Access Lead

2 days ago

Harrisburg, Pennsylvania, United States UPMC Life Changing Medicine Full time

Job Summary:

UPMC Life Changing Medicine is seeking a highly skilled Access Lead to coordinate and lead the daily functions of the designated work area. The successful candidate will provide direction and support to staff as needed, escalate concerns or problems to management, and facilitate the completion of statistical reporting and data analysis to ensure UPMC guidelines are being supported.

Key Responsibilities:

  • Support and Contribute to UPMC Core Values: Embody the guiding principles of Your Care, Our Commitment, and abide by all UPMC departmental policies, procedures, and goals.
  • Advise Clinical Staff: Inform clinical staff of the need for a possible referral to a participating healthcare facility when appropriate.
  • Serve as an Advocate and Resource: Represent management, troubleshoot issues, and provide support to staff as needed.
  • Monitor Patient Flow: Respond to changes in workload, patient volume, and staffing levels, planning services accordingly.
  • Manage Revenue Reports: Work within established time frames to ensure a successful billing process.
  • Ensure Precertification Requirements: Verify that precertification requirements have been met prior to treatment.
  • Interact with Clinical Staff and Ancillary Departments: Resolve reimbursement issues and provide feedback to management.
  • Train and Orient New Staff: Provide ongoing education and communication as necessary.
  • Update Patient Demographic and Insurance Information: Verify insurance benefit information with all available carriers via electronic verification system or telephone if not previously completed.
  • Education and Experience: 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.
  • Skills and Qualifications: Medical terminology, third-party healthcare coverage experience, and strong understanding of managed care regulations are required. Strong interpersonal, organizational, and communication skills are essential.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran.

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