Emergency Department Patient Access Lead

UnitedHealth Group • Chandler, AZ

102d • $20 - $35 • Onsite

About The Position

The Patient Access Lead functions as an integral member of the team and is the first point of contact for all persons inquiring about the provider's practice. The primary role is to organize the practice's daily activities and paperwork, while ensuring a positive patient experience throughout the financial clearance process. Primary duties include financially clearing patients prior to discharge, counseling patients about their financial liability, verifying payer sources, assessing and referring patients to alternative payment sources, including the Payment Assistance Program and government and non-government-based payment assistance programs. The Patient Access Lead can work in all registration areas as needed. Working under the supervision of the Registration Leadership, this position is responsible for assisting the Registration Management Team with training, quality assurance review and reporting, and developing and maintaining the staff schedules. The Patient Access Lead ensures timely, accurate and complete capture of all demographic and insurance information to ensure appropriate reimbursement for services rendered. In addition, the Patient Access Lead determines and collects the patient's financial liability and/or arranges payment plans for patients in need of them. The Patient Access Lead is an information source for patients and families by explaining hospital policies, patient financial obligations, alternative payer sources, and Patient Rights and Responsibilities.

Requirements

• High School Diploma/GED (or higher)
• 2+ years of experience analyzing and solving complex customer problems
• 1+ years of Patient Access and/or Patient Registration experience
• Ability to work 100% onsite at 1955 W Frye Rd., Chandler, AZ
• Must be 18 years of age or older

Nice To Haves

• 1+ years of experience with prior authorizations
• 1+ years of team lead experience in patient access
• Experience with Microsoft Office products
• Experience in requesting and processing financial payments
• Experience in insurance reimbursement and financial verification
• Working knowledge of medical terminology
• Understanding of insurance policies and procedures
• Ability to perform basic mathematics for financial payments

Responsibilities

• Maintains up-to-date knowledge of specific registration requirements for all areas, including but not limited to: Main Admitting, OP Registration, ED Registration, Maternity, and Rehabilitation units.
• Ensures complete, accurate and timely entry of demographic information into the ADT system at the time of registration.
• Properly identifies the patient to ensure medical record numbers are not duplicated.
• Responsible for reviewing assigned accounts to ensure accuracy and required documentation is obtained and complete.
• Meet CMS billing requirements for the completion of the MSP, issuance of the Important Message from Medicare, issuance of the Observation Notice, and other requirements, as applicable and documenting completion within the hospital's information system for regulatory compliance and audit purposes.
• Collects and enters required data into the ADT system with emphasis on accuracy of demographic and financial information to ensure appropriate reimbursement.
• Carefully reviews all information entered in ADT on pre-registered accounts. Verifies all information with patient at time of registration; corrects any errors identified.
• Identifies all forms requiring patient/guarantor signature and obtains signatures.
• Ensures all required documents are scanned into the appropriate system(s).
• Identifies all appropriate printed material hand-outs for the patient and provides them to the patient/guarantor (Patient Rights and Responsibilities, HIPAA Privacy Act notification, Advance Directive, etc.).
• Follows 'downtime' procedures by manually entering patient information; identifying patient's MRN in the MPI database, assigning a financial number; and, accurately entering all information when the ADT system is live.
• Follows EMTALA-compliant registration steps for both Emergency Department and Labor and Delivery areas.
• Assesses self-pay patients for presumptive eligibility and when appropriate, initiates the process.
• In the Emergency Department follows protocol for special cases, including but not limited to 5150, Sexual Assault Response Team (SART), Domestic Violence patients, Child Protective Services, incarcerated patients, Worker Compensation patients, auto accidents, animal bite reporting, etc. as required.
• Monitors and addresses tasks associated with the Mede/Analytics PAI tool.
• Follows approved scripting, verify insurance benefits on all patients registered daily by using electronic verification systems or by contacting payers directly to determine the level of insurance coverage.
• Thoroughly and accurately documents insurance verification information in the ADT system, identifying deductibles, copayments, coinsurance, and policy limitations.
• Obtains referral, authorization and pre-certification information; documents this information in the ADT system and submits notices of admission when necessary.
• Verifies medical necessity checks have been completed for outpatient services. If not completed and only when appropriate, uses technology tool to complete medical necessity check and/or notifies patient that an ABN will need to be signed. Identifies payer requirements for medical necessity.
• Verifies patient liabilities with payers, calculates patient's payment, and requests payment at the time of registration.
• Identifies any outstanding balance due to previous visits, notifies patient and requests patient payment.
• Sets up payment plans for patients who cannot pay their entire current copayment and/or past balance in one payment.
• Thoroughly and accurately documents the conversation with the patient regarding financial liabilities and agreement to pay.
• When collecting patient payments, follows department policy and procedure regarding applying payment to the patient's account and providing a receipt for payment.
• Clarifies division of financial responsibility if payment for services is split between a medical group and an insurance company. Ensure this information is clearly documented in the ADT system.
• When necessary, escalates accounts to appropriate Patient Registration leadership staff, based on outcomes of the verification process and patient's ability to pay clinic(s).

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED