Top 19 Patient access specialist Jobs in Mentor Oh

Pharmacy Support Liaison - Patient Engagement Team (Hybrid)
University Hospitals —Warrensville Heights, OH
- $22.22 - $34.76 an hour
- Medical office experience
- Mid-level
- 3 years
4d
Pharmacy Support Liaison, Bolwell
University Hospitals —Cleveland, OH
- $22.22 - $34.76 an hour
- Medical office experience
- Mid-level
- 3 years
Maternity Services Representative-Delivery Room; 80 hrs Biweekly, Evenings
METROHEALTH MEDICAL CENTER —Cleveland, OH
- Full-time
- Hospital
- HIPAA
- High school diploma or GED
Medical Office Receptionist
Premise Health —Solon, OH
- $18.40 - $23.00 an hour
- Full-time
- 3 years
- High school diploma or GED
- Clinic
- Wellness program
- Paid holidays
Prior Authorization Certified Pharmacy Technician
Shields Health Solutions —Cleveland, OH
- $19.45 - $22.21 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- Research
Quick Apply
11d
ROI Medical Records Specialist
MRO Corporation —Cleveland, OH
- $16 - $22 an hour
- Full-time
- Computer literacy
- Medical office experience
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Medical Records Specialist-Correctional Medicine 80hrs Biweekly Eves
County Correctional Cleveland —Cleveland, OH
- Full-time
- Customer service
- Medical office experience
- HIPAA
Medical Office Specialist
Neighborhood Family Practice —Cleveland, OH
- $15.50 - $19.00 an hour
- Full-time
- Spanish
- Computer literacy
- English
Quick Apply
Trauma Data Specialist II-Surgery Trauma Support; 80 HRS Days
METROHEALTH MEDICAL CENTER —Cleveland, OH
- Full-time
- Anatomy knowledge
- Surgery
- Customer service
Certified Pharmacy Technician - Support Liaison - Ambulatory Infusion Center
University Hospitals —Warrensville Heights, OH
- $22.22 - $34.76 an hour
- Hybrid work
- Medical office experience
- Mid-level
- 3 years
9d
Patient Support Advocate, Bolwell Pharmacy
University Hospitals —Cleveland, OH
- $17.56 - $27.46 an hour
- Mid-level
- Analysis skills
- Bachelor's degree
Area Supervisor, Medical Records, Release of Information
MRO Corporation —Cleveland, OH
- $51,000 - $69,000 a year
- Full-time
- Management
- Hospital
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Senior Revenue Cycle Precert Specialist Ophthalmology
University Hospitals —Cleveland, OH
- $18.76 - $29.34 an hour
- 5 years
- High school diploma or GED
- Senior level
3d
Director, Clinical Informatics; Information Technology
The Centers —Cleveland, OH
- $105,000 - $120,000 a year
- Full-time
- 5 years
- HIPAA
- Master's degree
Quick Apply
14d
Utilization Management Team Lead
Florida Cancer Specialists & Research Institute —United States
- Full-time
- Background check
- Medical office experience
- Mid-level
- Tuition reimbursement
- 401(k) matching
2h

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Pharmacy Support Liaison, Bolwell
University Hospitals —Cleveland, OH
Triage and respond to incoming phone calls providing information and assistance to meet the caller’s needs. Bachelor's Degree in health care related or business…
$22.22 - $34.76 an hour
Pharmacy Support Liaison - Patient Engagement Team (Hybrid)
University Hospitals —Warrensville Heights, OH
Triage and respond to incoming phone calls providing information and assistance to meet the caller’s needs. Bachelor's Degree in health care related or business…
$22.22 - $34.76 an hour
4d

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Part-time Express Clinic Evening Patient Access Representative
Equitas Health, Inc. —Columbus, OH
Working under the supervision of the Clinic Manager, the Patient Access Representative will work closely with the medical, mental health and recovery, and other…
$18.13 - $21.78 an hour
Quick Apply
Patient Onboarding Specialist
AndHealth —Columbus, OH
Serve as the first problem-solver for incoming calls from patients, partners, or other stakeholders – diagnose the need, resolve directly when possible, or…
Quick Apply
4d

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Pharmacy Support Liaison - Patient Engagement Team (Hybrid)

University Hospitals -
Warrensville Heights, OH

Apply Now

Job Details

$22.22 - $34.76 an hour
4 days ago

Qualifications

Medicare
Medical office experience
PTCB Certification
High school diploma or GED
Medicaid health insurance
ICD-9
ICD-10
Medicare regulations
Centers for Medicare and Medicaid Services (CMS)
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid regulations
Medicaid
Medical terminology

Full Job Description

Sign on bonus: $3,000!!

