Patient Access Lead Representative

Job Summary

Working Location: St Mary's Medical Center
Shift Information: M-F 3p-1130p, Rotating Weekends

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 which may include but not limited to 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, collaborating with Department leaders in process and operational excellence.

Essential Duties And Responsibilities

• Greeting customers following Conifer Standards of Care, providing world-class customer service
• Completes full patient registration at date of service adhering 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.)
• Scans Protected Health Information, creates and files patient information packets/folders for upcoming Hospital services
• Schedules diagnostic and/or surgical procedures, conducts physician office/patient interviews, and explains hospital procedure guidelines and policies
• Collaborates 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

• 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 crossed trained in all Patient Access service areas
• Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
• Buils 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

Physical Demands

• 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

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