Access Lead- UPMC Carlisle, Full-time

Responsibilities

• Support and contribute to UPMC core values and guiding principles of Your Care.
• Absorb and adhere to all UPMC departmental policies, procedures, and goals.
• Facilitate the completion of all statistical reporting and data analysis to ensure UPMC guidelines are supported.
• Serve as the primary information source and advocate for financial matters on site.
• Represent Management and be empowered to make decisions.
• Train new staff and orient to department work area.
• Provide ongoing education and communication as necessary.
• Provide feedback on a regular basis to management about all personnel, department issues, and concerns for areas of direct responsibility.
• Maintain oversight of patient flow and respond to changes in workload, patient volume, and staffing levels, planning services accordingly.
• Ensure precertification requirements have been met prior to treatment.
• Update patient demographic and insurance information in the system as necessary.
• Verify insurance benefit information with all available carriers via electronic verification system or telephone if not previously completed.
• Interact with the clinical staff and/or ancillary departments to resolve reimbursement issues.
• Advise the clinical staff of the need for a possible referral to a participating health care facility when appropriate.
• Work various revenue reports within established time frames.
• Take action accordingly to ensure a successful billing process.
• Perform in accordance with system-wide competencies/behaviors.
• Perform other duties as assigned.

Requirements

• High school diploma or GED and at least 3 years of experience in a related fiscal/admissions/registration function, or Associate degree and 1 year experience; or an equivalent combination of education and experience required.
• Medical terminology, third party health care coverage experience, and strong understanding of managed care regulations are required.
• Strong interpersonal, organizational, and communication skills, and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances.
• Ability to effectively problem solve and make independent decisions.
• Prior working experience on personal computers and various office equipment.
• Knowledge and skills necessary to provide care and/or interact appropriately with all ages of patients.

Qualifications

• Licensure, Certifications, and Clearances: Act 34