Health Access Rep - Lead

Health Access Representative

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.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed minimum pay reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Minimum Pay : $19.71

Position Overview

• Assists in training, problem solving, and quality review with subordinate health access representatives. Assigns duties to registrars as directed by Supervisor or Manager.
• 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 Self Pay procedure regarding No Surprise Billing Act and 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.
• Reports to Management Team regarding department deficiencies to include faulty equipment, supplies and concerns.
• 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.
• Provides coverage in working areas as required when on-call duties apply.
• Acts as a liaison for physician office and ancillary departments as needed.

Offers are contingent upon successful completion of our onboarding process and pre-employment physical. Capital Health will require all applicants 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.

For benefit eligible roles, in addition to cash compensation, we provide a comprehensive and highly competitive benefits package, with a variety of physical health, retirement and savings, caregiving, emotional wellbeing, transportation, robust PTO plan, overtime to eligible roles, and other benefits, including "elective" benefits employees may select to best fit the needs and personal situations of our diverse workforce.

The pay rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and / or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and / or incentive eligibility are determined by role and level.

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.