Lead Healthcare Access Specialist

Outer Cape Health Services; Orleans (MA); On-site; USD 34,000 - 40,000; Full time

Job summary

Outer Cape Health Services in Massachusetts is seeking a Lead Healthcare Access Specialist to advocate for low-income and uninsured clients, coordinate referrals, and support a patient-centered revenue cycle. This role works to connect patients with public and private programs and resources while guiding a dedicated Healthcare Access team.

Reporting to the Director of Revenue Cycle and Senior Director of Operations, you will mentor staff, ensure accurate documentation, and help patients navigate

Qualifications

• Associates’ degree or BA/BS required, or equivalent experience.
• Minimum of two years of experience in health care, public health, or social service field.
• Bi-lingual skills preferred (English/Spanish).
• Excellent interpersonal skills, written and verbal communication skills, organizational abilities, computer experience.

Responsibilities

• Advocate for patients and connect them with healthcare programs and resources that support their well-being.
• Lead Healthcare Access Specialist staff by providing day-to-day guidance, support and assistance with complex access issues.
• Coordinate daily workflow, coverage, priorities, and follow-up to ensure timely patient service and accurate documentation.
• Support onboarding, training, and ongoing education of Healthcare Access Specialist staff on policies and procedures.
• Monitor work quality, assist with audits, and identify opportunities to improve workflows and reimbursement outcomes.
• Elevate operational and staff concerns to the Director of Revenue Cycle and assist with timely resolution.
• Understand ACA, Medicare, and Massachusetts health insurance programs and benefits.
• Complete Lead CAC training and maintain required certifications; participate in ongoing forums and trainings.
• Educate and screen patients, providing enrollment assistance for insurance and other resources.
• Ensure health center reimbursement and maximize insurance benefits for uninsured patients.

Skills

Interpersonal skills

Team collaboration

Problem-solving

Customer service orientation

Bi-lingual English/Spanish

Education

Associates’ degree or BA/BS required, or equivalent experience

Tools

EPIC

Outlook

Microsoft Office

OneDrive

Job description

Our Culture- Why Work With Us

Joining Outer Cape Health Services isn't just about taking on a new role; it's about embracing a mission that goes beyond the day-to-day. Here, you become part of a dedicated team committed to safeguarding and nurturing invaluable community health resources. Our ethos is built on creating a vibrant and inclusive workplace where every team member is valued and recognized for their unique contributions.

Our Culture- Why Work With Us

Joining Outer Cape Health Services isn't just about taking on a new role; it's about embracing a mission that goes beyond the day-to-day. Here, you become part of a dedicated team committed to safeguarding and nurturing invaluable community health resources. Our ethos is built on creating a vibrant and inclusive workplace where every team member is valued and recognized for their unique contributions.

Who We Are

Our mission is to provide a full range of primary health care and supportive social services that promote the health and well-being of all who live in or visit the ten outermost towns of Cape Cod. OCHS now cares for more than 20,000 patients annually, and no one is denied access to services due to an inability to pay. Founded in 1987 through the merger of Health Associates of Provincetown (established in 1972) and the AIM Medical Center in Wellfleet (established in 1966), Outer Cape Health has a long history of successful growth and expansion in pursuit of this mission. As a Patient-Centered Medical Home, OCHS holds itself to the highest standards. Ensuring patients have access to care when they need it and request it and validating that staff are working at the top of their licensures are the foundations of this model.

Our Core Competencies

At Outer Cape Health Services, our core competencies are the foundation upon which our organization is built, guiding us in our mission to deliver exceptional health services to our communities. Our focus on fostering teamwork ensures that we operate as a cohesive unit, valuing each member's contribution and working synergistically towards common goals. Integrity and honesty stand at the heart of everything we do, creating a culture of trust and respect among our team and the communities we serve. Embracing technology, we continually seek innovative solutions to enhance our services and operations. Finally, being patient-centered, we prioritize the needs and well-being of those we serve, striving to exceed expectations and make a meaningful difference in their lives.

