Patient Access Facility Lead Split Shift

Inspire health. Serve with compassion. Be the difference.

Performs functions of moderate to difficult complexity with high visibility and high risk from a compliance and regulatory standpoint. Assists Management with training, orienting and monitoring day‑to‑day performance of team members to ensure departmental policies and processes are being followed, responsible for daily cash handling procedures, assists with the development of team member schedules and registers patients. Subject Matter Expert for the department.

• All team members are expected to be knowledgeable and compliant with Prisma Health's values:
  Inspire health. Serve with compassion. Be the difference.
• Interviews patient or other sources, in accordance with HIPAA guidelines, to obtain complete and accurate patient demographic and financial information for the purpose of establishing the patient record and facilitating timely claims payment.
• Collects and records information that supports the clinical team with ensuring requirements are met surrounding health equity and the social determinants of healthcare, which is subject to review by CMS and the Joint Commission.
• Performs routine account analysis and problem solving. Alleviates difficult situations and handles patient inquiries and/or concerns.
• Acts as a preceptor to ensure team members are equipped to complete efficient registration processes to support an optimal patient experience. This includes collecting demographic and financial information, in accordance with HIPAA guidelines, to facilitate timely payment, discussing the patient estimate and collecting patient balances due. A further responsibility includes collecting and recording information in the system that supports the clinical team with health equity and the social determinants of healthcare.
  
  This information is subject to review by The Joint Commission and DHEC. Includes education for team members that outlines specific workflows to be followed.
• Acts as a preceptor to ensure compliance with the provision of documents and forms as required by regulation; in some instances, signatures are required. Compliance regarding documents and forms is subject to review by CMS, DHEC and the Joint Commission. These forms/documents include but are not limited to Advance Directives, Lewis Blackman Patient Safety Act, Notice of Privacy Practices, Patient Rights and Responsibilities, Permission to Treat, Limited Visitation Policy, Medicare Admission Questionnaire, Medicare Important Message and Medicare Outpatient Observation Notice.
  
  Lack of compliance can create a regulatory finding or jeopardize participation with CMS.
• Maximizes collections and minimizes bad debt by providing estimated costs for patient responsibility at time of service. Collects current and past balances in accordance with departmental cash handling procedures. Monitors daily collections to identify trends and to recommend improvements.
• Collaborates with Patient Access Leadership to coordinate team member schedules, including scheduling rotation, time off, and call-offs as necessary. Ensures adequate coverage in accordance with organizational policies. Minimizes overtime while maximizing productivity. May be required to fill in for call-offs, staffing issues, or unexpected volumes.
• Provides education to inform team members of relevant changes and developments in payor requirements. Pivots to meet the changing needs of payor requirements to maximize cash flow for the organization.
• Performs other duties as assigned.

• This is a non-management job that will report to a supervisor, manager, director or executive.

• Education - High School diploma or equivalent OR post‑high school diploma/highest degree earned
• Experience - Four (4) years of hospital admissions, billing and/or credit/collections experience

• In lieu of education and experience detailed above, four (4) years in a service‑related position (i.e., customer service in a business/office setting, banking, or finance) to include two (2) years in a lead capacity. Preference is given to candidates with experience in hospital…