Lead Patient Access Representative

• Manages scheduling resources for patient appointments 

• Manages communication tools for patient scheduling requests by patients and care teams 

• Manages the pre-registration review process for insurance verification for upcoming appointments 

• Retrieves payment collection for services, flat rate services, co-pay or up-front collections 

• Collects documentation by the requirements and timeliness for registration compliance 

• Scan registration documents into the electronic health record 

• Reviews and assigns insurance tiering for proper payor assignment.  

• Validates insurance eligibility and pre-authorization requirements 

• Communicates with peers, patients, and care teams through multiple communication channels for appointment requests and patient-initiated outreach 

• Create new patient profiles in the electronic health record with quality data input of demographic information and proper identification collection 

• Manages multiple worklists assigned: New Patient Registration Worklist 

• Schedules and register for various disciplines: Primary Care, Behavioral Health, Optometry, Rehabilitation, Radiology, Laboratory, and others. Cross training for assigned coverage as a PRS.  

• Coordinates signing up patients in the MySEARHC patient portal 

• Enacts SEARHC’s 7 Standard of Service Excellence and provides exceptional customer service delivery  

• Works well with peers, patients, and leadership  

• Participates in departmental improvement efforts, maintains a clean and safe working environment for self, staff, and patients, and maintains compliance with annual competencies.  

• Identifies community resources, fosters partnerships, and utilizes resources effectively. 

• Refers all patients without insurance coverage or questions to a Financial Counselor for resolution.  

• Refers patients to the Patient Health Benefits team for screening/enrollment in available/qualified insurance resources  

• Provides training for new employees in the PRS Trainee and PRS roles 

• Under the guidance of supervisor, audits encounters of PRS Trainee and PRS team members and shares corrections that need to be made. 

• Reporting: Schedule fill rate tracking, third next available 

• Monitors incoming schedule requests messaging tools for timely response by team 

• Monitors standby/waitlist for timely response by team 

• Manages updates to providers 90 day rolling schedules and block placements 

• Provides supervisor support in the absence of the supervisor with guidance by manager 

• 60 % of the job will require training and work the tasks in the PRS Trainee and PRS JD 20% auditing and reporting and 20% care team/dyad partner communication. 

• Other duties as assigned

Education, Certifications, and Licenses Required 

• High School Diploma or GED preferred 

• Preference given to applicants with advanced degree. 

• Basic Life Support preferred. 

Experience Required 

• 2 years of healthcare office experience or a minimum of an associate degree in lieu of healthcare office experience required. 

• Internal candidates with at least 1 year of experience as a Patient Registration Specialist or similar role at SEARHC will be considered qualified for this role.  

Knowledge, Skills, and Abilities: 

Knowledge of 

• Available services at SEARHC, other tribal health organizations in Alaska, and community.  

• Customer service principles.  

• General knowledge of front-end revenue cycle requirements 

Skills in 

• Skilled at attention to detail and quality data input.  

• The use of equipment such as computers. 

• Oral and written, and interpersonal communications.  

• De-escalation and critical thinking skills 

• Quality review and providing training feedback 

Ability to 

• Prioritize work and multi-task in a fast-paced office setting with many interruptions 

• Receive escalated scenarios for review prior to escalating to supervisor 

• Read and comprehend simple instructions, short correspondence, and memos 

• Demonstrate time-management, organizational, and customer service skills 

• Work flexible hours with limited unplanned absence and ability to work independently 

Computer Skills:   

• Proficient in Microsoft Office Products including Word, Excel, and PowerPoint 

Other Qualifications:      

• Strong organizational & time management abilities 

• Teamwork  

• Leadership 

• Proficient in EHR systems 

Travel Required:   

• Travel  

Safety and Risk Management Responsibilities:   

• Employees are responsible for complying with safe work rules; reporting all accidents and injuries immediately; cooperating in all accident and injury investigations; reporting defective equipment and unsafe conditions. 

Physical Demands:   

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk; sit; use hands to finger, handle or feel and reach with hands and arms. 

• The employee is occasionally required to climb or balance; stoop, kneel, crouch or crawl. The employee must lift and/or move 50 lbs. 

Work Environment:   

• The noise level in the work environment is usually moderate.