Lead Consumer Access Specialist

About the Role

Manages relationships with clinical partners to ensure open communication between clinical, ancillary, and consumer access departments. Provides timely and continual coverage of assigned work areas to offer prompt patient service and availability for all clinical partner registration needs.

Responsibilities

• Manages relationships with clinical partners to ensure open communication between clinical, ancillary, and consumer access departments.
• Provides timely and continual coverage of assigned work areas to offer prompt patient service and availability for all clinical partner registration needs.
• Provides on-call support as needed.
• Contacts insurance companies to verify insurance eligibility and benefits, and determine coverage before scheduled appointments and during or after care for unscheduled patients.
• Obtains pre-authorizations from third-party payers and accurately enters required authorization information in the system.
• Registers patients for all services by obtaining critical demographic elements and ensuring accuracy.
• Performs Medicare compliance reviews, eligibility checks, and completes Medicare Secondary Payer Questionnaires.
• Ensures patient accounts are assigned the appropriate payor plans and updates financial assessments, eligibility, and benefits.
• Creates accurate estimates to maximize up-front cash collections and advises patients of expected costs, collecting payments or making appropriate payment agreements.
• Assists department supervisor with quality audits, mentoring staff, assisting with departmental training, and staff schedules.
• Coordinates with case management staff as necessary and ensures patients have logistical information necessary to receive their services.
• Documents all conversations with patients and insurance representatives in the appropriate fields.
• Actively attends department meetings and promotes positive dialogue within the team.
• Other duties as assigned.

Requirements

• Mature judgement in dealing with patients, physicians, and insurance representatives
• Intermediate knowledge of Microsoft programs and familiarity with database programs
• Ability to operate general office machines such as computer, fax machine, printer, and scanner
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion
• Ability to communicate professionally and effectively, both verbally and written
• Ability to adapt in ever changing healthcare environment
• Ability to follow complex instructions and procedures, with a close attention to detail
• Adheres to government guidelines such as CMS, EMTALA, and HIPAA and corporate policies
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital electronic medical report (EMR) system
• Basic medical terminology
• Must be able to read, write, and speak conversational English
• Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature as needed to perform duties
• Intermediate medical terminology
• Bilingual – English/Spanish
• Associate [Preferred]
• High School Grad or Equiv [Required]
• in business or related field
• 1+ customer service experience [Required]
• 1+ revenue cycle experience [Required]
• 2+ direct patient access experience [Preferred]
• Certified Healthcare Access Associate (CHAA) [Preferred]
• Certified Revenue Cycle Rep (CRCR) [Preferred]

Compensation

• Base pay: $21.19 - $33.90/hr

Benefits

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits