POSITION DESCRIPTION

JOB TITLE & CODE:	Lead Patient Access Specialist (101286)
DEPARTMENT:	Patient Access
REPORTS TO:	Regional Director, Patient Financial Access Services
FLSA STATUS:	Non-Exempt

POSITION SUMMARY:   Greets and receives patients into the health care facility. Responsible for accurate and timely processing of patient demographics and insurance information. Communicates and supports hospital departments using scheduling system as appropriate. Obtains electronic signature for consent to treat and patient financial obligation. Provides excellent customer service and uses strong written/verbal communication skills. This position is the first impression of WVU Healthcare to the patient. Maintains knowledge of revenue cycle operations, third party reimbursement, and medical terminology. Mentors employees new to the department. Works closely with the leadership team to identify and implement process improvements.

MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1.	High school graduate or equivalent.
2.	Obtain HFMA Certified Revenue Cycle Representative (CRCR) Certification within one (1) year of hire.
EXPERIENCE:
1.	Four (4) years of patient financial services, patient access, or registration experience.

PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1.	Associate degree in a related medical field such as medical assisting or medical office administration preferred.
2.	NAHAM Certified Healthcare Access Associate (CHAA) Certification AND HFMA Certified Revenue Cycle Representative (CRCR) Certification
EXPERIENCE:
1.	Experience in a medical office setting preferred.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.
1.	Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
2.	Prepares WVU Medicine standard consent form, notice of privacy practice and/or other necessary paperwork related to registration and presents to patient/family/legal guardian for signatures.  Obtains electronic signature for consent to treat and patient financial obligations.
3.	Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems.
4.	Directs patients needing financial assistance to speak with a Financial Counselor.
5.	Prepares armband for patient identification.
6.	Balances daily receipts and cash drawer for patient payments as needed.
7.	Follows up on accounts as indicated by system flags (courtesy dismissal/comments/red stickers).
8.	Maintains confidentiality according to policy and HIPAA when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information
9.	Provides to the patient, information concerning insurance, payment of bills and hospital procedures.  Consistently maintains current knowledge of major payer payment provisions.
10.	Answers phone calls in a professional and courteous manner. Uses phone system in correct manner.
11.	Schedules, reschedules, or cancels patients in accordance with hospital workflows.
12.	Checks for order completeness and validate order against scheduled service.
13.	Communicates with and supports hospital departments using the scheduling system.
14.	Follows hospital, state, and federal guidelines for ensuring safe environment for workers, patients, and the public. Ensures compliance by staff to hospital, governmental, and insurance regulations.
15.	Complies with Notices of Privacy Practices, and the Patient’s Rights and Responsibilities and cooperate with the WVUH Corporate Compliance Program during employment.
16.	Communicates and interacts with clients, families, visitors, physicians, departmental, and hospital staff and the public in general in a manner that demonstrates professionalism and concern for the individuals’ need(s).
17.	Participates in the processes to assess and improve the services provided and compliance with regulatory requirements. Reports results of assessments and improvement processes to the appropriate leader.
18.	Reviews assigned areas work flows and makes recommendations to leadership for changes that will improve operations.
19.	Oversees core responsibilities of assigned area(s), for instance tracking IMM completion rates and making changes to improve compliance percentage.
20.	Field and coordinate questions of new staff to ensure they have proper understanding of operations once they are off the training schedule.
21.	Will coordinate patient issues for assigned area(s) that arise i.e. handling escalations with patients to resolve and de-escalate the problem.
22.	Acts as a representative in registration to help ensure the patient experience related to registration is working efficiently and is effective. Assists staff with problem resolution in a timely manner.
23.	Assists leadership with the interviewing process for potential employees and helps coordinate new employee training.
24.	Assists leadership in coordinating staff schedules including leave time, call offs, and on call rotation to ensure adequate departmental coverage. Assists leadership in reporting and monitoring of patient access related functions as requested by leadership.
25.	Monitors reports and work queues daily as assigned by leadership.
26.	Helps coordinate established downtime procedures.
27.	Performs Registrar duties as needed indicated by patient volumes or as assigned by leadership.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1.	Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping and feeling are necessary body movements utilized in performing duties throughout the work shift.
2.	Must be able to sit for extended periods of time.
3.	Must have reading and comprehension ability.
4.	Visual acuity must be within normal range.
5.	Must be able to exert in excess of 50 pounds of force occasionally to move patients or objects.
6.	Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1.	Office type environment.
2.	Patient care environment.

SKILLS AND ABILITIES:
1.	Excellent oral and written communication skills.
2.	Working Knowledge of computers.
3.	Basic knowledge of medical terminology preferred.
4.	Basic knowledge of third party payers preferred.
5.	General knowledge of time of service collection procedures preferred.
6.	Excellent customer service and telephone etiquette.
7.	Must demonstrate the ability to use tact and diplomacy in dealing with others.
8.	General knowledge of time of service collection procedures preferred.

Date Reviewed/Revised:  May 2022