Access Lead

UPMC•Warwick, RI

About The Position

UPMC is hiring a full-time Access Lead to support UPMC Lock Haven in both the Emergency Department and Outpatient Registration. The role works varied days and shifts. Emergency Department shifts may be daylight, evening, or overnight, typically 7:00 a.m.–3:30 p.m., 3:00 p.m.–11:30 p.m., or 11:00 p.m.–7:00 a.m. Outpatient Registration shifts fall between 6:30 a.m. and 5:00 p.m., typically 6:30 a.m.–3:00 p.m., 7:30 a.m.–4:00 p.m., or 8:30 a.m.–5:00 p.m. The role requires working every third weekend, with a scheduled shift of either 7:00 a.m.–7:00 p.m. or 7:00 p.m.–7:00 a.m., and rotating holidays in 4-, 8-, or 12-hour shifts. The Access Lead coordinates and leads the daily functions of the designated work area and provides direction and support to staff as needed, escalating concerns or problems to management when necessary. The role facilitates statistical reporting and data analysis to support UPMC guidelines and serves as the primary on-site information source and advocate for financial matters.

Requirements

High school diploma or GED and at least 3 years of experience in a related fiscal, admissions, or registration function; or an associate degree and 1 year of experience; or an equivalent combination of education and experience.
Knowledge of medical terminology.
Experience with third-party health care coverage and a strong understanding of managed care regulations.
Strong interpersonal, organizational, and communication skills.
Ability to remain professional and courteous when handling sensitive issues and stressful circumstances.
Ability to effectively problem-solve and make independent decisions.
Prior working experience with personal computers and various office equipment.
Knowledge and skills necessary to provide care and/or interact appropriately with patients of all ages.
Ability to assess data reflecting a patient's status and interpret information needed to identify age-specific patient requirements.
Ability to provide care needs described in department policies and procedures.
Act 34 clearance.

Responsibilities

Support UPMC core values and guiding principles, and follow departmental policies, procedures, and goals.
Incorporate dignity and respect into daily interactions.
Serve as an advocate, resource, troubleshooter, and designated leader at assigned work sites.
Represent management and make decisions within the role's authority.
Train new staff and orient them to the department work area.
Provide ongoing education and communication as needed.
Give management regular feedback about personnel, department issues, and concerns within areas of direct responsibility.
Monitor patient flow and respond to changes in workload, patient volume, and staffing, planning services accordingly.
Ensure precertification requirements are met before treatment.
Update patient demographic and insurance information in the system as needed.
Verify insurance benefit information with available carriers through electronic verification systems or by telephone when not previously completed.
Work with clinical staff and ancillary departments to resolve reimbursement issues.
Advise clinical staff when referral to a participating health care facility may be appropriate.
Complete revenue reports within established time frames.
Take appropriate action to support a successful billing process.
Facilitate statistical reporting and data analysis to support UPMC guidelines.
Serve as the primary on-site information source and advocate for financial matters.
Perform in accordance with system-wide competencies and behaviors.
Perform other duties as assigned.