Patient Access Lead Representative

Conifer Health Solutions•Harlingen, TX

4d•Onsite

About The Position

This role demonstrates knowledge of departmental financial clearance and displays Patient Access leadership skills to lead a wide range of duties in support of departmental efficiencies. This may include arranging support hospital services requested by patients through referrals, performing thorough analysis of admission discharge transfers (ADT) and Revenue Cycle Reports, driving team performance accountability, leading shift Patient Access Operations, and collaborating with Department leaders in process and operational excellence. The position requires greeting customers following Conifer Standards of Care, providing world-class customer service, completing full patient registration, adhering to financial and cash control policies, explaining and securing legal forms, scanning protected health information, and creating patient information packets. Responsibilities also include scheduling procedures, conducting interviews, explaining guidelines and policies, coordinating with clinical departments, providing financial counseling, education, and referrals, collecting patient liability, performing cash reconciliation, and securing medical necessity checks and insurance verifications. The role involves completing work lists, obtaining authorizations, securing inpatient visit notifications, analyzing reports, completing operational reports, and leading shift operations. The ideal candidate will have advanced customer service skills, experience in a fast-paced environment, and advanced understanding of third-party payor requirements and compliance standards. The role also involves using negotiation techniques, building collaborative relationships, and identifying opportunities to improve patient relations and registration processes. Conifer requires candidates to obtain and provide confirmation of all required vaccinations and screenings prior to employment, which may include COVID-19 and influenza vaccinations.

Requirements

Minimum typing skills of 35 wpm
High level working knowledge of all Software, programs and equipment, including PCs
Advance Customer service skills and experience
Ability to work in a fast paced environment
Ability to receive and express detailed information through oral and written communications
Must be crossed trained in all Patient Access service areas
Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors
Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy
Identifies opportunities to improve patient relations and shorten the time it takes to handle registration processes
High School Diploma or GED required
2 – 4 years experience in medical facility, health insurance, or related area
3– 5 years experience in Patient Access preferred
1 – 2 years in supervisory or lead role preferred
Must be available to work hours and days as needed based on departmental/system demands.
Must be available for on-call scheduling support when required.
Spanish Required

Nice To Haves

Knowledge of function and relationships within a hospital environment preferred
Advanced Understanding of Third Party Payor requirements preferred
Advanced Understanding of Compliance standards preferred
Advanced Patient Liability Collection performance and high achievement in productivity
2-4 year college degree in Business, Accounting, Medical Administration or related area preferred

Responsibilities

Greeting customers following Conifer Standards of Care and providing world-class customer service.
Completing full patient registration at date of service and adhering to financial & cash control policies & procedures.
Thoroughly explaining and securing Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.).
Scanning Protected Health Information and creating and filing patient information packets/folders for upcoming Hospital services.
Scheduling diagnostic and/or surgical procedures, conducting physician office/patient interviews, and explaining hospital procedure guidelines and policies.
Coordinating with clinical departments on schedule modifications.
Providing full patient financial counseling, education & referrals.
Employing and completing all patient liability collection escalations through proper, compliant patient liability collection techniques before, during & after date of service.
Performing Hospital cash reconciliation & secured payment entry in adherence to financial & cash control policies & procedures.
Securing medical necessity checks/verification in accordance to Centers for Medicare & CMS services.
Verifying insurance, benefits, coverage & eligibility.
Completing assigned registration financial clearance work lists activities.
Obtaining insurance authorizations for scheduled & unscheduled Hospital services.
Securing inpatient visit notification to payors.
Performing thorough analysis of admission discharge transfers (ADT) and Revenue Cycle Reports.
Completing departmental operational reports based on team performance accountability.
Leading shift Patient Access Operations.
Collaborating with Department leaders in process and operational excellence.
Resolving Physician's office and Patient issues.
Handling extreme patient volumes and uncooperative Patients.