Lead Patient Access Representative

To obtain accurate & complete patient information & payer verification in a Customer focused manner, to assure expedient care & accurate billing. Serves as a facilitator/resource person to ensure effective daily department operations.

Description:
Acts as a resource for Patient Access reps when questions or problems arise.
Ensure effective daily department operations & participate in the staffing process to ensure adequate staffing in all registration areas.
Assist department manager with training & orienting new employees.
Provides patient receipts & posts payment information into financial system.
Interview patient &/or patient representative to obtain required information necessary to complete the registration process in the hospital information system & maintains the accuracy, confidentiality & integrity of the automated database.
Coordinate & communicate accurate & updated registration/admission/& pre-admission activities with Medical Records, Care/Case Management, Utilization Management, Physicians' offices, Patient accounts, & any other hospital departments, as may be required, to support the appropriate, accurate, safe & effective patient care.
Initiate & maintain organized files & records, related to orders, payer authorizations, booking slips, schedules, & others per department procedure.
Contacts patients, employers, insurers & patient representatives to obtain insurance & other information necessary to secure hospital reimbursement, verifies benefits & pre-certifies all insurance plans to ensure maximum reimbursement to the hospital.
Verifies benefits, utilizing insurance verification systems. Obtains referrals & authorizations required & documents complete information, along with approved bed status, if applicable, in the computer system. Obtains pre-certifications in a manner to ensure maximum allowable reimbursement to the hospital.
Maintains a thorough knowledge of departmental policies & procedures to ensure maximum reimbursement to the hospital.
Attends departmental & other meetings as requested by the immediate supervisor.
Ensure timely placement of patients in the most effective & appropriate manner. Process admissions, discharges & transfers of all Hospital patients, per department procedures.
Explain & process payments from patients, which may include but not limited to co-pays, co-insurance, & deductibles.
Follows department procedures related to securing payment information & reconciling daily receipts.
Provide information to patient &/or representative on: Health Care Proxy, Advanced Beneficiary Notice, Important Medicare Message (IMM) forms, Financial issues & refers to Financial Counselor if appropriate. Obtain completed forms as available.
Perform other work-related duties & activities as assigned or requested by manager/supervisor.

Qualifications:
Minimum of 3 years' experience in Patient Registration/Patient Access Rep with proven ability to demonstrate competency in the following areas; Emergency Center registration, Referred Outpatient registration, Admitting & Surgical Day Care registration.
Ability to read, write & communicate in English at a high school level.
Ability to type at the rate of 30 WPM as demonstrated by a timed test.
Successful passage of a Medical Terminology course or successful passage of Medical Terminology challenge exam.
Demonstrated ability to work independently & to work under pressure.
Demonstrated strong leadership, organizational, communication & problem-solving skills.
Demonstrated ability to triage work to achieve maximum productivity & efficiency.
Demonstrated ability to maintain harmonious & cooperative relations with fellow employees, medical staff, patients & guests & serves effectively as part of the departmental team in performing professional service to patients.

Schedule Details:
40 Hours Per Week, Rotating Eves/Nights, 5p-1a, 6p-2a, Every Other Weekend & Rotating Holidays