A Brief Overview

The team requires a highly motivated, energetic, team player who is responsible for completing necessary functions to ensure optimal intake and reimbursement for high cost and infusion medications for patients receiving care within the UH Meds enterprise of pharmacy operations. The Pharmacy Support Liaison must have a strong knowledge of Medicare and Medicaid regulations and commercial insurer criteria for payment of home care services. Additionally, they will be responsible for verification of insurance, and benefits for Home Care Pharmacy services – inclusive of new referrals and therapy changes, adjudication of claims and obtaining the initial authorization for visits from commercial insurers. This position will work with Home Care RN Coordinators, Pharmacist and other clinical teams to ensure that required clinical documentation is obtained prior to acceptance onto service. They will also enters pertinent information into the pharmacy and/or certified home health software systems used by the enterprise. The position works closely with and is a supportive role to the Transition Specialist, Clinic Based/Distributional Pharmacists, Central Intake RN's and the Document Control Specialist.

What You Will Do

Access care management documentation systems for data entry and to support the existing programs and processes by collecting information, utilizing appropriate department policies, procedures and guidelines specific to members’ eligibility, benefits and contracts.
Perform intake of service requests from providers or members received electronically, or via telephone or fax.
Triage and respond to incoming phone calls providing information and assistance to meet the caller’s needs.
Authorize service(s) based on plan design or clinical guidelines in accordance with the department policies/guidelines.
Improve patient service experience and maximize pharmacy revenue through provision of prior authorization services on behalf of patients needing high cost medications.
Conduct patient insurance, benefits and financial investigation and verification by directly communicating with patients. Complete initial and renewal prior authorization forms, negotiate authorization status with insurers, track status of medication approval, and when necessary, alert stakeholders of denials or nonresponse.
Identify patient needs and ensure coverage of medication on their insurance plan through benefits investigation. If not covered, obtain necessary information from medical record, patient, and provider to enable justification for Patient Assistance program or copay assistance. Contact patients to provide information related to these resources.
Facilitate enrollment of patients in patient assistance programs and collaborate with social services and case management on patient assistance. Assist pharmacists with preparing letters of medical necessity and coordinating peer-to-peer conferences.
Expedite pharmacy workflow and enhance patient care by preventing therapy interruptions due to insurance issues in conjunction with pharmacists, physicians, transition care coordinators, nursing, and clinic staff. Communicate and collaborate regarding patient therapy interruptions, additional therapy monitoring requirements, and alternative care delivery setting options.
Participate in revenue cycle committees to help identify causes of denied claims and develop workflow solutions to optimize revenue capture
Facilitate staff training and competency, education and practice advancement
- Train new staff members
- Maintain a training and competency program for all staff that meets accreditation standards
- Coordinate with Pharmacy leadership to develop training experiences/competencies
- Represent the department at hospital meetings, committees, and events as requested
Patient Engagement Tele pharmacy Support:
- Answer incoming calls and respond to electronic communications
- Assist health care providers and patients by greeting them by phone; answering questions and requests; referring inquiries to the site pharmacist(s) as needed.
- Handle customer inquiries both telephonically and by email
- Research required information using available resources
- Manage and resolve customer complaints

Additional Responsibilities

Performs other duties as assigned.
Complies with all policies and standards.
For specific duties and responsibilities, refer to documentation provided by the department during orientation.
Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.

Education

High School Equivalent / GED (Required)
Bachelor's Degree in health care related or business field (Preferred)

Work Experience

3+ years Strong clinical background experience in a medical office or other health care setting (Required)

Knowledge, Skills, & Abilities

Knowledge of medical terminology and ICD9, ICD10, CPT, and DRG codes (Required proficiency)
Knowledge of third-party insurance billing practices, federal and state regulations with regard to billing and reimbursement, internal billing structure, and billing procedures (Required proficiency)
Experience with patient assistance programs (Required proficiency)

Licenses and Certifications

Certified Pharmacy Technician (CPhT) (Required Upon Hire)

Physical Demands

Standing Occasionally
Walking Occasionally
Sitting Constantly
Lifting Rarely up to 20 lbs
Carrying Rarely up to 20 lbs
Pushing Rarely up to 20 lbs
Pulling Rarely up to 20 lbs
Climbing Rarely up to 20 lbs
Balancing Rarely
Stooping Rarely
Kneeling Rarely
Crouching Rarely
Crawling Rarely
Reaching Rarely
Handling Occasionally
Grasping Occasionally
Feeling Rarely
Talking Constantly
Hearing Constantly
Repetitive Motions Frequently
Eye/Hand/Foot Coordination Frequently

Travel Requirements

Apply Now

Refine Your Search

patient access specialist jobs in mentor oh

Pharmacy Support Liaison - Patient Engagement Team (Hybrid)

Pharmacy Support Liaison, Bolwell

Maternity Services Representative-Delivery Room; 80 hrs Biweekly, Evenings

Medical Office Receptionist

Prior Authorization Certified Pharmacy Technician

ROI Medical Records Specialist

Medical Records Specialist-Correctional Medicine 80hrs Biweekly Eves

Medical Office Specialist

Trauma Data Specialist II-Surgery Trauma Support; 80 HRS Days

Certified Pharmacy Technician - Support Liaison - Ambulatory Infusion Center

Patient Support Advocate, Bolwell Pharmacy

Area Supervisor, Medical Records, Release of Information

Senior Revenue Cycle Precert Specialist Ophthalmology

Director, Clinical Informatics; Information Technology

Utilization Management Team Lead

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