Under the supervision of the Access Supervisor, the Lead Patient Access Specialist is responsible for coordinating and directing the daily activities of the staff engaged in providing services in the Patient Access Department. The Lead Patient Access Specialist directs the daily operations and work assignments to accommodate patient flow and acts as a resource to staff to resolve daily operational issues, participate in orientation and training emphasizing customer service and technical accuracy as the main priorities. The Lead Access Specialist participates in the hiring of new staff for their area of responsibility.

Essential Job Functions

• Supports and models behaviors consistent with the mission and philosophy of Billings Clinic and department/service.
• Analyzes patient volumes in each area and coordinates staff to meet the needs of our patients and internal customers. Independently makes determination to reallocate or flex staff as needed. Maintains competency in the daily functions of each registration area of responsibility by actively performing the duties of staff. Prioritizes tasks and projects that are frequently non-routine, and ensures projects are completed within established timeframes. Independently makes necessary adjustments/changes to daily schedule to accommodate unexpected needs.
• Acts as a resource to staff and other departments assisting with professional and technical job-related issues, resolution of problems, issues or concerns that may arise from questions received from the staff while maintaining a focus on quality outcomes. Participates in on-call rotation for evenings and weekends.
• Acts as liaison between Access Departments and clinical area including the development and sustaining of a positive relationship with physicians, nursing staff, clinical managers, etc.
• Responsible for training staff in the collection of co-pays and deductibles, assuring that department policies and procedures are followed consistently and accurately. Provides on-site support for training of new technology, policies and procedures. Ensures adequate number of staff within the assigned areas are cross trained in all assigned departments for ease in moving staff from one area to the next.
• Ability to triage diverse complex situations performing necessary investigation and research to gather pertinent data. Takes action as appropriate with minimal input or supervision. Orients and trains staff to understand the potential for legal ramifications due to errors.
• Understands the revenue cycle and educates staff in the relevance of their role in the revenue cycle by getting errors corrected timely so as not to hinder claims submission, performing quality assurance using various reports to ensure there are no critical errors in patient demographic and insurance information that could delay payment of the patient claim.
• Represents the Access Specialists as an end- user in relation to new technology. Provides end user expertise in the testing and development of new technology and process flow.
• Identifies the need for appropriate quality improvement within the scope of her/his position and brings forward recommendations for such. Monitors and executes quality assurance activities by either developing or requesting reports and/or data from appropriate resources, analyzing data to identify areas in need of improvement, track and log quality indicators for performance appraisal standards, presenting findings to staff and admitting leadership with minimal supervision.
• Assists Supervisor by participating in and providing meaningful feedback and observations into the development of departmental policies and procedures, interview, hiring, and the performance appraisal process. In coordination with the Supervisor, Director and Human Resources Department, makes recommendation for disciplinary actions as needed that adhere to established human resource management policies and procedures.
• Identifies needs and sets goals for own growth and development; meets all mandatory organizational and departmental requirements.
• Maintains competency in all organizational, departmental and outside agency environmental, employee or patient safety standards relevant to job performance.
• Performs other duties as assigned or needed to meet the needs of the department/organization.
• Supports and models behaviors consistent with Billings Clinic’s mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.

Minimum Qualifications

Education

• High School or GED equivalent

Experience

• Six (6) months Billings Clinic admitting, registration or PFS experience required
• Previous healthcare reimbursement and/or insurance experience preferred