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Lead Patient Encounter Associate
Full/Part Time: Full Time
Location/Affiliates: Mount Sinai Medical Center (Manhattan)
Department: 380 - Ruttenberg Cancer Center
Requisition Number: 13-1561270
The Lead Patient Encounter Associate is a go-to expert on patient services, and is responsible to facilitate support functions related to patient reception, scheduling and financial pre-clearance, ensuring a high degree of patient satisfaction and maximum reimbursement to the institution. In this role the Lead will provide support and guidance to the PEA while performing the responsibilities that include but are not limited to: scheduling, pre-registration, self-pay screening and insurance eligibility determination. Facilitates the process with the responsibility for obtaining and verifying patient demographic and insurance information, determining insurance/payment source, identifying necessary authorization or referral requirements, and assisting with determining and resolving insurance issues.
The lead role provides an opportunity to perform a higher level of patient service through the coaching and mentoring of co-workers based on their content expertise and exceptional behaviors. In this role the lead will facilitate the processes of patient scheduling, financial pre-clearance, billing resolution and patient flow management.
Duties and Responsibilities:
1. Reception - Oversees the front desk reception function of greeting patients in person and by telephone and updates their insurance/demographic information in the practice management system, trains new staff, identifies and facilitates the resolution of issues in the reception area.
2. Registration - Facilitates and educates staff on the process for gathering registration and financial information for patient pre-registration, enters the information into the practice management system and ensures all entries are complete and accurate.Assists with the daily audit process to ensure compliance.
3. Access and Scheduling - Manages the communication from the practice and the patients by answering phones; scheduling and re-scheduling appointments, and cancels patient appointments based on established protocols.Lead will ensure that all visits are closed by end of day. Lead will identify opportunities to improve the process and enhance patient access. Lead works with the clinical staff to facilitate access for the practice and patients. Trains staff on the optimal process for scheduling appointments per the scheduling guidelines.
4. Financial Screening - Assist with quality review for financial screening process that includes checking in patients upon arrival at the practice and performs full registration, including: verification of demographics, completion of financial screening, prioritizing and verifying insurance as appropriate with third-party providers, making follow-up appointments, discussing MSMC's self-pay policy for new patients, completing of Medicare as Secondary Payer questionnaire if appropriate, and having patient read and sign NOPP.
5. Collection of Patient Responsibility - Tracks the performance and ensures the patient has paid, or collects, the appropriate co-pay under the direction of billing management, and provides the patient with a receipt as per cash-control protocols.
6. Authorization - Facilitates prior authorization and appointment scheduling for diagnostic testing requested by providers for patients in EPIC. Ensure that the work list is managed and that we are current on the authorization requests. Ensures prior approval and other required procedures are met prior to delivery of care, by working collaboratively with other hospital departments.
7. Patient Flow and Wait time Management - Identifies delay and implements strategies to resolve delays. Works with the staff to identify opportunities to reduce delays and keep patients informed of the wait time. Works collaboratively with the COA to ensure optimal patient flow.
8. Billing -Provides updates on the billing WIP and open visits and ensure that we meet targets and eliminate delinquent accounts. Works billing edit reports and reviews encounters which may require correction.
9. Medical Records - Ensures timely scanning of documents to support the clinical practice and compliance. Scans documents into EPIC on a daily basis.
10. System Development and Quality Improvement - Participates in system development and process improvement by providing feedback to Manager regarding issues in registration and change posting that impact negatively on operations.
11. Compliance - Follows all HIPAA and other federal/state agency requirements regarding proper handling of PHI documents.
12. Facilitate PEA staff assignments to make sure all appointments are scheduled appropriately and all patients are checked in correctly at the front desk, providing feedback to the Admin Manager.
13. Assist in the development of new roles and responsibilities.
14. Assists in the development of education and training of staff on existing and new skills.
15. Facilitates in the development of behavioral standards and models the behaviors and standards.
16. Other duties as assigned.
HS/GED; Associates degree preferred
2 years physician practice experience, with a minimum of six week training on-site which will be provided by practice. Preferred: experience in a medical office setting, utilizing a computer system for physician scheduling
2 years of experience as a PEA
Must demonstrate proficiency and mastery of:
* the scheduling process
* the registration process
* the billing process
* the authorization process
* the access and patient flow process
* teaching new skills
* the ability to manage and improve processes
Keyboarding skills are necessary, CERNER, EPIC or other practice management experience preferred
Mount Sinai Medical Center is an equal opportunity/affirmative action employer. We recognize the power and importance of a diverse employee population and strongly encourage applicants with various experiences and backgrounds. Mount Sinai Medical Center--An EEO/AA-D/V Employer.