Responsible for ensuring the appropriate levels of complex patient access activity for ancillary, diagnostic, surgical and emergency services as assigned to facilitate efficient operations, expeditious reimbursement and optimal customer satisfaction and employee satisfaction
The following describes the basic position duties that an employee MUST be able to perform for this role. This information is intended to be descriptive of the key responsibilities of the position. The list of essential functions below DOES NOT identify all duties performed by any single person in the position.
Has developed breadth and/or specialized skills in a range of processes, procedures and systems, or acts as the technical expert within the discipline
Uses knowledge of how related teams impact achievement of objectives; regularly interacts with other teams
Provides advanced subject matter guidance to more junior team members; may allocate work to less experienced colleagues
Identifies and solves complex problems that arise with little or no precedent
Impacts the effectiveness of own team and closely related teams
Develops and recommends solutions to existing challenges that can be adopted broadly within the organization
Clearly and accurately conveys complex (potentially sensitive or controversial ) information
JOB SPECIFIC RESPONSIBILITIES:
Ensures the appropriateness of complex registration activity including verifying patient demographic information, processing point of service payments, obtaining signatures for required consent paperwork, document imaging and following documentation standards to facilitate efficient patient access according to assigned protocol
Ensures the appropriateness of complex patient access transactions including coverage eligibility, insurance verification, patient portion calculation and authorization requirement activity utilizing available systems and resources according to assigned protocol
Acts as a liaison to resolve complex patient access and account issues, responds to questions on reimbursement and serves as a resource and systems expert for patient access specialists, including on-the-job training; assess DNB work queues for performance improvement and appropriateness of complex patient access transactions
Provides guidance, feedback and training to staff on multiple processes, payers and systems; monitors work queue assignments and assess productivity
Demonstrates the components of the Children's Health System Vision, Mission and The Children's Way Values
Prepares consolidated payer-specific registration and reimbursement data for presentation
Possesses the ability to interpret and demonstrates compliance with performance standards, third party contracts, guidelines, regulations and policies and procedures; assists with maintaining specific procedural guidelines and policies
Initiates and coordinates the implementation of team-oriented process improvement initiatives for the department and organization
Follows all safety rules while on the job, reports accidents promptly and corrects minor safety hazards
Performs other duties as assigned
Four years of customer service experience with three years of healthcare experience including Patient Access operations activities Required
Extensive knowledge of general procedures and guidelines used by health insurance companies, government agencies, employer benefit departments and internal departments as they relate to registration Required
Excellent mathematical skills, computer skills, Microsoft applications and word processing programs skills and minimum of 40 words per minute Required
Ability to develop and maintain productive working relationships to fully integrate within a team Required
Proficient in English, written and verbal, communication skills Required
High school diploma or equivalent Required
Two-year Associate's degree or equivalent experience Required
LICENSES and CERTIFICATIONS:
National Association of Healthcare Access Management CHAA Certification Required
Healthcare Financial Management Association CRCR Certification Required
Epic Proficiency or Certification with ADT/Prelude Required
Epic Proficiency or Certification with Cadence Preferred
Specific Knowledge, Skills and Abilities:
Maintain effectiveness when experiencing major changes in work responsibilities or environment; adjust effectively to work within new work structures, processes, requirements, or cultures.
Use appropriate interpersonal styles to establish effective relationships with customers and internal partners; interact with others in a way that promotes openness and trust and gives them confidence in one's intentions.
Ensure that the customer perspective is a driving force behind business decisions and activities; craft and implement service practices that meet customers' and own organization's needs.
Develop and use collaborative relationships to facilitate the accomplishment of work goals.
Identify and understand issues, problems, and opportunities; compare data from different sources to draw conclusions; use effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.
Take prompt action to accomplish objectives; take action to achieve goals beyond what is required; be proactive.
Deal effectively with others in an antagonistic situation; use appropriate interpersonal styles and methods to reduce tension or conflict between two or more people.
Effectively manage one's time and resources to ensure that work is completed efficiently.
Accomplish tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.
Set high standards of performance for self and others; assume responsibility and accountability for successfully completing assignments or tasks; self impose standards of excellence rather than having standards imposed.
Assimilate and apply new job-related information in a timely manner.
Clearly convey information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the message.
Light - Exerting up to 20 lbs. occasionally, 10 lbs. frequently, or negligible amounts constantly and may require walking or standing to a significant degree.
very highly regarded in the community. I had no idea how many lives Children’s Health had helped until I started wearing my scrubs with our logo on them. I am always getting stopped with compliments about our care.
Speech Language Pathologist