Patient Access Lead Representative

Conifer Health Solutions•San Antonio, TX

1d•Onsite

About The Position

The Patient Access Lead Representative supports departmental financial clearance and patient access operations while providing leadership for shift operations and promoting departmental efficiency. The role includes patient registration and financial counseling, insurance and medical-necessity verification, authorization and notification work, patient-liability collection, cash reconciliation, and operational reporting. The representative analyzes admission, discharge, and transfer (ADT) information and revenue-cycle reports, supports team accountability, and collaborates with department leaders on process and operational improvement. The position is based at Northcentral Baptist and is listed for a 1:00 p.m.–9:30 p.m. Monday–Friday shift. Duties may include notifications, financial-clearance audits, and inpatient accounts. The representative may also arrange hospital services through referrals, schedule diagnostic or surgical procedures, interview patients and physician offices, and coordinate schedule changes with clinical departments. Work takes place in hospital administration and may involve patient-care locations.

Requirements

High school diploma or GED.
Two to four years of experience in a medical facility, health insurance, or a related area.
Minimum typing speed of 35 words per minute.
Ability to work in a fast-paced environment and communicate detailed information orally and in writing.
Advanced customer-service skills and experience.
Ability to use software, programs, equipment, and PCs at a high working-knowledge level.
Must be cross-trained in all Patient Access service areas.
Must be available to work hours and days as needed based on departmental or system demands and to provide on-call scheduling support when required.
As applicable and permitted by law, obtain and provide confirmation of required vaccinations and screenings before starting employment.

Nice To Haves

Two- to four-year college degree in business, accounting, medical administration, or a related area.
Three to five years of Patient Access experience.
One to two years in a supervisory or lead role.
Knowledge of functions and relationships within a hospital environment.
Advanced understanding of third-party payor requirements.
Advanced understanding of compliance standards.
Advanced patient-liability collection performance and high productivity achievement.

Responsibilities

Greet customers in accordance with Conifer Standards of Care and provide customer service.
Complete full patient registration at the date of service and follow financial and cash-control policies and procedures.
Explain and obtain required hospital and patient legal forms, including advance directives, conditions of service, consent for treatment, Important Message from Medicare, and EMTALA forms.
Scan protected health information and create and file patient information packets or folders for upcoming hospital services.
As needed, schedule diagnostic or surgical procedures, conduct physician-office and patient interviews, explain hospital procedure guidelines and policies, and coordinate schedule modifications with clinical departments.
Provide patient financial counseling, education, and referrals.
Complete patient-liability collection escalations using proper and compliant collection techniques before, during, and after the date of service.
Perform hospital cash reconciliation and secure payment entry in accordance with financial and cash-control policies.
Complete medical-necessity checks and verification in accordance with Centers for Medicare & Medicaid Services requirements.
Verify insurance, benefits, coverage, and eligibility; complete assigned financial-clearance work-list activities; obtain authorizations for scheduled and unscheduled hospital services; and secure inpatient visit notifications to payors.
Analyze admission, discharge, and transfer information and revenue-cycle reports, and complete departmental operational reports based on team performance accountability.
Lead shift Patient Access operations and collaborate with department leaders on process and operational excellence.
Use professional negotiation techniques to collect money owed by patients or guarantors.
Build and maintain collaborative relationships with internal and external clients to support communication, productivity, and accuracy.
Identify opportunities to improve patient relations and reduce registration processing time.
Resolve physician-office and patient issues and provide on-call scheduling support when required.
Work hours and days as needed based on departmental or system demands.