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Lead Patient Access

1 month ago

Greenville, United States Prisma Health Full time

Inspire health. Serve with compassion. Be the difference.

Job Summary

Performs functions of moderate to difficult complexity with high visibility and high risk from a compliance and regulatory standpoint. Assists Management with training, orienting and monitoring day to day performance of team members to ensure departmental policies and processes are being followed, responsible for daily cash handling procedures, assists with the development of team member schedules and registers patients. Subject Matter Expert for the department.

Essential Functions

  • Accurate patient identification and registration is a key component in patient safety and essential to ensuring proper clinical treatment. Interviews patient or other sources, in accordance with HIPAA guidelines, to obtain complete and accurate patient demographic and financial information for the purpose of establishing the patient record and facilitating timely claims payment. Collects and records information that supports the clinical team with ensuring requirements are met surrounding health equity and the social determinates of healthcare, which is subject to review by CMS and The joint Commission. Performs routine account analysis and problem solving. Alleviates difficult situations and handles patient inquiries and/or concerns. - 30%

  • Acts as a preceptor to ensure team members are equipped to complete efficient registration processes to support an optimal patient experience. This includes collecting demographic and financial information, in accordance with HIPAA guidelines, to facilitate timely payment, discussing the patient estimate and collecting patient balances due. A further responsibility includes collecting and recording information in the system that supports the clinical team with health equity and the social determinates of healthcare. This information is subject to review by The Joint Commission and DHEC. Includes education for team members that outlines specific workflows to be followed. - 15%

  • Acts as a preceptor to ensures compliance with the provision of documents and forms as required by regulation; in some instances signatures are required. Compliance regarding documents and forms is subject to review by CMS, DHEC and the Joint Commission. These forms/documents include but are not limited to Advance Directives, Lewis Blackman Patient Safety Act, Notice of Privacy Practices, Patient Rights and Responsibilities, Permission to Treat, Limited Visitation Policy, Medicare Admission Questionnaire, Medicare Important Message and Medicare Outpatient Observation Notice. Lack of compliance can create a regulatory finding or jeopardize participation with CMS. - 15%

  • Maximizes collections and minimizes bad debt by providing estimated costs for patient responsibility at time of service. Collects current and past balances in accordance with departmental cash handling procedures. Monitors daily collections to identify trends and to recommend improvements. - 15%

  • Collaborates with Patent Access Leadership to coordinate team member schedules; including scheduling rotation, time off, and call-offs as necessary. Ensures adequate coverage in accordance with organizational policies. Minimizes overtime while maximizing productivity. The Patient Access Lead may be required to fill in for call-offs, staffing issues, or unexpected volumes. - 15%

  • Maintains a working knowledge of third-party payment requirements, including (as applicable) Medicare, Medicaid, managed care organizations, private insurers, and worker‘s compensation carriers. Provides timely education to inform team members of relevant changes and developments in payor requirements. Proactively pivots to meet the changing needs of payor requirements to maximize cash flow for the organization. - 10%

  • Performs other duties as assigned.

Supervisory/Management Responsibilities

  • This is a non-management job that will report to a supervisor, manager, director or executive.

Minimum Requirements

  • Education - High School diploma or equivalent OR post-high school diploma/highest degree earned

  • Experience - 4 years - Hospital Admissions, Billing and/or Credit/ Collections

In Lieu Of

  • An associate degree plus two (2) years experience - OR - four (4) years in a service-related position such as customer service in a business/office setting, banking, or finance to include a minimum of two (2) years in a lead capacity. Preference is given to candidates with experience in hospital admissions, billing, or credit/collections. Education Substitutes: BS degree plus one (1) year at the lead level or Associates degree with three (3) years at the lead level will substitute for four (4) years with two (2) years at the lead level if coming from a service-related position such as customer service, banking, or finance ORBS degree plus one (1) year at the lead level will substitute for four (4) years with two (2) years at the lead level.

Required Certifications, Registrations, Licenses

  • NA

Knowledge, Skills and Abilities

  • Ability to foster an environment that focuses on an optimal patient experience through accountability, collaboration, team member participation, and effective communication, both written and oral.

  • Proficient computer skills including word processing, spreadsheets and database

Work Shift

Night (United States of America)

Location

Greenville Memorial Med Campus

Facility

7001 Corporate

Department

70019065 Patient Access-GMH Campus

Share your talent with us Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.