Lead Patient Access Representative

Purpose of Position
To obtain accurate and complete patient information and payer verification in a Customer focused manner, to assure expedient care and accurate billing. Serves as a facilitator/resource person to ensure effective daily department operations.

Description
1. Acts as a resource for Patient Access reps when questions or problems arise.
2. Ensure effective daily department operations and participate in the staffing process to ensure adequate staffing in all registration areas.
3. Assist department manager with training and orienting new employees.
4. Provides patient receipts and posts payment information into financial system.
5. Interview patient and/or patient representative to obtain required information necessary to complete the registration process in the hospital information system and maintains the accuracy, confidentiality and integrity of the automated database.
6. Coordinate and communicate accurate and updated registration/admission/and pre-admission activities with Medical Records, Care/Case Management, Utilization Management, Physicians' offices, Patient accounts, and any other hospital departments, as may be required, to support the appropriate, accurate, safe and effective patient care.
7. Initiate and maintain organized files and records, related to orders, payer authorizations, booking slips, schedules, and others per department procedure.
8. Contacts patients, employers, insurers and patient representatives to obtain insurance and other information necessary to secure hospital reimbursement, verifies benefits and pre-certifies all insurance plans to ensure maximum reimbursement to the hospital.
9. Verifies benefits, utilizing insurance verification systems. Obtains referrals and authorizations required and documents complete information, along with approved bed status, if applicable, in the computer system. Obtains pre-certifications in a manner to ensure maximum allowable reimbursement to the hospital.
10. Maintains a thorough knowledge of departmental policies and procedures to ensure maximum reimbursement to the hospital.
11. Attends departmental and other meetings as requested by the immediate supervisor.
12. Ensure timely placement of patients in the most effective and appropriate manner. Process admissions, discharges and transfers of all Hospital patients, per department procedures.
13. Explain and process payments from patients, which may include but not limited to co-pays, co-insurance, and deductibles.
14. Follows department procedures related to securing payment information and reconciling daily receipts.
15. Provide information to patient and/or representative on: Health Care Proxy, Advanced Beneficiary Notice, Important Medicare Message (IMM) forms, Financial issues and refers to Financial Counselor if appropriate. Obtain completed forms as available.
16. Perform other work related duties and activities as assigned or requested by manager/supervisor.

Qualifications
· Minimum of 3 years experience in Patient Registration/Patient Access Rep with proven ability to demonstrate competency in the following areas; Emergency Center registration, Referred Outpatient registration, Admitting and Surgical Day Care registration.
· Ability to read, write and communicate in English at a high school level.
· Ability to type at the rate of 30 WPM as demonstrated by a timed test.
· Successful passage of a Medical Terminology course or successful passage of Medical Terminology challenge exam.
· Demonstrated ability to work independently and to work under pressure.
· Demonstrated strong leadership, organizational, communication and problem solving skills.
· Demonstrated ability to triage work to achieve maximum productivity and efficiency.
· Demonstrated ability to maintain harmonious and cooperative relations with fellow employees, medical staff, patients and guests and serves effectively as part of the departmental team in performing professional service to patients.