Patient Access Lead Representative

Working Location: Piedmont Medical Center

Schedule

• Sunday–Tuesday: 7 p.m.–7 a.m.
• Wednesday: 7 p.m.–1 a.m.
• 3–5 weeks of Monday–Friday day-shift training required before transitioning to night shift.

Responsibilities

• Greet customers following Conifer Standards of Care; provide world-class customer service.
• Complete full patient registration at date of service; adhere to financial and cash-control policies and procedures.
• Thoroughly explain and secure hospital and patient legal forms (e.g., Advance Directives, Conditions of Service, 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; 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 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 & 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; 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.
• Collaborate with department leaders in process and operational excellence.

Requirements

• 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 in Patient Access preferred.
• 1–2 years in a supervisory or lead role preferred.
• Minimum typing skills of 35 WPM.
• High-level working knowledge of all software, programs, and equipment, including PCs.
• Knowledge of hospital environment and relationships 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 internal and external clients to improve communication, productivity, and accuracy.
• Identifies opportunities to improve patient relations and shorten 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 employment (e.g., COVID-19 vaccination, influenza vaccination, and any future required vaccines).

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 setting.
• May work in patient care locations with potential exposure to life-threatening patient conditions.