Lead Patient Access Representative

Working Location: St. Mary's Medical Center

Schedule

• 11pm–7am shift
• Rotating weekends and holidays

About the role

Demonstrates knowledge of departmental financial clearance and displays Patient Access leadership skills to lead a wide range of duties in support of departmental efficiencies. Responsibilities may include arranging support hospital services requested by patients through referrals, performing thorough analysis of admission discharge transfers (ADT), Revenue Cycle Reports, driving team performance accountability, leading shift Patient Access Operations, and collaborating with department leaders in process and operational excellence.

Responsibilities

• Greet customers following Conifer Standards of Care, provide world-class customer service, and complete full patient registration at date of service while adhering to financial and cash control policies and procedures.
• Thoroughly explain and secure hospital and patient legal forms (e.g., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA).
• Scan Protected Health Information, create and file patient information packets/folders for upcoming hospital services.
• Schedule diagnostic and/or surgical procedures, conduct physician office/patient interviews, and explain hospital procedure guidelines and policies.
• Coordinate with clinical departments on schedule modifications.
• Provide full patient financial counseling, education, and referrals.
• Employ and complete all patient liability collection escalations through proper, compliant techniques before, during, and after date of service.
• Perform hospital cash reconciliation and secured payment entry in adherence to financial and cash control policies and procedures.
• Secure medical necessity checks/verification in accordance with Centers for Medicare and Medicaid Services.
• Verify insurance, benefits, coverage, and eligibility.
• Complete assigned registration financial clearance work list activities.
• Obtain insurance authorizations for scheduled and unscheduled hospital services and secure inpatient visit notification to payors.
• Perform thorough analysis of admission discharge transfers (ADT) and Revenue Cycle Reports.
• Complete departmental operational reports based on team performance accountability.
• Lead shift Patient Access Operations and collaborate with department leaders in process and operational excellence.

Requirements

• 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.
• Advanced 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 cross-trained in all Patient Access service areas.
• Uses proper negotiation techniques to professionally collect money owed by patients/guarantors.
• Builds and maintains collaborative relationships with both internal and external clients to enhance communication, productivity, and accuracy.
• Identifies opportunities to improve patient relations and shorten the time it takes to handle registration processes.
• 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 office and patient issues.
• May experience extreme patient volumes and uncooperative patients.
• As applicable and permitted by law, candidates must obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment (e.g., COVID-19 vaccination, influenza vaccination, and any future required vaccines and screenings).

Qualifications

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

Physical Demands

• Must be able to sit at a 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

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