Lead Patient Access Representative

Job Description

Working Location: St Mary's Medical Center

Shift Information: M-F 3p-1130p, Rotating Weekends

Demonstrates knowledge of departmental financial clearance and displays Patient Access leadership skills to lead a wide range of duties in support of departmental efficiencies which may include but not limited to arranging support Hospital services requested by patients through referrals, performs thorough analysis of admission discharge transfers (ADT), Revenue Cycle Reports, drive team performance accountability, leads shift Patient Access Operations, collaborates with Department leaders in process and operational excellence.

Essential Duties And Responsibilities

Include the following. Others may be assigned.

• Greeting customers following Conifer Standards of Care, provides world-class customer service, completes full patient registration at date of service adheres to financial & cash control policies & procedures, thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.). Scan Protected Health Information, create and file patient information packets/folders for upcoming Hospital services. May also schedule diagnostic and/or surgical procedures, conducts physician office/patient interviews, and explains hospital procedure guidelines and policies. Coordinates with clinical departments on schedule modifications.
• Provides full patient financial counseling, education & referrals, employs and completes all patient liability collection escalations through proper, compliant patient liability collection techniques before, during & after date of service, performs Hospital cash reconciliation & secured payment entry in adherence to financial & cash control policies & procedures.
• Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicare services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors.
• Performs thorough analysis of admission discharge transfers (ADT), Revenue Cycle Reports, completes departmental operational reports based on team performance accountability, leads shift Patient Access Operations, and collaborates with Department leaders in process and operational excellence.

Knowledge, Skills, Abilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Minimum typing skills of 35 wpm
• High level working knowledge of all Software, programs and equipment, including PCs
• Knowledge of function and relationships within a hospital environment preferred
• Advance Customer service skills and experience
• Ability to work in a fast paced environment
• Ability to receive and express detailed information through oral and written communications
• Advanced Understanding of Third Party Payor requirements preferred
• Advanced Understanding of Compliance standards preferred
• Advanced Patient Liability Collection performance and high achievement in productivity
• Must be crossed trained in all Patient Access service areas
• Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
• Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy
• Identifies opportunities to improve patient relations and shorten the time it takes to handle registration processes

Education / Experience

Include minimum education, technical training, and/or experience preferred to perform the job.

• High School Diploma or GED required
• 2-4 year college degree in Business, Accounting, Medical Administration or related area preferred
• 2 – 4 years experience in medical facility, health insurance, or related area
• 3– 5 years experience in Patient Access preferred
• 1 – 2 years in supervisory or lead role preferred

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to sit at computer terminal for extended periods of time
• Occasionally lift/carry items weighing up to 25 lbs.
• Frequent prolonged standing, sitting, and walking
• Occasionally push a wheelchair to assist patients with mobility problems.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Hospital administration
• Can work in patient care locations which include potential exposure to life-threatening patient conditions.

Other

• Must be available to work hours and days as needed based on departmental/system demands.
• Must be available for on-call scheduling support when required.
• Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients.

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!