Health Access Rep Lead - FT - Day - Patient Access Services Hamilton NJ

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

$19.71 - $25.62

Scheduled Weekly Hours:

40

Position Overview

Functions as a super user to insure department compliance with system and operational changes and assists in training to support ongoing staff education and development. Applies financial screening guidelines to insure collectable accounts and functions as a resource to staff. Communicates effectively and works cooperatively with others. Has respect for and understanding of other registration disciplines. Utilizes standards, guidelines, and written procedures for performing registration functions.

MINIMUM REQUIREMENTS

Education:High school diploma or equivalency.

Experience:One year of Health Access experience. Knowledge of all Capital Health departments required.

Other Credentials:

Knowledge and Skills:Health Access Representative productivity exceeds 90% with less than 10% error rate. Strong customer service and problem-solving skills.

Special Training:Proficient computer skills. Advanced health insurance and prior authorizations knowledge.

Mental, Behavioral and Emotional Abilities: Possesses ability to work independently and as a team member.

Usual Work Day:8 Hours  

ESSENTIAL FUNCTIONS

• Assists in training, problem solving, and quality review with subordinate health access representatives. Assigns duties to registrars as directed by Supervisor or Manager.
• Follows compliance with computer system procedures, department procedures, and training guidelines to accurately complete each registration. Serves as a resource for company protocols.
• Audits charts for accurate demographics, Medicare compliance, authorizations and referrals, necessary signatures, and completion of forms and charts.
• Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Advance Beneficiary Notice, Advance Directives, Patients Rights, and the Interpreter flag as measured by quality assurance and observation.
• Follows and monitors staff compliance with following payer requirements for authorization, pre-authorization, referrals, coordination of benefits forms, and in-network verification according to Insurance Card Database, and Insurance Verification guidelines.
• Audits charts for final billing. Ensures accurate demographics, authorizations or referrals, necessary signatures, and completion of forms and charts.
• Follows Self Pay procedure regarding No Surprise Billing Act and referrals to Medicaid and charity.
• Assists with training and education of patient access staff.
• Communicates effectively with Health Access team members and is open to feedback and suggestions in order to identify opportunities for improvement.
• Identifies and seeks out members of the registration department as a resource to increase knowledge and seek validation of department guidelines and procedures.
• Reports to Management Team regarding department deficiencies to include faulty equipment, supplies and concerns.
• Identifies unit and department goals and supports the culture of organization.
• Supports department performance improvement initiatives. Initiates ideas to meet department goals.
• Attends all mandatory department meetings.
• Follows patient identification policy.
• Serves as a resource for Health Access department. Leads department through daily workload and divides work as needed.
• Provides coverage in working areas as required when on-call duties apply.
• Acts as a liaison for physician office and ancillary departments as needed.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include: Sitting ,