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UPMC · 15 hours ago

Access Lead (UPMC Mercy)

Pittsburgh, PA

Full-time

Onsite

Mid Level

3+ years exp

UPMC is looking to hire an Access Lead to support UPMC Mercy. The Access Lead will coordinate and lead the daily functions of the designated work area, provide direction and support to staff, and ensure compliance with UPMC guidelines through statistical reporting and data analysis.

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Responsibilities

Support and contribute to UPMC's core values and guiding principles of Your Care. Our Commitment and abide by all UPMC departmental policies, procedures and goals in the process of performing all job responsibilities. Incorporates acts of dignity and respect in daily interactions

Serve as an advocate, resource, troubleshooter, and designated leader at specific work sites. Represents Management and is empowered to make decisions

Responsible for training new staff and orienting to the department work area. Provide ongoing education and communication as necessary

Provide feedback on a regular basis to management about all personnel, department issues and concerns for areas of direct responsibility

Monitor patient flow and respond to changes in workload, patient volume, and staffing levels, planning services accordingly

Ensure precertification requirements have been met prior to treatment

Update patient demographic and insurance information in the system as necessary

Verify insurance benefit information with all available carriers via electronic verification system or telephone if not previously completed

Interact with the clinical staff and/or ancillary departments to resolve reimbursement issues

Advise the clinical staff of the need for a possible referral to a participating health care facility when appropriate

Work various revenue reports within established time frames

Take action accordingly to ensure a successful billing process

Performs in accordance with system-wide competencies/behaviors

Performs other duties as assigned

Qualification

Medical terminologyThird party health care coverageManaged care regulationsData analysisStatistical reportingComputer proficiencyPatient interactionInterpersonal skillsOrganizational skillsCommunication skillsProblem solvingDecision making

Required

High school diploma or GED and at least 3 years of experience in a related fiscal/admissions/registration function, or Associate degree and 1 year experience; or an equivalent combination of education and experience required

Medical terminology, third party health care coverage experience and strong understanding of managed care regulations are required

Strong interpersonal, organizational and communication skills and be able to remain professional and courteous when dealing with sensitive issues and stressful circumstances

Ability to effectively problem solve and make independent decisions

Prior working experience on personal computers and various office equipment

Knowledge and skills necessary to provide care and/or interact appropriately with all ages of patients

Possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs

Provide the care needs as described in the department's policy and procedure

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