Patient Access Associate Team Lead
Company: Connecticut Children's Medical Center
Location: Hartford
Posted on: March 16, 2023
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Job Description:
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button labeled "Explore your accessibility options". Patient Access
Associate Team Lead - #12920 High School Diploma, GED, or a higher
level of education that would require the completion of high
school, is required. Bachelors or Associates Degree strongly
preferred. 2-4 years directly related experience required; 1 year
of CT Children's direct related experience preferred. Healthcare
experience required. Licenses and Certifications CHAA (Certified
Healthcare Access Associate) required CHAM (Certified Healthcare
Access Management) preferred and/or discussed Location Hartford, CT
Projected Schedule (not guaranteed) Requisition Number 12920
Department Patient Access - ED & Admittng-010804 Job Description To
be considered for next steps in the interview process for a
Referral/Patient Access/Financial Associate opportunity, we require
all external applicants to introduce themselves to us through our
digital video interview process. (Applicants that are current
employees of Connecticut Children's do not need to complete a video
interview.) Please complete your application, and then return to
this page to complete your digital video interview. Independently
coordinates and performs multiple complex functions within the
Patient Access department. Utilizes considerable judgment in
interpreting departmental policies to resolve routine to complex
inquiries or patient account problems. Identifies opportunities for
process improvements, offers and implements solutions. Mentoring
and coaching team members to identify and complete lean process
improvements. Participates and coordinates meetings as a
representative of the department. Serves as the primary resource to
team members and Level III Patient Access Associates for training,
complex patient accounts, etc. Performs all duties in a manner that
promotes a team concept and reflects the mission, behaviors, core
values, and philosophy of CT Children's Medical Center. ROLE
RESPONSIBILITIES Administrative: As a first line representative of
CT Children's, this person must have the ability to deal
compassionately and professionally with patients and families.
Following department protocol provides expert receptionist,
secretarial support or Health Unit Coordinator functions. Performs
and manages with limited supervision a variety of administrative
support activities in support of the unit operations. Responds with
tact and discretion to the needs of patients and families.
Maintains privacy and confidentiality by abiding by HIPAA policies.
Independently creates staffing assignments, scheduling, and
delegation of tasks or work assignments. Independently provides
training and quality assurance to new and current staff members.
Independently identifies trends in process opportunities and
provides educational training to team members for improvement.
Performs Quality Assurance (QA) & Training: Audits Complete
Registration data including documentation records regarding
incomplete information at time of scheduling/registration/account
follow-up, patient or guarantor interaction, efforts to collect
co-payments, estimated self-pay balances, and referrals to
Medicaid. Ensures all outstanding issues are resolved in a timely
manner. Identifies trends and conducts follow-up training to reduce
number and frequency of outstanding issues. Provides weekly review
for new employees; at minimum monthly review for current employees.
Tracks and ensures employees drawers are closed in a timely
fashion, per standard process. Creates/maintains spreadsheets and
databases for trend reporting to management. Acts a liaison with
patient accounting department for denials and account problem
resolution. Registration: Collects and enters accurate demographic,
guarantor and financial data for Emergency Department, Inpatient
and Outpatient cases and Physician Practice Office appointments.
Verifies all required insurance and billing information and uses
the proper payer plan codes. Generates all necessary forms for
patient visit and obtains patient/parent/legal guardian signature
for Assignment/ Authorization and consent. Performs
pre-registration for scheduled patients and registers patients
adhering to standard department procedure. Makes corrections and
updates patient information in ADT systems as necessary. Asks
patients/families whether their visit was satisfactory and attempts
to address any questions/issues prior to patient departure.
Attempts to collect the patient liability, co-payment on all
accounts at the designated collection point. Documents thorough,
clear, explanatory notes regarding reasons for incomplete
information at time of registration and documents insurance
verification method along with response. Documents concise and
understandable comments regarding patient or guarantor interaction,
efforts to collect co-payments and referrals to Financial
Counseling. Follows-up on open items to resolve outstanding issues
and complete the file. Reviews and works assigned work queues for
registration information to ensure that accounts are accurate at
time of visit and or billing. Creates feedback loop to front-end
user in regards to correct and complete registration. Scheduling:
Schedules routine and complex appointments either in person or via
telephone. Creates/inputs routine and complex department provider
appointments. May schedule/coordinate appointments with other areas
of the hospital. Builds and maintains scheduling templates. Ensure
all consent and privacy forms are signed. Work directly with DCF to
obtain appropriate signatures/legal guardian information.
