What are the responsibilities and job description for the Patient Access Team Leader position at AtlantiCare?
POSITION SUMMARY.
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 while maintaining exemplary levels of customer service in accordance with the AtlantiCare Mission, Vision, and Values.
This position maintains a liaison relationship with other Revenue Cycle departments to ensure ongoing performance improvement, regulatory compliance, and achievement of best practice targets.
The Patient Access Team Leader has the knowledge, skill, and the ability to lead the handling of the patient registration process, general admissions, and financial arrangements. The Patient Access Team Leader will also possess the knowledge, skill, and the ability to oversee the verification of third party payor accounts, pre-authorization, and pre-certification requirements. The Patient Access Team Leader communicates and collaborates with Patient Access team members and other ancillary departments as needed.
The Patient Access Team Leader 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.
The Patient Access Team Leader possesses the knowledge and skill necessary to verify diagnosis codes, complete medical necessity checks for Medicare, complete patient estimates for the self- pay population, and provide consumer shopper comparisons. The Patient Access Team Leader must have knowledge of ICD-10 and its predecessor ICD-9 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.
The Patient Access Team Leader is responsible for assisting, and leading the day to day operations of their site/area. The Patient Access Team Leader is responsible for patient flow and throughput. The leader is responsible for redeploying staff as needed in order to maintain work levels, productivity, wait times, and flow as well as assisting in the operations during high volume in order to maintain and provide the best customer experience. The Patient Access Team Leader rotates weekends on call in order to provide leadership on weekends at the point of service sites. The Patient Access Team Leader assists in handling call outs and finding staffing replacements using proper protocol to utilize pool staff optimally to keep OT at minimal levels. The Patient Access Team Leader is responsible for providing feedback on daily registration processes and staffing issues to the Patient Access Manager/Supervisor. The Patient Access Team Leader is 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.
The Patient Access Team Leader 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 regards 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.
The Patient Access Team Leader can perform all job duties based on department procedure and protocol independently. 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 Medicaid Presumptive Eligibility and Certified Application Counselor certifications.
The Patient Access Team Leader 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 aid staff in ensuring department goals and initiatives are met in regards to established productivity rates, cash collection goals, and other KPIs established within the department. The Patient Access Team Leader assists leadership in the communication of new procedures and appropriately engaging staff participation and monitoring staff compliance.
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 will assist in monitoring individual staff performance including coaching, mentoring, training, providing constructive feedback and be an active participant in performance improvement efforts. The Patient Access Team Leader aids in providing staff education and training and is responsible for motivating and orienting 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 the training and precepting new hires upon onboarding.
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. The Patient Access Team Leader must be proficient in all requirements of Patient Access Associate I to IV AND 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.
This position supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating commitment to teamwork and cooperation.
QUALIFICATIONS
EDUCATION: High School diploma required; Associate's Degree preferred. LICENSE/CERTIFICATION: Litmos Revenue Cycle Certified Master or HFMA Certified Revenue Cycle Representative required within 1 year from date of hire or transfer. EXPERIENCE: Minimum 2 years' experience in Healthcare registration preferred or relevant customer service environment required. The Patient Access Team Leader must be proficient with registration processes and procedures throughout the department. Incumbents are required to maintain a Valued Contributor Performance Rating annually including no disciplinary action, to progress within Patient Access Leadership and Atlanticare. Demonstrates knowledge of general computer, and data entry functions required. Excellent communication, organizational and analytical skills required. 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. 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. Bilingual preferred.
PERFORMANCE EXPECTATIONS
Demonstrates the competencies as established on the Assessment and Evaluation Tool for this position.
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.
This position reports to department leadership. The above statement reflects the general details considered necessary to describe the principle 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.
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 while maintaining exemplary levels of customer service in accordance with the AtlantiCare Mission, Vision, and Values.
This position maintains a liaison relationship with other Revenue Cycle departments to ensure ongoing performance improvement, regulatory compliance, and achievement of best practice targets.
The Patient Access Team Leader has the knowledge, skill, and the ability to lead the handling of the patient registration process, general admissions, and financial arrangements. The Patient Access Team Leader will also possess the knowledge, skill, and the ability to oversee the verification of third party payor accounts, pre-authorization, and pre-certification requirements. The Patient Access Team Leader communicates and collaborates with Patient Access team members and other ancillary departments as needed.
The Patient Access Team Leader 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.
The Patient Access Team Leader possesses the knowledge and skill necessary to verify diagnosis codes, complete medical necessity checks for Medicare, complete patient estimates for the self- pay population, and provide consumer shopper comparisons. The Patient Access Team Leader must have knowledge of ICD-10 and its predecessor ICD-9 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.
The Patient Access Team Leader is responsible for assisting, and leading the day to day operations of their site/area. The Patient Access Team Leader is responsible for patient flow and throughput. The leader is responsible for redeploying staff as needed in order to maintain work levels, productivity, wait times, and flow as well as assisting in the operations during high volume in order to maintain and provide the best customer experience. The Patient Access Team Leader rotates weekends on call in order to provide leadership on weekends at the point of service sites. The Patient Access Team Leader assists in handling call outs and finding staffing replacements using proper protocol to utilize pool staff optimally to keep OT at minimal levels. The Patient Access Team Leader is responsible for providing feedback on daily registration processes and staffing issues to the Patient Access Manager/Supervisor. The Patient Access Team Leader is 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.
The Patient Access Team Leader 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 regards 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.
The Patient Access Team Leader can perform all job duties based on department procedure and protocol independently. 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 Medicaid Presumptive Eligibility and Certified Application Counselor certifications.
The Patient Access Team Leader 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 aid staff in ensuring department goals and initiatives are met in regards to established productivity rates, cash collection goals, and other KPIs established within the department. The Patient Access Team Leader assists leadership in the communication of new procedures and appropriately engaging staff participation and monitoring staff compliance.
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 will assist in monitoring individual staff performance including coaching, mentoring, training, providing constructive feedback and be an active participant in performance improvement efforts. The Patient Access Team Leader aids in providing staff education and training and is responsible for motivating and orienting 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 the training and precepting new hires upon onboarding.
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. The Patient Access Team Leader must be proficient in all requirements of Patient Access Associate I to IV AND 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.
This position supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating commitment to teamwork and cooperation.
QUALIFICATIONS
EDUCATION: High School diploma required; Associate's Degree preferred. LICENSE/CERTIFICATION: Litmos Revenue Cycle Certified Master or HFMA Certified Revenue Cycle Representative required within 1 year from date of hire or transfer. EXPERIENCE: Minimum 2 years' experience in Healthcare registration preferred or relevant customer service environment required. The Patient Access Team Leader must be proficient with registration processes and procedures throughout the department. Incumbents are required to maintain a Valued Contributor Performance Rating annually including no disciplinary action, to progress within Patient Access Leadership and Atlanticare. Demonstrates knowledge of general computer, and data entry functions required. Excellent communication, organizational and analytical skills required. 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. 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. Bilingual preferred.
PERFORMANCE EXPECTATIONS
Demonstrates the competencies as established on the Assessment and Evaluation Tool for this position.
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.
This position reports to department leadership. The above statement reflects the general details considered necessary to describe the principle 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.
Patient Access Specialist (ED)
Ensemble RCM LLC -
Lewes, DE
Patient Access Specialist
Ensemble RCM LLC -
Lewes, DE
