Access Lead

UPMC; Seneca (PA); On-site; USD 48,000 - 62,000; Full time

Job summary

UPMC Northwest is seeking a full-time Access Lead to manage the daily patient access workflow, lead staff at the site, and serve as the liaison for billing and insurance matters.

The role requires a high school diploma or GED (or an Associate degree) with related experience, strong communication skills, and computer proficiency. Shifts include 3:00pm–11:30pm with weekend/holiday rotation and occasional flexibility for staffing coverage.

Qualifications

• High school diploma or GED with 3+ years in admissions/registration, or an Associate degree with 1+ year experience.
• Medical terminology and knowledge of managed care regulations required.
• Strong interpersonal, organizational and communication skills; able to stay professional under pressure.
• Experience with computers and office equipment.

Responsibilities

• Support and contribute to UPMC core values and department goals while performing duties.
• Serve as a leader at the work site and communicate with staff and management.
• Train new staff and orient to department work area; provide ongoing education.
• Monitor patient flow, adjust staffing, and ensure accurate scheduling.
• Verify eligibility and precertification, and update demographic/insurance data.
• Resolve reimbursement issues with clinical staff and third-party carriers.
• Generate and review revenue reports; support billing processes.
• Perform duties in line with system competencies and other assigned tasks.

Skills

Interpersonal skills

Organizational skills

Communication skills

Problem solving

Computer literacy

Education

High school diploma or GED

Associate degree

Act 34 clearance

Tools

Office software

Electronic health records (EHR)

Billing and verification systems

Job description

Purpose:

Do you have experience in patient registration? Are you looking to grow your career in patient access and customer service? UPMC is hiring a full-time Access Lead to support UPMC Northwest. This position would work varying days, including rotating weekends and holidays, primarily 3:00pm until 11:30pm, however flexibility is required to cover other shifts as needed for staffing coverage.

Do you have experience in patient registration? Are you looking to grow your career in patient access and customer service? UPMC is hiring a full-time Access Lead to support UPMC Northwest. This position would work varying days, including rotating weekends and holidays, primarily 3:00pm until 11:30pm, however flexibility is required to cover other shifts as needed for staffing coverage.

Purpose:

Do you have experience in patient registration? Are you looking to grow your career in patient access and customer service? UPMC is hiring a full-time Access Lead to support UPMC Northwest. This position would work varying days, including rotating weekends and holidays, primarily 3:00pm until 11:30pm, however flexibility is required to cover other shifts as needed for staffing coverage.

The Access Lead will coordinate and lead the daily functions of the designated work area, as well as provide direction and support to staff as needed. They will elevate any concerns or problems to management when necessary. Additionally, the Access Lead will facilitate the completion of all statistical reporting and data analysis to ensure UPMC guidelines are being supported, as well as serve as the primary information source and advocate for financial matters on site.

Are you looking to grow your career in Patient Access? If so,

Responsibilities:

• Support and contribute to UPMC core values and guiding principles of Your Care. Our Commitment 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.
• Serve as an advocate, resource, troubleshooter, and designated leader at specific work sites.
• Represent management and be empowered to make decisions.
• 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.
• Monitor patient flow and respond to changes in workload, patient volume, and staffing levels, planning services accordingly.
• Ensure precertification requirements have been met prior to treatment.
• Update patient demographic and insurance information in the system as necessary.
• Verify insurance benefit information with all available carriers via electronic verification system or telephone if not previously completed.
• Interact with the clinical staff and/or ancillary departments to resolve reimbursement issues.
• Advise the clinical staff of the need for a possible referral to a participating health care facility when appropriate.
• Work various revenue reports within established time frames.
• Take action accordingly to ensure a successful billing process.
• Perform in accordance with system-wide competencies/behaviors.
• Perform other duties as assigned.
• High school diploma or GED and at least 3 years of experience in a related fiscal/admissions/registration function, or Associate degree and 1 year experience; or an equivalent combination of education and experience required.
• Medical terminology, third party health care coverage experience and strong understanding of managed care regulations are required.
• Strong interpersonal, organizational and communication skills and ablility to remain professional and courteous when dealing with sensitive issues and stressful circumstances.
• Ability to effectively problem solve and make independent decisions.
• Prior working 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 is an Equal Opportunity Employer/Disability/Veteran