skills and a track record of excellent customer service.
? Proven ability to careful attention to detail and must be able to perform work according to department standards.
? Excellent multi-tasking in a challenging fast-paced environment and demonstrate the ability to manage large caseloads efficiently.
? Must possess excellent people skills, be mature, apply critical thinking skills and effectively function under stressful situations.
? Proficient in MS Office applications which include Outlook, Word, Excel, and PowerPoint
Education:
? High School Diploma or GED required, college degree or some college preferred

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