Lead Patient Access Services Representative

Job Description

Team leads responsibilities include reviewing insurance benefits, validating authorizations, communicating authorization statuses with physician offices, and assisting with daily team needs/training. Below outlines a more detailed job description.

Job Responsibility

• Communicates professionally and courteously with patients and physician offices while obtaining or clarifying insurance information and authorization requirements.
• Utilizes PAI system to complete complex elective procedural accounts.
• Contacts insurers to verify patients’ insurance benefits, utilizes insurance websites and other means of electronic insurance verification (HDX) to obtain all information necessary for securing patient accounts. (Coordination of benefits, benefit coverage, limits, copay / deductible amounts, and authorization)
• Secures authorizations for admissions and procedures when necessary.
• Ensures high quality information is always recorded in systems.
• Works on problems of diverse scope and complexity ranging from moderate to substantial.
• Coordinates and provides input into work schedules; monitors adherence to schedules and reports absences.
• Makes decisions regarding daily priorities for a workgroup/function; provides guidance to and/or assists team members on non-routine or escalated issues
• Regularly models/mentors and trains team members on technical skills
• Provides work guidance, including checking and assigning work, to ensure accurate and timely completion of tasks
• Identifying training needs for staff and update action plan.
• Attend Meetings - Rounding, Forums, and Huddles/ Management meetings.
• Creating a supportive trusting working relationship with management team and staff members
• Reinforce a culture of care within the team
• Being pro - active to support the needs of the department.
• Assist Leadership Team with Daily Reports and Quality Reviews
• Partner and collaborate with Management to assist in our day-to-day duties conveying staff’s questions, arranging work assignments, delegating task, website administrator, they are also responsible to completer 35-45 cases daily for scheduled procedures.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• Associate's Degree required, or equivalent combination of education and related experience.
• 5-7 years of relevant experience, required.