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Access Lead

  • Job ID: 001899664
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Community Medicine Incorporated
  • Department: 55162 ZCMS1 Metro ENT
  • Location: 100 Delafield Road, Pittsburgh PA 15215
  • Union Position: No
  • Salary Range: $15.24 to $23.27 / hour

Description

UPMC Community Medicine Incorporated is seeking a full-time Access Lead to support Metropolitan ENT Associates - UPMC at the UPMC St. Margaret Medical Arts Building!

The Access Lead will assist in coordinating and leading the daily functions of the designated work area, along with providing direction and support to staff as needed. This role escalates any concerns or problems to management, when necessary, and facilitates the completion of all statistical reporting and data analysis to ensure UPMC guidelines are being supported.

Additional responsibilities include, but are not limited to, mentoring and training staff, registering patients and completing the check-out process, scheduling patients for necessary tests and appointments, updating physician templates, completing authorizations, and serving as a primary information source and advocate for financial matters on site.

The ideal candidate for this position will have previous medical office or healthcare setting work experience, with previous leadership experience being preferred. Exceptional customer service and interpersonal skills are vital to this role, while any health insurance regulation knowledge is a plus.

 

Responsibilities:

  • Support and contribute to UPMC core values and guiding principles of UPMC and abide by all UPMC departmental policies, procedures, and goals in the process of performing all job responsibilities.
  • Incorporate acts of dignity and respect in daily interactions.
  • Advise the clinical staff of the need for a possible referral to a participating healthcare facility when appropriate.
  • Serve as an advocate, resource, troubleshooter, and designated leader at specific work sites.
  • Represent management and is empowered to make decisions.
  • Monitor patient flow and respond to changes in workload, patient volume, and staffing levels, planning services accordingly.
  • Work various revenue reports within established time frames.
  • Take action accordingly to ensure a successful billing process.
  • Ensure precertification requirements have been met prior to treatment.
  • Interact with the clinical staff and/or ancillary departments to resolve reimbursement issues.
  • Responsible for training new staff and orienting to department work area.
  • Provide ongoing education and communication, as necessary.
  • Provide feedback on a regular basis to management about all personnel, department issues, and concerns for areas of direct responsibility.
  • Update patient demographic and insurance information in the system, as necessary.
  • Verify insurance benefits information with all available carriers via electronic verification system or telephone if not previously completed.

 

Qualifications

  • High School diploma or equivalent AND at least three years of experience in a related fiscal/admissions/registration function,
  • OR Associate's Degree AND one year of experience,
  • OR an equivalent combination of education and experience required.
  • Medical terminology, third-party health care coverage experience, and a strong understanding of managed care regulations are required.
  • Strong interpersonal, organizational, and communication skills, and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances.
  • Ability to effectively problem solve and make independent decisions.
  • Prior work experience on personal computers and various office equipment.
  • Knowledge and skills necessary to provide care and/or interact appropriately with all ages of patients.
  • Possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs.
  • Provide the care needs as described in the department's policy and procedure.


Licensure, Certifications, and Clearances:

  • Act 34

 

UPMC has a Center for Engagement and Inclusion that is charged with executing leading-edge and next-generation diversity strategies to advance the organization’s diversity management capability and its national presence as a diversity leader. This includes having Employee Resource Groups, such as PRIDE Health or UPMC ENABLED (Empowering Abilities and Leveraging Differences) Network, which support the implementation of our diversity strategy. 

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct