Lead Consumer Access Specialist

About the role

Manages relationships with clinical partners to ensure open communication between clinical, ancillary, and consumer access departments.

Provides timely and continual coverage of assigned work areas to offer prompt patient service and availability for all clinical partner registration needs.

Provides on-call support as needed.

Contacts insurance companies to verify insurance eligibility and benefits, and determine coverage before scheduled appointments and during or after care for unscheduled patients.

Obtains pre-authorizations from third-party payers and accurately enters required authorization information in the system.

Registers patients for all services by obtaining critical demographic elements and ensuring accuracy.

Performs Medicare compliance reviews, eligibility checks, and completes Medicare Secondary Payer Questionnaires.

Safeguards patient accounts by ensuring they are assigned the appropriate payor plans and updating financial assessments, eligibility, and benefits.

Creates accurate estimates to maximize up-front cash collections and advises patients of expected costs, collecting payments or making appropriate payment agreements.

Affords on-call support to the department supervisor with quality audits, mentoring staff, assisting with departmental training, and staff schedules.

Collaborates with case management staff as necessary and ensures patients have logistical information necessary to receive their services.

Documents all conversations with patients and insurance representatives in the appropriate fields.

Actively attends department meetings and promotes positive dialogue within the team.

Responsibilities

• Manages relationships with clinical partners
• Ensures timely and continual coverage of assigned work areas
• Provides on-call support
• Verifies insurance eligibility and benefits
• Obtains pre-authorizations from third-party payers
• Registers patients for all services
• Performs Medicare compliance reviews
• Safeguards patient accounts
• Creates accurate estimates
• Affords on-call support to the department supervisor
• Collaborates with case management staff
• Documents conversations with patients and insurance representatives
• Attends department meetings

Requirements

• Mature judgement in dealing with patients, physicians, and insurance representatives
• Intermediate knowledge of Microsoft programs and familiarity with database programs
• Ability to operate general office machines such as computer, fax machine, printer, and scanner
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion
• Ability to communicate professionally and effectively, both verbally and written
• Ability to adapt in ever changing healthcare environment
• Follows complex instructions and procedures, with a close attention to detail
• Adheres to government guidelines such as CMS, EMTALA, and HIPAA and corporate policies
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital electronic medical report (EMR) system
• Basic medical terminology
• Must be able to read, write, and speak conversational English
• Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature as needed to perform duties
• Intermediate medical terminology
• Bilingual – English/Spanish

Qualifications

• Associate [Preferred]
• High School Grad or Equiv [Required]
• Field Of Study in business or related field
• 1+ customer service experience [Required]
• 1+ revenue cycle experience [Required]
• 2+ direct patient access experience [Preferred]

Skills

• Mature judgement in dealing with patients, physicians, and insurance representatives
• Intermediate knowledge of Microsoft programs and familiarity with database programs
• Ability to operate general office machines such as computer, fax machine, printer, and scanner
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion
• Ability to communicate professionally and effectively, both verbally and written
• Ability to adapt in ever changing healthcare environment
• Follows complex instructions and procedures, with a close attention to detail
• Adheres to government guidelines such as CMS, EMTALA, and HIPAA and corporate policies
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital electronic medical report (EMR) system
• Basic medical terminology
• Must be able to read, write, and speak conversational English
• Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature as needed to perform duties
• Intermediate medical terminology
• Bilingual – English/Spanish

Benefits

Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

Paid Time Off from Day One

403-B Retirement Plan

Whole Person Well-being Resources

Mental Health Resources and Support

Pet Benefits

Schedule

Full time

Shift Day (United States of America)

Address

9395 CROWN CREST BLVD

Parker, Colorado 80138