Patient Access Lead

Guidehouse•Ventura, CA

2d•Onsite

About The Position

The Patient Access Lead, in partnership with the Patient Access Supervisor, Manager and Director are responsible for the proactive oversight, of client relationships and strategic initiatives, to ensure quality measures in front-end patient intake operations are consistently met. This role provides guidance to frontline staff, ensures operational practices are in compliance with State and Federal healthcare regulations (including but not limited to HIPAA, EMTALA and NSA) and serves as one of the communication links between Patient Access and our client’s administrative and clinical partners. The Lead is a Subject Matter Expert (SME), dedicated to maintaining high – quality data integrity and engages the Patient Access Trainer on developing and putting to practice standardized operating procedures that keep the team informed of evolving workflow updates and or operational compliance requirements. Provide Lead cross-departmental support in ED, Mother Child Health, Same Day Surgery, Pre-Registration, Outpatient Registration (Main Admitting), PBX Communications. At the discretion of upper management, lead meetings with client clinical and or administrative leadership. Assist client’s effort of neutralizing multi-million dollar impact by 1. Minimizing Do Not Bill days 2. Accelerate claim adjudication by addressing Claim Edit and DNB Workqueues trends. Analyze opportunity for improvement patterns and trends, categorize root-causes per technology, workflow and or isolated vs. systemic causes. Partner with leadership on establishing Quality Assurance measures that address and minimize the impact of trended opportunities rooted in workflow. Escalate to client’s IT leadership opportunities categorized and rooted in technology. Provide staff guidance to assure quality in registration, admissions, insurance verification and PBX Communication operations which include but are not limited to: Client Software application - TempTrak monitoring of temperature, pressure, and humidity across hospital equipment and environments, ensuring regulatory compliance and maintaining accurate records. Monitoring of software applications and tools which identify fire locations within the client’s facility. Adherence to client’s crisis and emergency management plan activation requirements associated with PBX. Monitor and partner with upper management on productivity, quality, and service standard findings. Generate reports and or Electronic Health Record Dashboards which demonstrate performance metrics. Partner with upper management on workflow design, development, orientation and implementation. Support upper management in the maintenance of and staff’s adherence to standardized operating procedures. Address patient escalations real-time and or engage upper management when appropriate. Provide front-line operational support when coverage gaps are present and or during patient high census. Analyze daily operations and patient census across the various services lines and present upper management with staff reassignment recommendations when optimization opportunities are present. Ensure staff adherence to State and Federal meal and rest break requirements. Partner with upper management in the development of workflow standards to address operational opportunities for improvement. In partnership with the Patient Access Trainer, assist in ensuring GH New Joiners are assigned a department preceptor and help facilitate GH New Joiner interdepartmental training. In partnership with upper management, lead hospital emergency and crisis response and mitigation plans. Ensure staff conduct aligns with GH Code of Conduct expectations and exemplifies behaviors of excellence that facilitate a positive work environment. Adhere to and help ensure staff adherence to both GH and client learning and development assignments and initiatives. Lead audit/root-cause investigative findings meeting with client/hospital clinical leadership and or client administrative leadership. Provide coaching of Patient Access best practices to client’s decentralized patient access/patient intake leaders and or areas that do not fall within Guidehouse Leadership reporting structure. Provide mentorship and non-disciplinary coaching to front-line staff. Support Supervisory functions if and when the Supervisor is unavailable (excluding disciplinary discussions with front-line staff). Work under minimal supervision, effectively manage time and competing priorities. Apply knowledge of Microsoft Word, Excel and or Power Point to present data and or construct summary of audit, root-cause and or investigative findings. Consistently demonstrate excellent customer service and service recovery when escalations present themselves. Effectively apply knowledge of medical terminology and revenue cycle terminology. Offer flexibility to support operational needs, including occasional coverage for areas that run 24/7. Co-lead planning and implementation of client software application activations (e.g. implementing an EHR or payment processing system). Performs all other duties as assigned. Soft Skills Ability to assess priorities in a high-volume, high-stress environment and provide empathetic leadership.

Requirements

High School Diploma or equivalent required
4-8 years of experience in Customer Service, Patient Access, Medical Billing and/or Healthcare Revenue Cycle
Ability to assess priorities in a high-volume, high-stress environment and provide empathetic leadership
Knowledge of Microsoft Word, Excel and/or Power Point
Knowledge of medical terminology and revenue cycle terminology

Nice To Haves

University degree or vocational certification in Healthcare Administration preferred
Advanced proficiency in Electronic Health Records (Epic, Cerner, etc.) and data analysis
Expertise Robust knowledge of medical terminology, insurance verification, and federal healthcare mandates

Responsibilities

Proactively oversee client relationships and strategic initiatives to ensure quality measures in front-end patient intake operations.
Provide guidance to frontline staff and ensure operational practices comply with State and Federal healthcare regulations.
Serve as a communication link between Patient Access and client's administrative and clinical partners.
Maintain high-quality data integrity and engage the Patient Access Trainer in developing standardized operating procedures.
Provide cross-departmental support in ED, Mother Child Health, Same Day Surgery, Pre-Registration, Outpatient Registration, and PBX Communications.
Lead meetings with client clinical and/or administrative leadership.
Minimize Do Not Bill days and accelerate claim adjudication by addressing Claim Edit and DNB Workqueues trends.
Analyze opportunities for improvement, categorize root-causes, and partner with leadership on Quality Assurance measures.
Escalate technology-related opportunities to client's IT leadership.
Assure quality in registration, admissions, insurance verification, and PBX Communication operations.
Monitor software applications for regulatory compliance and accurate record-keeping (e.g., TempTrak).
Monitor software applications identifying fire locations and adhere to crisis and emergency management plan activation requirements.
Monitor and partner with upper management on productivity, quality, and service standard findings.
Generate reports and/or Electronic Health Record Dashboards demonstrating performance metrics.
Partner with upper management on workflow design, development, orientation, and implementation.
Support upper management in maintaining and ensuring staff adherence to standardized operating procedures.
Address patient escalations in real-time and engage upper management when appropriate.
Provide front-line operational support during coverage gaps or high patient census.
Analyze daily operations and patient census to recommend staff reassignments for optimization.
Ensure staff adherence to State and Federal meal and rest break requirements.
Partner with upper management in developing workflow standards to address operational improvement opportunities.
Assist in ensuring new joiners are assigned a department preceptor and facilitate interdepartmental training.
Lead hospital emergency and crisis response and mitigation plans.
Ensure staff conduct aligns with GH Code of Conduct and exemplifies behaviors of excellence.
Ensure staff adherence to GH and client learning and development assignments and initiatives.
Lead audit/root-cause investigative findings meetings with client/hospital leadership.
Provide coaching of Patient Access best practices to client's decentralized patient access/patient intake leaders.
Provide mentorship and non-disciplinary coaching to front-line staff.
Support Supervisory functions when the Supervisor is unavailable (excluding disciplinary discussions).
Work under minimal supervision, effectively manage time and competing priorities.
Apply knowledge of Microsoft Word, Excel, and/or PowerPoint to present data and construct summaries.
Demonstrate excellent customer service and service recovery when escalations present themselves.
Apply knowledge of medical terminology and revenue cycle terminology.
Offer flexibility to support operational needs, including occasional coverage for 24/7 areas.
Co-lead planning and implementation of client software application activations.

Benefits

Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program