Team Lead, Patient Access

Med-Metrix•Red Bank, NJ

About The Position

The Team Lead, Patient Access will be the subject matter expert for insurance verification, registration edits, referrals, and authorizations. The Team Lead, Patient Access will support the Supervisor in the fulfillment of their responsibilities as well as support the team at the rep level including, reports, analytics, productivity, quality, daily monitoring, facilitating daily huddles, projects, and providing direction that aligns/supports departmental and associate targets and goals. In addition, this role must coordinate the training, ramp up training schedule, and mentorship for new hires that are onboarding onto the team.

Requirements

High school diploma or equivalent required
Medical terminology knowledge required
Minimum of 2-3 years of healthcare or physician's office related experience in obtaining and handling pre-authorizations
Extensive knowledge of individual payor websites, including eviCore, Navinet and Novitasphere
Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes
Ability to work well individually and in a team environment
Strong organizational and task prioritization skills
Proficiency with MS Office. Must have basic Excel skillset
Strong communication skills/oral and written
Strong organizational skills
Strong interpersonal skills, ability to communicate well at all levels of the organization
Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results oriented
Excellent written and verbal communication skills required
Gracious and welcoming personality for customer service interaction

Nice To Haves

Preferred experience in a Team Lead or coordinator role
Experience with GE Centricity, EPIC PB, Allscripts, Cerner, preferred

Responsibilities

Works effectively with insurance companies to obtain/verify pre-certification/ authorization for services
Ability to understand/interpret documented clinical information and relay pertinent medical/clinical information to the insurance company
Faxes to pre-certification request form to insurance company
Maintains files and security of confidential information utilizing host system to scan and input data as per established procedures
Verifies medical insurance information and documents in scheduling/registration modules
Accurately enters and updates patient data, and other general data, into the computer system
Patient intake; insurance verification, notification of copays/patient liability and confirmation of demographics
Maintain account work progress, including but not limited to updating authorization logs, account referral in EMR, authorization paperwork and issue reports
Demonstrates knowledge of varied managed care insurance and regulatory guidelines
Meets and maintains daily productivity/quality standards established in departmental policies
Uses the MPower workflow system, client host system and other tools available to them to collect payments and resolve accounts
Adheres to the policies and procedures established for the client/team
Communicate effectively with physician offices and patients.
Place outbound call to patients with precertification notification.
Work independently from assigned work queues
Always maintain confidentiality
Maintain a professional attitude
Other duties as assigned by the management team
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Understand and comply with Information Security and HIPAA policies and procedures at all times
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties