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Access Lead
2 months ago
As an Access Lead at UPMC Life Changing Medicine, you will play a vital role in coordinating and leading the daily functions of the designated work area. You will provide direction and support to staff as needed, escalating any concerns or problems to management when necessary. Your expertise will be essential in facilitating the completion of all statistical reporting and data analysis to ensure UPMC guidelines are being supported.
Key Responsibilities:- Support and contribute to UPMC's core values and guiding principles of Your Care.
- Abide by all UPMC departmental policies, procedures, and goals in the process of performing all job responsibilities.
- Advise clinical staff of the need for a possible referral to a participating healthcare facility when appropriate.
- Serve as an advocate, resource, troubleshooter, and designated leader at specific work sites.
- Represent Management and make decisions as empowered.
- Monitor patient flow and respond to changes in workload, patient volume, and staffing levels, planning services accordingly.
- Work various revenue reports within established time frames and take action to ensure a successful billing process.
- Ensure precertification requirements have been met prior to treatment.
- Interact with clinical staff and/or ancillary departments to resolve reimbursement issues.
- Responsible for training new staff and orienting to department work area, providing ongoing education and communication as necessary.
- Provide feedback on a regular basis to management about all personnel, department issues, and concerns for areas of direct responsibility.
- Update patient demographic and insurance information in the system as necessary, verifying insurance benefit information with all available carriers via electronic verification system or telephone if not previously completed.
- High school diploma or GED and at least 3 years of experience in a related fiscal/admissions/registration function, or Associate degree and 1 year experience; or an equivalent combination of education and experience required.
- Medical terminology, third-party healthcare coverage experience, and a strong understanding of managed care regulations are required.
- Strong interpersonal, organizational, and communication skills, with the ability to remain professional and courteous when dealing with sensitive issues and stressful circumstances.
- Ability to effectively problem-solve and make independent decisions.
- Prior working experience on personal computers and various office equipment.
- Knowledge and skills necessary to provide care and/or interact appropriately with all ages of patients.
- Possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to their age-specific needs.
