Patient Access Team Leader

POSITION SUMMARY

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The Patient Access Team Leader acts as a role model and resource for Patient Access staff. This role leads activities of a Patient Access site of service team. The Patient Access Team Leader serves as a technical expert and a resource for staff, patients, and visitors. The Team Leader maintains focus on essential activities of patient's arrival and visit and proactively takes steps to ensure the streamlining of activities. This position supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating commitment to teamwork and cooperation in accordance with the AtlantiCare Mission, Vision, and Values.

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES

• Provides relief for Patient Access staff for vacation, sickness, leave, staffing shortages, and heavy work volume.
• This position maintains a liaison relationship with other Revenue Cycle departments to ensure ongoing performance improvement, regulatory compliance, and achievement of best practice targets.
• Establishes effective working relationships with other ancillary departments, physicians, and their staff. Serves as single point of contact for initial communication and is the first stage of the escalation process to management.
• Provides first level of response to physician, patient, visitor, and employee complaints related to patient access.
• Has the knowledge, skill, and the ability to lead the handling of the patient registration process, general admissions, financial clearance, and financial arrangements. The Patient Access Team Leader will possess the knowledge, skill, and ability to oversee the verification of third-party payor accounts, pre-authorization, and pre-certification requirements.
• Will be knowledgeable of state and federal government funding programs such as Medicare, Medicaid, TRICARE/CHAMPUS, Workers' Compensation; No Fault Auto, and commercial insurance payers; billing and reimbursement guidelines and methodologies for state and federal government and non-government payers; insurance terminology; medical terminology, EMTALA, HIPAA privacy, and compliance practices.
• Possesses the knowledge and skill necessary to verify diagnosis codes, complete medical necessity checks for Medicare, complete patient estimates, and provide consumer shopper comparisons. The Patient Access Team Leader must have knowledge of ICD-10 in order to ensure accurate diagnosis entry for reimbursement.
• The Patient Access Team Leader is considered a customer service champion responsible for delivering great customer service and ensuring staff are delivering great customer service at each entry point throughout the health system. The Patient Access Team Leader is responsible for patient throughput, established wait times and turnaround (TAT) times along with aiding in the achievement of top box customer service scores for each respective Patient Access point of service site.
• Responsible for assisting, and leading the day-to-day operations of their multiple areas/sites.
• Responsible for patient flow and throughput.
• Responsible for redeploying staff as needed to maintain work levels, productivity, wait times, and flow as well as assisting in the operations during high volume to maintain and provide the best customer experience.
• Aid staff in ensuring department goals and initiatives are met in regard to established productivity rates, cash collection goals, and other KPIs established within the department.
• Rotates weekends on call to provide leadership on weekends at the point of service sites.
• Assists in handling call outs and finding staffing replacements using proper protocol to utilize pool staff optimally to keep OT at minimal levels.
• Responsible for daily reconciliation of money from daily cash collections of Patient Access staff. The Patient Access Team Leader assists in preparing the bank deposit daily and reports any discrepancies to the Manager/Supervisor.
• Reviews daily audit reports and reports on performance statistics and productivity.
• Assists staff with questions related to Patient Access workflows.
• Identifies problems proactively for expedited resolution.
• Aids in providing staff education and training and is responsible for motivating and orienting staff. Duties will include guidance and mentoring of new/existing staff with daily work. Assists with training and job shadowing for new staff and cross-training of current staff. The Patient Access Team Leader must be proficient and actively working as a preceptor in two or more specific areas of Patient Access. The Patient Access Team Leader will be responsible for training and precepting new hires upon onboarding.
• Will assist in monitoring individual staff performance including coaching, mentoring, training, providing constructive feedback and be an active participant in performance improvement efforts.
• Responsible for providing feedback on daily registration processes and staffing issues to the Patient Access Supervisor The Patient Access Team Lead performs real time registration audits and QA checks to ensure staff performs at the level of quality needed in registration.
• Assists leadership in the communication of new procedures and appropriately engaging staff participation and monitoring staff compliance.
• The Patient Access Team Leader can independently perform all job duties based on department procedure and protocol.
• Attends all recommended trainings and in-services and passes all competency tests associated with the in-services. The Patient Access Team Leader is responsible for passing any additional certifications that aid in the proficiency of their designated areas such as NJ Medicaid Presumptive Eligibility and Certified Application Counselor.
• May be responsible for additional duties as assigned with respect to the Patient Access job scope.

