Patient Access Lead Representative

Conifer Health Solutions•San Antonio, TX

16h

About The Position

The Patient Access Lead Representative demonstrates knowledge of departmental financial clearance and uses Patient Access leadership skills to support departmental efficiency. The role leads shift Patient Access Operations, analyzes admission, discharge, and transfer (ADT) information and Revenue Cycle Reports, monitors team performance and accountability, and collaborates with department leaders on process and operational excellence. Duties may also include arranging support hospital services requested by patients through referrals. The position performs patient registration and financial clearance activities, provides customer service and financial counseling, explains and obtains required hospital and patient legal forms, verifies insurance and medical necessity, obtains authorizations and payer notifications, and handles compliant patient-liability collection and cash reconciliation. It may also support scheduling, patient and physician office interviews, coordination of schedule changes with clinical departments, and preparation of patient information packets. The role is based in hospital administration and may involve work in patient-care locations with potential exposure to life-threatening patient conditions. The employee must be available for hours and days as departmental or system demands require, including on-call scheduling support when required.

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.
High-level working knowledge of software, programs, and equipment, including PCs.
Advanced customer service skills and experience.
Ability to work in a fast-paced environment.
Ability to receive and express detailed information through oral and written communication.
Advanced patient-liability collection performance and high achievement in productivity.
Must be cross-trained in all Patient Access service areas.
Must be able to perform the essential duties satisfactorily, with reasonable accommodations where applicable.
Must obtain and provide confirmation of required vaccinations and screenings before employment, as applicable and permitted by law.

Nice To Haves

Two- to four-year college degree in Business, Accounting, Medical Administration, or a related area.
Three to five years of experience in Patient Access.
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.

Responsibilities

Greet customers according to Conifer Standards of Care and provide world-class customer service.
Complete full patient registration at the date of service and follow financial and cash control policies and procedures.
Explain and secure 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.
Schedule diagnostic or surgical procedures when applicable, 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, compliant 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 and procedures.
Secure medical necessity checks and verification in accordance with Centers for Medicare and Medicaid Services requirements.
Verify insurance, benefits, coverage, and eligibility; complete assigned registration financial-clearance worklist activities; obtain authorizations for scheduled and unscheduled hospital services; and secure inpatient visit notifications to payors.
Analyze admission, discharge, and transfer (ADT) information and Revenue Cycle Reports.
Complete departmental operational reports based on team performance and accountability.
Lead shift Patient Access Operations and collaborate with department leaders on process and operational excellence.
Use professional negotiation techniques to collect amounts owed by patients or guarantors.
Build and maintain collaborative relationships with internal and external clients to improve communication, productivity, and accuracy.
Identify opportunities to improve patient relations and shorten registration processing time.
Resolve physician office and patient issues.