Health Access Rep Lead

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

$19.71 - $25.62

Scheduled Weekly Hours:

40

Position Overview

Functions as a super user to insure department compliance with system and operational changes and assists in training to support ongoing staff education and development. Applies financial screening guidelines to insure collectable accounts and functions as a resource to staff. Communicates effectively and works cooperatively with others. Has respect for and understanding of other registration disciplines. Utilizes standards, guidelines, and written procedures for performing registration functions.

MINIMUM REQUIREMENTS

Education:High school diploma or equivalency.

Experience:One year of Health Access experience. Knowledge of all Capital Health departments required.

Other Credentials:

Knowledge and Skills:Health Access Representative productivity exceeds 90% with less than 10% error rate. Strong customer service and problem-solving skills.

Special Training:Proficient computer skills. Advanced health insurance and prior authorizations knowledge.

Mental, Behavioral and Emotional Abilities: Possesses ability to work independently and as a team member.

Usual Work Day:8 Hours  

ESSENTIAL FUNCTIONS

• Assists in training, problem solving, and quality review with subordinate health access representatives. Assigns duties to registrars as directed by Supervisor or Manager.
• Follows compliance with computer system procedures, department procedures, and training guidelines to accurately complete each registration. Serves as a resource for company protocols.
• Audits charts for accurate demographics, Medicare compliance, authorizations and referrals, necessary signatures, and completion of forms and charts.
• Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Advance Beneficiary Notice, Advance Directives, Patients Rights, and the Interpreter flag as measured by quality assurance and observation.
• Follows and monitors staff compliance with following payer requirements for authorization, pre-authorization, referrals, coordination of benefits forms, and in-network verification according to Insurance Card Database, and Insurance Verification guidelines.
• Audits charts for final billing. Ensures accurate demographics, authorizations or referrals, necessary signatures, and completion of forms and charts.
• Follows Self Pay procedure regarding No Surprise Billing Act and referrals to Medicaid and charity.
• Assists with training and education of patient access staff.
• Communicates effectively with Health Access team members and is open to feedback and suggestions in order to identify opportunities for improvement.
• Identifies and seeks out members of the registration department as a resource to increase knowledge and seek validation of department guidelines and procedures.
• Reports to Management Team regarding department deficiencies to include faulty equipment, supplies and concerns.
• Identifies unit and department goals and supports the culture of organization.
• Supports department performance improvement initiatives. Initiates ideas to meet department goals.
• Attends all mandatory department meetings.
• Follows patient identification policy.
• Serves as a resource for Health Access department. Leads department through daily workload and divides work as needed.
• Provides coverage in working areas as required when on-call duties apply.
• Acts as a liaison for physician office and ancillary departments as needed.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include: Sitting , Wrist position deviation , Pinching/fine motor activities

Occasional physical demands include: Standing , Walking , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Keyboard use/repetitive motion

Continuous physical demands include: Talk or Hear

Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perception, Accurate Hearing

Anticipated Occupational Exposure Risks Include the following: Bloodborne Pathogens , Airborne Communicable Disease , Extreme Noise Levels , Dust/Particulate Matter

This position is eligible for the following benefits:

• Medical Plan

• Prescription drug coverage & In-House Employee Pharmacy

• Dental Plan

• Vision Plan

• Flexible Spending Account (FSA)

- Healthcare FSA

- Dependent Care FSA

• Retirement Savings and Investment Plan

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance

• Disability Benefits – Long Term Disability (LTD)

• Disability Benefits – Short Term Disability (STD)

• Employee Assistance Program

• Commuter Transit

• Commuter Parking

• Supplemental Life Insurance

- Voluntary Life Spouse

- Voluntary Life Employee

- Voluntary Life Child

• Voluntary Legal Services

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance

• Voluntary Identity Theft Insurance

• Voluntary Pet Insurance

• Paid Time-Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level. 

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.