Patient Access Lead

Job Family:

Admitting Representative

Travel Required:

None

Clearance Required:

None

What You Will Do:

The Patient Access Lead, in partnership with the Patient Access Supervisor, Manager and Director are responsible for the proactive oversight, of client relationships and strategic initiatives, to ensure quality measures in front-end patient intake operations are consistently met.

This role provides guidance to frontline staff, ensures operational practices are in compliance with State and Federal healthcare regulations (including but not limited to HIPAA, EMTALA and NSA) and serves as one of the communication links between Patient Access and our client’s administrative and clinical partners.

The Lead is a Subject Matter Expert (SME), dedicated to maintaining high – quality data integrity and engages the Patient Access Trainer on developing and putting to practice standardized operating procedures that keep the team informed of evolving workflow updates and or operational compliance requirements.

Core Responsibilities:

Operational Leadership & Communication

• Team Guidance: Leads a team of Patient Access Representatives, providing daily guidance to ensure tasks like registration, insurance verification, and financial counseling are completed accurately.
• Strategic Alignment: Establishes and monitors key performance indicators (KPIs) such as wait times, point-of-service collections, and clean claim rates.
• Stakeholder Liaison: On occasion, communicates with hospital leadership, clinical departments (ER, Surgery, Imaging, Case Management, Patient Safety and Compliance), and external payers to resolve complex patient account issues or process bottlenecks.

Compliance, Innovation & Quality

• Regulatory Oversight: Monitors departmental compliance with State and Federal laws impacting patient intake operations, ensuring all staff adhere to patient privacy practices and billing guidelines.
• Process Improvement: Acts as an SME to identify “pain points” in the claim journey; proposes and implements enhancements to the registration workflow to improve the overall patient experience.
• Complex Problem Solving: Resolves moderately complex issues involving mismatched patient identities, coordination of benefits (COB), or operational opportunities for improvement that impact procedure/service authorization matters.

Talent Management and Training

• Staff Development: Responsible for ensuring staff training compliance requirements are met, delegating, and reviewing the work of junior staff to ensure a high level of data quality and professional patient interaction.
• Resource Creation: Is aware of where to obtain Educational Learning Resources (ELRs) and “tip sheets” for various workflows completed in the hospital’s software (EHR/EMR) systems.
• Project Oversight: May manage specific departmental projects, such as the implementation of new check-in technology (Epic My Chart), a new financial clearance workflow, within defined budget parameters and or the expansion of registration services to auxiliary departments/service lines.

Core Responsibilities in Detail

• Provide Lead cross-departmental support in ED, Mother Child Health, Same Day Surgery, Pre-Registration, Outpatient Registration (Main Admitting), PBX Communications.   
• At the discretion of upper management, lead meetings with client clinical and or administrative leadership.
• Assist client’s effort of neutralizing multi-million dollar impact by 1. Minimizing Do Not Bill days 2. Accelerate claim adjudication by addressing Claim Edit and DNB Workqueues trends.
• Analyze opportunity for improvement patterns and trends, categorize root-causes per technology, workflow and or isolated vs. systemic causes.
• Partner with leadership on establishing Quality Assurance measures that address and minimize the impact of trended opportunities rooted in workflow.
• Escalate to client’s IT leadership opportunities categorized and rooted in technology.
• Provide staff guidance to assure quality in registration, admissions, insurance verification and PBX Communication operations which include but are not limited to:
• Client Software application - TempTrak monitoring of temperature, pressure, and humidity across hospital equipment and environments, ensuring regulatory compliance and maintaining accurate records.
• Monitoring of software applications and tools which identify fire locations within the client’s facility.
• Adherence to client’s crisis and emergency management plan activation requirements associated with PBX.
• Monitor and partner wi