Ld Pre-Access Specialist

Position Details

Department: CORP | CBO Financial Clearance
Category: Patient Access
Location: Phoenix
Employee Type: Regular
Posting #: 688657
Posted On: 7/29/2022

Position Summary

The Lead Pre Access Specialists primary purpose is to oversee the Pre Access staff and process. This position reports to the Pre Access Supervisor. This position will also be responsible for the accurate and complete pre-registration, insurance verification and authorization of scheduled professional and hospital services across all services. The lead is expected to have an understanding of various divisions and protocols for each division.

Position Duties

  1. Oversees Staff
    • This position oversees assigned Pre Access Specialists working directly and collaboratively with manager, supervisors and staff to provide a high level of satisfaction with patients and families utilizing PCH services.
  2. Oversees Process
    • Works directly and collaboratively with manager, supervisors, staff, and clinical partners to provide best practice for verifying insurance coverage, obtaining authorization for all scheduled professional and hospital services to ensure a high-level of customer satisfaction. Prepares reports that drive work flow within the department and leadership reports as needed. Organizes, prioritizes and reviews daily work activity to ensure that complete, accurate, and compliant insurance verification, authorization, and Pre-Registration has been performed.
  3. Financially clears patients for upcoming services.
    • Verifies insurance benefits using an automated verification tool, insurance carrier websites, or by phone. Obtains all necessary authorizations for scheduled professional and hospital procedures and clinic visits. Accurately documents all information in the appropriate fields and/or account notes. Contacts the patient/guarantor and obtains all current demographics including insurance making updates and creating accounts in the EMR if appropriate. Notifies the patient/guarantor of an applicable deductible, copay, annual maximum and other out of pocket expenses and requests payment.
  4. Provides Training
    • Proactively researches and trends denials, staff QA, and process improvement related to Pre Access to include changes to hospital-system, best practice in process of Pre Access Accuracy, efficiency and overall patient, provider, and staff satisfaction. Assists Trainer in hand offs and Service Matter Expert training of new and existing staff.
  5. Maintains Proficiencies/Seeks Education
    • Participates in a variety of unit, hospital, and/or outside agency education, when approved, programs to maintain and enhance current skills and competency levels.
  6. Performs miscellaneous job related duties as requested.

Phoenix Children's Mission, Vision, & Values

Mission

To advance hope, healing and the best healthcare for children and their families

Vision

Phoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.

We realize this vision by:

  • Offering the most comprehensive care across ages, communities and specialties
  • Investing in innovative research, including emerging treatments, tools and technologies
  • Advancing education and training to shape the next generation of clinical leaders
  • Advocating for the health and well-being of children and families
Values
  • We place children and families at the center of all we do
  • We deliver exceptional care, every day and in every way
  • We collaborate with colleagues, partners and communities to amplify our impact
  • We set the standards of pediatric healthcare today, and innovate for the future
  • We are accountable for making the highest quality care accessible and affordable
The position has been closed or filled.

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