A Day In The Life Of This Role

Reporting to the Director of Revenue Cycle and Senior Director of Operations, the Lead Healthcare Access Specialist at Outer Cape Health Services serves as an advocate for low-income, uninsured clients, as well as a day-to-day resource for the Healthcare Access team. This role facilitates access to healthcare, referrals to local community resources, team coordination, training, workflow consistency, quality monitoring, and problem resolution.

Summary Of Duties

• Advocate for patients and community members by connecting them with public and private healthcare programs and resources that support the well-being of each community member.
• Serve as a lead resource for Healthcare Access Specialist staff by providing day-to-day guidance, support, and assistance with complex patient access, insurance, enrollment, and community resource issues.
• Coordinate daily workflow, coverage, priorities, and follow-up activities to support timely patient service, accurate documentation, and consistent access across all sites.
• Support onboarding, training, and ongoing education of Healthcare Access Specialist staff regarding policies, procedures, workflows, program requirements, documentation expectations, and customer service standards.
• Monitor work quality, assist with audits, review tracking systems and patient records for accuracy, and identify opportunities to improve workflows, compliance, patient experience, and reimbursement outcomes.
• Elevate operational, patient access, insurance, enrollment, and staff workflow concerns to the Director of Revenue Cycle, and support timely resolution and follow-up as directed.
• Understand the general policies, facts, and benefits of subsidized and non-subsidized health insurance programs under the Affordable Care Act, Medicare, and Massachusetts state health insurance programs.
• Complete all initial and ongoing Lead Certified Application Counselor (CAC) training requirements and maintain required certifications.
• Participate in all Massachusetts Health Care Training Forums and web- and telephone-based training sessions to maintain current knowledge and, as appropriate, share relevant information with staff and clients.
• Educate and screen patients and community members, providing application, enrollment, and post-enrollment assistance for insurance and other programs and resources, including case management when needed.
• Ensure health center reimbursement for services provided to uninsured patients. Counsel patients and staff to maximize patient insurance benefits, minimize limitations, while maximizing reimbursement.
• Maintain an accurate patient record to reflect evolving insurance eligibility status, re-classing of encounters, and keeping an accurate patient demographic record.
• Maintain accurate in-house tracking systems of client contact, enrollment and assistance statistics for grant and administrative reporting.
• Perform outreach through personal contact, print, or public speaking to inform the community of healthcare program availability.
• Build trust with community members by reducing barriers and promoting consistent access to primary care and other needed services.
• Other related duties and projects as assigned.

Qualifications

What we need from you:

• Associates’ degree or BA/BS required, or equivalent experience.
• Minimum of two (2) years of experience in health care, public health, or social service field.
• Prior leadership, training, mentoring, and Process Improvement experience preferred.
• Ability to achieve LEAD Certified Application Counselor accreditation and working knowledge of curriculum within 6 months of employment
• Bi-lingual skills preferred (English/Spanish).
• Excellent interpersonal skills, written and verbal communication skills, organizational abilities, computer experience, and the ability to work within a collaborative team setting.
• Proficiency in computer skills including EPIC, Outlook, Microsoft office, OneDrive, etc.
• Excellent judgment and ability to solve problems in a timely manner.
• Demonstrated ability to support staff, resolve routine workflow issues, monitor documentation accuracy, and maintain confidentiality and compliance standards.
• Demonstrated ability to work effectively both as a team member and independently within a culturally diverse and inclusive environment.

AAP/EEOC Statement

Outer Cape Health Services is committed to providing equal employment opportunity in all our employment programs and decisions. Discrimination in employment on the basis of any protected class under federal, state, or local law is a violation of our policy and is against the law. Equal employment opportunity is provided to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, covered veterans’ status, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, political affiliation, or any other protected characteristic. This policy applies to all terms and conditions of employment, including, but not limited to, recruitment and hiring, placement, promotion, termination, reductions-in-force, recall, transfer, leave of absence, compensation, and training.

In accordance with Massachusetts law, we are committed to wage transparency. The salary range for this position is $25.00 - $29.00. This range is provided to promote equity and transparency in our hiring process. Actual compensation may vary based on factors such as experience, qualifications, internal equity, and other job-related criteria.