Lead Consumer Access Specialist Lake Placid

Responsibilities

• 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.
• Ensures patient accounts are assigned the appropriate payor plans and updates 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.
• Assists department supervisor with quality audits, mentoring staff, assisting with departmental training, and staff schedules.
• Coordinates 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.
• Other duties as assigned.

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
• Ability to follow 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
• Must be able to read, write, and speak convers