Lead-Patient Access Rep ED

Job Summary:
Under the direction of the Admitting Manager, the Lead Patient Access Representative
Admitting Lead is responsible for Supervising the Admitting Staff, including but not limited to in-service education, staff organization, evaluation, continuous quality improvement and guest relations promotion/satisfaction. Lead Patient Access Representative is responsible for interviewing incoming patients (inpatient, outpatient and emergency room) to obtain all pertinent data for admission. This includes medical record information, as well as demographic and financial related information. Works with physician office managers to obtain necessary pre-admit information and authorizations. The Lead Patient Access Representative will be responsible for maintaining adequate staff coverage during shifts. Assist in maintaining logs within the admitting department and emergency room departments to obtain productivity and accuracy among the department staff. The Admitting Lead will show by example and contributes to the professional, courteous and efficient operation of the department at all times: maintaining an acceptable patient flow so that all patients receive prompt and courteous attention. The Admitting Lead will monitor the work in the department for accuracy, timeliness and compliance with laws and regulations. The monitoring will be done through daily editing of accounts utilizing the editing tools to track the results.

Essential Competencies/Performance Expectations:

• Assists in the training of new employees.
• Closely monitors patient valuables in accordance with Hospital policy and procedure.
• Demonstrates awareness and sensitivity to rights of patients and significant others, as identified within the situation.
• Document any financial arrangements made in the patient’s account notes. Notifies the Admitting Manager or Business Office Manager of all problem accounts that require special attention.
• Functions with an awareness of safety issues and reports unsafe issues appropriately, as identified within the institution.
• Is able to obtain Advance Directive information from inpatient, ER, OPS, and bed patients.
• Accurate data is entered in the computer and on the Conditions of Admission.
• It is the responsibility of the Lead Patient Access Representative to support management and Organizational/ department goals at all times; Acknowledging patients or guests and their requests. Offering assistance promptly, cordially, and completely. Making patient needs the first priority. Exhibiting concern, tact and discretion in all working relationships. Promoting unity and teamwork among co-workers and other department. Appearing professional in dress, grooming and hygiene.
• Must be able to physically able to push a wheelchair.
• Must be able to work and be cross-trained in all areas of Admitting/Emergency Department without difficulty. This includes, but is not limited to, inpatient, Outpatient, bed board and emergency room.
• Must be familiar with the Hospital layout in order to direct patients or guests to the proper destination.
• Must be willing to meet staffing needs of the department and be available to work overtime, holidays, and shift changes.
• Must remain informed and compliant with HIPPA, EMTALA, the Fair Debt and Collection Practices Act, Medicare Secondary Payor, and other laws and regulations that govern Patient Financial Services.
• Must remain informed regarding all PPO, HMO, Medicare, Medi-Cal and indigent service programs and requirements for timely processing of claims.
• Patient care is of the utmost priority in all aspects of registration. Must be comfortable with sick patients and able to summon medical assistances when needed. Must be BLS certified each year.
• Performs various other duties, as assigned.
• Responsible for appropriately handling all confidential information while at work, as well as when away from the facility.
• Responsible for choosing the correct medical record numbers, gathering current patient data, photocopying insurance cards, identification cards, and other pertinent information, obtaining authorization, obtaining signatures on all appropriate forms, and obtaining accurate insurance and demographic information.
• Responsible for compiling paperwork for the patient’s medical chart, as well as the electronic medical record, ensuring that all appropriate paperwork is sent to the proper destination in a timely fashion.
• Responsible for maintaining adequate staff coverage during shifts.
• Responsible for speaking with the patient in regards to their financial responsibility for the ill. Collect deposits on all self-pay patients and co-payments from patients whose insurance requires one. If the patient is unable to meet their financial obligation at the time of service, the Lead Patient Access Representative is responsible to speak to them regarding the Hospital’s requirements and make financial arrangements. Complete promissory note, when necessary.
• Responsible for understanding and participating in the organization-wide Performance Improvement Program through orientation, education, departmental, and inter-departmental quality control, and quality planning activities.
• Responsible for understanding Consent form, Advance Directive, and any other forms the patient is required to sign in order to accurately and clearly state the intention of each paragraph. Patients are to be well informed before a signature can be obtained.
• Responsible to take call one week per month.
• Responsible to perform, understand and demonstrate ability of all courses designated, within 90 days of hire for new employees, and within 1 year of 02/12/2018 for current employees. Current employees must successfully pass a competency test every two years from that original date completed.

Experience/Qualifications:

• A minimum of 2-3 years of admitting experience.
• Ability and desire to work consistently under pressure in a hectic, high paced Atmosphere.
• Ability to work independently, accomplishing tasks with minimal supervision.
• Computer Proficiency to include A/D/T system and various software programs.
• Demonstrate attention to detail, must be able to demonstrate ability to teach.
• Demonstrate strong leadership skills.
• Excellent English communication skills, both verbal and written.
• Medical terminology and spelling accuracy are highly preferred.
• Must be able to type 40 words per minute and operate a calculator.
• Must have the ability to resolve issues that arise in a moderate constructive manner.
• Outstanding customer service skills required must be able to interact well and develop a rapport with department staff as well as with other departments.
• Strong knowledge of admitting operations, laws and regulations as well as working knowledge of insurance reimbursement, Medicare, Medi-Cal, HMO and PPO is essential.

Education:

• High School graduate or equivalent preferred

Licensure/Certification:

• Must be BLS certified or must provide BLS certificate within 30 days of hire.
• Obtain/Posses current Mgmt of Assaultive Behavior Certification; can obtain within 6 months of hire.