Patient Access Team Lead - Emergency Department - West Penn - Full Time

Job Title

Creates the first impression of Allegheny Health Network's (AHN) services to patients, families, and other external customers upon arrival.

Job Description

Assumes clinical and financial risk of the organization when collecting and documenting information on the patient's behalf. Completes one or more of the following processes (proper patient identification, scheduling, registration, financial clearance, authorization, and referral validation, creates estimate, and payment collection when applicable). Connects patient to financial advocacy resources when appropriate, provides or obtains signatures on regulatory paperwork as required. Articulates information in a manner that patients, guarantors, and family members understand so they know what to expect and understand their financial responsibilities. Displays a strong attention to detail, excellent communication skills, empathy and compassion for patients and their families. Has the ability to multitask, work swiftly under pressure in a high acuity patient environment, and work collaboratively with healthcare professionals. Must stand for extended periods of time and use a computer on wheels at bedside. Adheres to all EMTALA guidelines and AHN policies and procedures while performing routine duties. Follows standard precautions and isolation precautions to provide adequate protections for healthcare workers, patients, and visitors. This position coordinates and leads the daily functions in the Emergency Department along with providing direction and support to staff as needed. Serves as the subject matter expert and primary information source for revenue cycle functions by identifying and providing training needs, resolving work related issues and technical problems during working hours. Facilitate the completion of all statistical reporting and data analysis to ensure regulatory compliance and KPIs are met.

Essential Responsibilities

• Coordinates activities and workflow for the emergency department processes, including performing all essential responsibilities outlined in the Patient Access Coordinator II / Emergency Department job profile.
• Participates in monitoring, tracking, and assisting with evaluating staff performance and productivity as established by department/hospital goals. Provide feedback to management regularly about all personnel, department issues, and concerns related to scope of responsibility.
• Supports leadership team in achievement of organizational goals and initiatives. Serves as an advocate, resource, and designated leader to staff, patients, and internal and external customers. Represents management and is empowered to make decisions within scope of responsibility.
• Identifies and resolves registration, scheduling, insurance verification, coding, and billing issues and takes appropriate action within established timeframes. Monitors and maintains all assigned work queues.
• Responsible for training staff. Ensures staff competency and compliance with all technical and clerical components of the patient access processes as per policies and regulatory requirements.
• Other duties as assigned or requested.

Qualifications

Required

• High school diploma or GED; or one three months related experience and/or training; or equivalent combination of education and experience
• 3-5 years of related experience, preferably within a medical setting, financial services setting, and/or a demanding customer service environment
• Medical terminology, third party health care coverage experience, and strong understanding of managed care regulations
• Experience with various computer software programs

Preferred

• Associate's degree
• Experience with benefit verification, collections, and financial counseling

Skills

• Ability to effectively problem solve and make independent decisions
• Strong interpersonal, organizational, and communication skills; ability to remain professional and courteous when dealing with sensitive issues and stressful circumstances

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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