Patient Access Central Unit Team Lead in Nashville, TN at Parallon

Date Posted: 8/8/2018

Job Snapshot

Job Description



Job Summary – The Central Unit Team Lead is responsible for assisting the Central Unit Manager in the areas of Preregistration, Insurance Verification, Pre-Certification and Insurance Notification (as assigned) including coordination of staff activities and assists in performing day to day tasks in all assigned areas.

Supervisor – PTAC Central Unit Manager

Supervises – not applicable

Duties (included but not limited to):

• Assist with new hire and continual training and communication for PTAC Central Unit staff

• Assist with evaluations for PTAC Central Unit employees

• Perform pre-registration and insurance verification according to SSC standards and guidelines

• Document benefits verification and pre-certification in Meditech Standard Customer Defined screens

• Contact physician and/or insurance company to resolve issues regarding prior authorization or referral forms

• Assign Insurance Plans (IPLANS) accurately

• Perform electronic eligibility confirmation when applicable and document results

• Research Patient Visit History to ensure compliance with the Medicare 72 hour rule per SSC standards and guidelines

• Complete Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module change to OnBase

• Calculate patient cost share and be prepared to collect via phone or make payment arrangement per SSC standards and guidelines

• Contact patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment

• Receive and record payments from patient for services rendered per SSC standards and guidelines

• Utilize appropriate communication system to facilitate communication with facility PTAC and other departments as required

• Perform insurance verification and pre-certification follow up for prior day’s walk in admissions/registrations and account status changes by assigned facility per SSC standards and guidelines

• Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre-existing, non- covered, and re-certification issues per SSC standards and guidelines

 

• Utilize Meditech account notes and the Artiva system as appropriate to document benefit, pre-authorization and other necessary information

• Meets with the PTAC Central Unit Manager regularly to effectively communicate and resolve research and correspondence issues, set and prioritize goals, improve processes and review productivity.

• Assists with staff communication, providing updates, resolving issues, setting goals and maintaining standards.

• Assists with all phases of answering account inquires.

• Ensure appropriate indexing of physician orders

• Assist the PTAC Central Unit Manager in maintaining established departmental policies and procedures, objectives, patient, and customer service policies

• Perform quality reviews as required by Parallon/SSC policy.

• Work as a liaison between team members, facility staff members, and SSC staff

• Assist with payroll activities for team members (i.e., time cards,lan edit sheets)

• Assist manager with developing team goals and action plans

• Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"

• Other duties as assigned

EDUCATION

High School diploma or GED required.

EXPERIENCE

At least one year of related experience required.