Sr Patient Access Representative - Pediatrics N Sparks

About the Role

This position performs duties outlined in the Patient Access Representative job description and supports the work of Patient Access Departments. The role includes providing department education, performing registration audits, creating and maintaining standard work, coordinating representatives' efforts to resolve complex accounts, and ensuring compassionate patient interactions during registration. The Senior Patient Access Representative may lead projects, review productivity, join committees, and float to various admitting sites within the health system. This role monitors registration and collection activities, serves as a day-to-day resource for representatives, and works in coverage as needed.

Responsibilities

• Conduct comprehensive registration with minimal assistance, in person or by phone, identifying all potential payer sources (federal, state, county assistance programs) to ensure reimbursement for services rendered.
• Ensure the registration process is expeditious, non-imposing, and meets payer requirements for insurance authorizations.
• Coordinate and relay accurate information pertaining to patient admissions, insurance authorizations, and potential denials.
• Prioritize workload to secure accounts financially and communicate delays to appropriate personnel.
• Use diplomacy to communicate effectively with patients, guardians, family members, physicians, and co-workers.
• Coordinate with interdisciplinary teams to ensure a seamless registration process.
• Serve as a primary resource for patient de-escalation and service recovery.
• Develop team members through group and one-on-one training and in-services.
• Facilitate, implement, monitor, and react to quality assurance mechanisms (JACHO).
• Monitor and develop workflows to improve Patient Experience.
• Develop and revise procedures relevant to the assigned area in coordination with other Patient Access teams.
• Conduct registration audits and share results with representatives and leadership; work with representatives to improve performance.
• Resolve operational issues with Patient Access Leadership.
• Communicate and track progress toward meaningful goals.
• Ensure patient financial liabilities are properly estimated and communicated to the patient.
• Produce education for Patient Access personnel to improve financial collection techniques.
• Participate in and/or assist with quality management processes.
• Work with Patient Access Leadership on department projects.
• Act as a resource for day-to-day operational questions.
• Serve as a customer service resource for walk-in patients in hospital lobby/patient registration area.
• Maintain a thorough understanding of federal and state regulations, payer requirements, and third-party financial assistance programs.
• Analyze insurance protocols for referrals, co-payments, deductibles, and allowances to determine patients' out-of-pocket liabilities.
• Train and onboard newly hired employees.
• Meet goals and productivity standards set by management, including performing quality assurance controls to ensure clean claims and meeting collection goals.
• Perform other duties as assigned by supervisors.
• Demonstrate professionalism in accordance with Renown's values of Integrity, Collaboration, Caring, and Excellence.

Requirements

• Working-level knowledge of the English language, including reading, writing, and speaking English.
• Minimum of 12 months of experience as a Patient Access Representative or lead experience in a relevant role.
• Experience in an acute hospital, surgical center, or outpatient center preferred.
• Completion of level 1 from the Retention and Development Program, "LEVL UP" preferred.
• Renown Health Patient Access "LEVL UP" program completed within the first year of hire.
• Active CHAA Certification preferred.
• Must possess or obtain within 90 days the computer skills necessary for online learning, accessing forms/policies, and completing online benefits enrollment.
• Thorough knowledge and proficiency with MS Excel and MS Word.
• Experience with EPIC system preferred.
• Typing skills of 35-45 words per minute.