Health Access Rep - Lead - Day Shift - Full time
Location
Pune | India
Job description
Work Shift
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 advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.
Position Overview Weekends & On-Call required - Assists in training, problem solving, and quality review with subordinate health access representatives. Assigns duties to registrars as directed by team leader or supervisor. Provides coverage in working area as required.
- 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 Financial Screening and Self Pay procedure regarding 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.
- 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.
- Acts as a liaison for physician office and ancillary departments as needed.
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 skills.
Special Training: Basic computer skills. Health insurance knowledge, prior authorizations knowledge, and scheduling experience required.
Mental, Behavioral and Emotional Abilities: Possesses ability to work independently and as a team member.
Usual Work Day: 8 Hours
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
Offers are contingent upon successful completion of our onboarding process and pre-employment physical. Capital Health will require all applicants (including contractors, travelers and consultants) to have an annual flu vaccine prior to start date, with the exception of individuals with medical and religious exemptions. 'Company will never ask candidates for social security numbers or date of birth during application phase. If you are asked for this information online, you may be a target for identity theft.'
Job tags
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