The Patient Access Lead is a pre-supervisory level of the Patient Access career path.
In addition to the primary and essential responsibilities of a Specialist, the Team Lead supports the daily operations of the specific work area. Under the supervision of the Patient Access Supervisor the Patient Access Lead will serve as the first line of escalation for staff questions on workflows and processes as well as provide coverage in the absence of the Supervisor. The lead will be responsible for onboarding new staff and serve as the go-to resource to staff. This individual will be responsible for quality assurance audits and performing process improvement activities.
The Team Lead must be a self-starter, comfortable working in a fast paced, results oriented, collaborative, people-centered environment. This position is customer service driven and the Lead must have the ability to effectively promote positive customer service while working in a highly stressful and complex environment. The lead can quickly assess an urgent situation and provide issue resolution and de-escalation.
Responsibilities:
Works collaboratively with individuals and teams to create plans that develop competence to achieve goals and priorities.
Encourages staff to be proactive in identifying problems and developing/recommending solutions.
Provides superior customer Service; meets the needs of the patient by using clear and respectful communication while obtaining necessary information.
Educates/trains others on insurance basics/verification and authorization/referral processes.
Complete quality improvement and productivity activities.
Serve as knowledge expert and an escalation point for staff questions and concerns.
System(s) Super User.
Timely and precise completion of each registration, following all department processes and procedures. Must verify that all demographic and insurance information is accurate; utilize Epic, payer websites or telephone for insurance verification. Obtain current copies of insurance cards and photo identification. Secures patient signatures for required forms. The Advanced Beneficiary process must be completed accurately when appropriate based on pre-established guidelines.
Perform point of service collections: Responsible for meeting monthly collection goals, having financial conversations with patients as it relates to their co-payments, deductibles, co-insurance, deposit amounts and outstanding balances. Documents payments/actions in the EHR. Provides pricing estimates (when applicable) and communicates patient liability. Follows cash drawer balancing procedures, as appropriate, reconciles payments against deposit totals.
Identify the patient using two factor identification. Complies with EMTALA regulation when creating the quick registration account (when applicable).
Review, research and resolve accounts in assigned work queues.
Assist with following up on accounts in denial status
Complete financial registration responsibilities including but not limited to creating guarantor accounts, interpreting eligibility requirements, collecting document signatures, insurance card scanning, identity verification, collecting patient payments, and creating financial estimates.
Recognizes and evaluates situations for appropriate escalation.
Ensure all pre-authorizations are obtained prior to service, as applicable. Notify supervisor of any insurance authorization issues.
As appropriate, completes Medicare Secondary Payer questionnaire without errors to support compliance with CMS policies.
Displays aptitude and willingness to learn new responsibilities.
Responds to disaster and mass casualty situations in a calm and appropriate fashion. Maintains and understands the emergency management processes and procedures specific to that unit.
Adheres to department and system policies. Interact with co-workers, visitors, and other staff consistent with the Bayhealth values.
Scheduling (as applicable) – may need to schedule appointments, following procedures and protocols. Assist patients with referral needs in obtaining additional appointments with specialists, and insurance approval authorization for additional visits.
Patient flow (as applicable) - maintain efficient patient flow in the registration and check-in process. Accurately complete reception duties in accordance with policies.
All other duties as assigned within the scope and range of job responsibilities.
Required Education, Credential(s) and Experience:
Education: High School Diploma or GED ;
Credential(s): None Required
Experience: Required: Three (3) years’ experience in Patient Access, Healthcare Revenue Cycle role.
Preferred: Five (5) years’ of experience in Patient Access, Healthcare Revenue Cycle, or clinic operation role with progressive leadership responsibilities.
Preferred Education, Credential(s) and Experience:
Education: Associate Degree Associate Degree Associate Degree Associate Degree Business Administration Related field Finance Health Information Management