1 year of experience required
The Patient Access Lead position is responsible for the intial patient contact, via the
pre-admitting/pre-registration function and assisting with the control and maintenance of the
patients' account until discharge. In addition, this employee will also serve as a source of
response, either directly by referral to any type of complaint received from the patient.
position will also provide back-up assistance to the cashier and/or Financial Counselor.
Responsible for Point of Service (POS) collection goals.
Essential Duties and Responsibilities:
?Review of assigned accounts to insure accurate payer data (billing address, policy number,
group number, subscriber info)
?Review accounts on hold in a timely manner
?Insure compliance with hospital, state, and federal regulator and compliance requirements-
i.e. 3 day rule, ABN, MSP, etc.
?Obtain additional insurance information as needed
?Assure all required forms have been properly signed
?Monitors scheduling information for all departments to initiate the pre-admissions/pre-reg
?Assist patients with their questions and concerns about healthcare bills
?Maintain knowledge and comply with payer specific requirements
?Maintain complete and accurate documentation of account activity in computer system
?Inform supervisor of complex or unusual circumstances regarding delays in payments
General Duties and Responsibilities
?Interviews patients and/or their representatives either by telephone or in-house to secure all
demographic and financial data as necessary to accurately and completely document the
patient visit in the medical and financial files
?Verifies insurance and other benefits with patient's employer, insurance company or other
agency for all admission and specific outpatient services
?Daily communication with other admission areas and Case Management to ensure proper
authorization and pre-certification of admissions and all out patient procedures requiring pre-
certification or authorization
?Counsels patients and family on insurance matters, outside resources, and patient's financial
?Negotiates payment of liability, collecting the same on admission if possible. Completes
a financial statement when required according to the Patient Financial Services and
Business Office Policies
?Refers patients to Financial Counselor when appropriate
?Assists with inquires from walk-in patients regarding billing questions and concerns.
?Acts as a resources within the hospital for any patient complaint or problem, either responding
directly or referring the problem to appropriate source for solution
?Keeps updated on all changes in the Medicare rules and regulations as well as changes in
Medicare coverage issues, Medicaid, and other payers
?Supports Quality Improvement and Key Performance process for the department
?Completes correspondence, including claims denials
?Any other duties as assigned by supervisor and/or director
Lead patient Access Counseler
Work with Patient Access Manager developing training tools for new Patient Access Associate
Be able to answer questions from Patient Access Associates as they need help
Act as Interim Patient Access Manager as requested by manager
Must be able to perform the functions of the Communication Patient Access Rep.
This position requires the full understanding and active participation in fulfilling the Mission
and Values of HRH. It is expected that the employee will demonstrate behavior,
consistent with the Core Values - Excellence, Caring Spirit, Integrity, Stewardship, and
Good Humor. The employee shall support HRH goals, and direction of the quality
Education, Experience, and Licensure/Certification Requirements:
representative of minimum level of knowledge, skills, and/or abilities.
1. High School Diploma or Equivalent.
2. One Year experience in healthcare billing environment
3. Knowledge of insurance explanation of benefits
4. Previous cash handling experience
5. Knowledge of health care billing requirements
6. Knowledge of credit card terminal operation
7. Experience, understanding and usage of computers, including Microsoft Office Suite as well
as ability to learn applications relevant to position
8. Experience with Point of Service Collections
St. Vincent Healthcare - 18 months ago