Access Lead (UPMC Presbyterian)

UPMC•Pittsburgh, PA

About The Position

UPMC is looking to hire an Access Lead to support UPMC Presbyterian. This position would work varying shifts on weekdays and weekends from 10:00am until 10:30pm and 5:00pm-1:30am. Holidays would be required for the role along with flexibility to cover other shifts as needed for staffing coverage. The Access Lead will coordinate and lead the daily functions of the designated work area, along with provide direction and support to staff as needed. The role will escalate any concerns or problems to management when necessary. Additionally, this employee will facilitate the completion of all statistical reporting and data analysis to ensure UPMC guidelines are being supported, as well as serve as the primary information source and advocate for financial matters on-site.

Requirements

High school diploma or GED and at least 3 years of experience in a related fiscal/admissions/registration function, or Associate degree and 1 year experience; or an equivalent combination of education and experience required.
Medical terminology, third-party health care coverage experience and a strong understanding of managed care regulations are required.
Strong interpersonal, organizational and communication skills and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances.
Ability to effectively problem solve and make independent decisions.
Prior working experience on personal computers and various office equipment.
Knowledge and skills necessary to provide care and/or interact appropriately with patients of all ages.
Possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs.
Provide the care needs as described in the department's policy and procedure.

Responsibilities

Support and contribute to UPMC's core values and guiding principles of Your Care. Our Commitment and abide by all UPMC departmental policies, procedures and goals in the process of performing all job responsibilities. Incorporates acts of dignity and respect in daily interactions.
Serve as an advocate, resource, troubleshooter, and designated leader at specific work sites. Represent Management and is empowered to make decisions.
Responsible for training new staff and orienting to the department work area. Provide ongoing education and communication as necessary.
Provide feedback on a regular basis to management about all personnel, department issues and concerns for areas of direct responsibility.
Monitor patient flow and respond to changes in workload, patient volume, and staffing levels, planning services accordingly.
Ensure precertification requirements have been met prior to treatment.
Update patient demographic and insurance information in the system as necessary.
Verify insurance benefit information with all available carriers via electronic verification system or telephone if not previously completed.
Interact with the clinical staff and/or ancillary departments to resolve reimbursement issues.
Advise the clinical staff of the need for a possible referral to a participating health care facility when appropriate.
Work various revenue reports within established time frames.
Take action accordingly to ensure a successful billing process.
Performs in accordance with system-wide competencies/behaviors.
Performs other duties as assigned.