QUALIFICATIONS

EDUCATION AND EXPERIENCE:

• High school diploma or equivalent required. Associate's Degree preferred or equivalent significant related work experience as detailed below.
• 5+ years' or more experience in Healthcare registration or relevant customer service environment required.

LICENSE/CERTIFICATION:

KNOWLEDGE AND SKILLS:

• Must be proficient in all requirements of Patient Access Associate I to IV.
• Must be proficient with registration processes and procedures throughout the department.
• Has a strong working knowledge of all online eligibility and precertification and eligibility tools and is able to train front line staff on their usage.
• Ability to effectively communicate both orally and in writing sufficient to perform the essential functions; read, understand, and apply policies and guidelines; obtain information from a variety of sources is required.
• Demonstrated knowledge of general computer, and data entry functions required.
• Excellent communication, customer service, organizational and analytical skills required.
• Ability to prioritize and manage multiple tasks simultaneously, and to effectively anticipate and respond to issues as needed in a dynamic work environment. Ability to perform job duties in a high volume fast paced environment.
• Candidates must continuously display professionalism, courtesy and respect to all customers that always mirror AtlantiCare's Values/Behaviors.
• Candidate must have reliable transportation.
• Bilingual preferred.

PERFORMANCE EXPECTATIONS

• Demonstrates the competencies as established on the Assessment and Evaluation Tool for this position.
• Incumbents are required to maintain a Valued Contributor Performance Rating annually including no disciplinary action, to progress within Patient Access Leadership and AtlantiCare.
• Must pass annual recertification with a score of 95% or above. This requirement is expected to be maintained every year. The Patient Access Team Leader will be required to re-take training and exam until they obtain the appropriate grade or disciplinary action will be taken in regard to performance. The Patient Access Team Leader must have a 95% or above accuracy on their charity care applications. This requirement is expected to be maintained continuously. Disciplinary action for performance will be taken if the requirement is not maintained.
• Maintains high accuracy rate A or above and established productivity rates for Key Performance Indicators (KPI) such as cash collections, wait and registration turnaround (TAT) times, pre-registration and registration productivity.
• The Patient Access Team Leader will attend ten hours or more self-scheduled voluntary or facilitated education sessions with ARMC or an approved outside learning opportunity in order to enhance growth and development.
• The Patient Access Team Leader must achieve Valued Contributor or Remarkable Talent on their annual evaluation with no written disciplinary documents on file. If the valued contributor rating is not achieved an action plan will be put in place to remediate the lead back to valued contributor.
• Maintains Certification through Litmos Revenue Cycle Certified Master or Healthcare Financial Management Association (HFMA) Certified Revenue Cycle Representative (CRCR). If Patient Access Team Leader chooses HFMA CRCR, this certification must be renewed every two years.

WORK ENVIRONMENT

• Potential for exposure to the hazards and risk of the hospital environment, including exposure to infectious disease, hazardous substances, and potential injury.
• This position requires reaching, stooping, kneeling, and crouching approximately 25% of the workday. This position requires frequently lifting, approximately 25-30 pounds, and occasional lifting of 50-100 pounds with assistance. This position also requires pushing and pulling computers on wheels approximately up to 100% of the day if assigned to the Emergency Department or Labor and Delivery.
• High volume fast-paced environment.
• The essential functions for this position are listed in the Assessment and Evaluation Tool.

REPORTING RELATIONSHIP

• This position reports to department leadership.

The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.

AtlantiCare offers eligible Full-time and Part-time team members the ability to participate in Medical, Dental, Vision, 401(k)/403(b), Life Insurance, Disability and other supplemental benefit programs.