Tracks/Reports Daily Fill Rate, with correlated barriers if metric
not met. Front Office (Check-In): Direct representative to
department managers, as a resource on process, concerns, etc.
Arrives patients for their appointment in the ADT system. Verifies
demographic and insurance information at time of arrival (including
securing patient financial liability at time of service). Enters
routine to complex patient charges into billing system for
physician or care provider visits, according to protocol.
Independently performs check out process including scheduling or
rescheduling future appointments. Answer telephone and triage calls
for the department. Ensure all consent and privacy forms are
signed. Work directly with DCF to obtain appropriate
signatures/legal guardian information. Other front office duties as
required. Direct process expert and insurance company liaison.
Responsible to work through and escalate difficult and/or abnormal
accounts, through account resolution with payers, managers, etc.
Responsible for various workqueues of scheduled and/or
non-scheduled appointments. Communicates with insurance companies
to obtain benefits, referrals, and/or authorization requirements.
Communicates with Clinical/Office staff regarding patient
eligibility, authorization status, and need for clinical
documentation. Completes chart reviews to submit all appropriate
documentation to insurance companies for authorization purposes.
Coordinates with third party payers regarding information necessary
for appropriate financial processing of patients, including:
follow-ups with primary care providers for referrals and
authorizations; notifying insurance carriers of admissions;
obtaining authorizations and verifying benefits eligibility. Refers
patients/families to Financial Counseling for updated and/or
eligibility issues. Works directly with RN, APRN, and MD level
staff to notify of denials requiring further action. Coordinates
with Utilization Review for status designation of
Outpatient/Inpatient Admissions. Coordinates daily assignments and
escalates clinic concerns to management team regarding
authorization barriers. Works directly with Insurance Provider
Representatives when necessary, in order to have outstanding
authorization issues resolved. Maintains abnormality tracking of
outstanding issues, which cause delay and/or denial of
authorization. Interviews patients and/or families, in-person or by
phone, to verify complete insurance and financial information,
explain financial policies, complete appropriate financial
evaluation forms. Refers patients/ families to DSS and Financial
Assistance. Determines guarantor's propensity to pay non-covered
charges, as well as determine potential eligibility for financial
assistance programs. Establishes financial arrangements / payment
plans with patients. Identifies reason(s) for non-payment and
follows-up to ensure resolution. Responsible to track abnormalities
in account registration and report feedback/education to front end
users throughout Patient Access, CCMC, and CCSG when necessary.
Verifies insurance plans using the various methods available such
as RTE, Web-Based, & Telecommunications. Investigates patient
insurance coverage, facilitates certification, manages process to
maximize payment from both commercial and managed care plans.
Follows-up with team member responsible for patient account to
resolve outstanding financial issues. Demonstrates knowledge of the
age-related differences and needs of patients in appropriate,
specific populations from neonate through adolescence and applies
them to practice. Demonstrates cultural sensitivity in all
interactions with patients/families. Demonstrates support for the
mission, values and goals of the organization through behaviors
that are consistent with the CT Children's STANDARDS. SUPERVISORY
RESPONSIBILITIES May be responsible to coordinate daily activities
of the department; delegate assignments to staff; and serve as a
primary resource to staff. First level resource to staff and
various leadership regarding daily processes and issues. Active
participant of minimum 1 hospital committee; shares departmental
and/or organizational initiatives with team members. Responsible
for ensuring standard work processes are up to date, accurate, and
include all pertinent information of performing job duties at staff
level. Direct resource between staff and management in regards to
daily operations.
Keywords: Connecticut Children's Medical Center, Hartford , Patient Access Associate Team Lead, Other , Hartford, Connecticut
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