Access Team Lead, Financial Clearance, Full Time, Days

Company: Northwestern Medicine
Location: Chicago
Posted on: November 1, 2024

Job Description:

DescriptionThe Access Team Lead reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.Responsibilities:Standards of Performance - Northwestern Medicine Values, Patient Satisfaction, and Service Excellence:

• Consistently practices Patients First philosophy and adheres to high standards of customer service. This includes setting an example to peers, coworkers, etc. by fostering a team atmosphere. Responds to questions and concerns.
• Forwards, directs and notifies Team Lead or Operations Coordinator of extraordinary issues as necessary.
• Maintains patient confidentiality per HIPAA regulations.Specific Responsibilities:
  • Provides exceptional customer service to consumers which establish a positive first impression of Northwestern Medicine.
  • Exceed all consumer requests and alert management of issues or concerns that require escalation.
  • Correctly identifies and collects patient demographic information in accordance with organization standards.
  • Interacts with various hospital departments and physicians offices to effectively schedule and direct patients through the NMHC systems in a patient/customer friendly manner.
  • Reaches out to patients to schedule an appointment as defined.
  • Performs medical necessity checks as necessary for scheduled services, communicates options to patient if appointment fails.
  • Facilitates the pre-authorization of diagnostic exams, between referring physicians and insurance carriers, through the use of online tools, work lists, and direct phone calls as necessary.
  • Informs patients of any issues with securing the financial account for their encounter.
  • Completes out-of-pocket estimations as requested by patients.
  • Provides training and education as needed.
  • Manages work schedule efficiently, completing tasks and assignments on time.
  • Completes other duties assigned by manager.
  • Cross-training between various departments may take place to ensure coverage.
  • Participates in Quality Assurance reviews to ensure integrity of patient data information.
  • Uses effective service recovery skills to solve problems or service breakdowns when they occur.
  • Utilizes department and hospital policies and procedures to complete assigned tasks.Communication and Collaboration:
    • Communicates information to the patient regarding questions about physician referrals, insurance referrals and consultations.
    • Collects authorization numbers in appropriate systems as applicable.
    • Provides professional and constructive environment for communication across units/departments and resolves operational issues.
    • May attend intra/interdepartmental meetings which involve walking within NM Campus.
    • Communicates customer satisfaction issues to appropriate individuals.
    • Demonstrates teamwork by helping co-workers within and across departments.
    • Communicates effectively with others, respects diverse opinions and styles, and acknowledges the assistance and contributions of others.
    • Interacts with internal customers to provide excellent support service to staff in departments which provide direct patient care.Technology:
      • Utilizes multiple online order retrieval systems to verify or print the patient's order.
      • Verifies insurance eligibility and benefit levels through the use of online tools (NDAS, ASF, etc.) or over the phone as necessary.
      • Completes accurate handoff instructions and notes to scheduling staff, by noting appropriately in Epic.
      • Demonstrates ability to use all computer applications efficiently and to the capacity needed in this position.Efficiency, Process Improvement, and Business Growth:
        • Is proactive in preventing issues with patient visit by double checking type of test, preps required, assuring no conflict with other tests, verifying time and location, communicating relevant information and documenting order retrieval in notes for check-in person.
        • Understands minimum data set required for a complete registration, collects and verifies critical data and updates that information into registration system.
        • Understands departmental and individual quality metrics.
        • Proactively analyzes account activity, identifies problems, and initiates appropriate actions/resolutions.
        • Evaluates procedures and suggests improvements to enhance customer service and operational efficiency.
        • Participates in departmental quality improvement activities.
        • Provides ideas and suggestions for process improvements within the department.
        • Monitors registration and scheduling, including insurance verification to ensure processing within prescribed quality standards.
        • Adjusts processes as needed to meet standards.
        • Uses organizational and unit/department resources efficiently.
        • Acts as a training resource for new staff and a resource for coworkers, sharing process and workflow information.Leadership Responsibilities:
          • Assists Operations Coordinator with staff training and development, as well as on-boarding new staff.
          • Ensures staff understanding and compliance of NM policies, procedures and expectations and assists in communicating any changes when applicable.
          • Identifies potential problems and notifies the Operations Coordinator and Manager.
          • Coordinates advanced troubleshooting to staff when issues or questions arise.
          • Serves as first line of assistance to staff.
          • Investigates and resolves patient, technical and workflow problems related to their area of responsibility or escalates to Operations Coordinator/Manager for assistance.
          • Helps coordinate and supervise section staffing to ensure sufficient staff to cover all aspects of service alongside Operations Coordinator.
          • Works proactively with Operations Coordinator to adjust daily staff work assignments due to sick leave or increased patient volume.
          • Monitors queues to make real-time adjustments as necessary.
          • Assures that all computer systems and technology are consistently working properly.
          • Coordinates the maintenance and repair activities as related to equipment and facilities.
          • Escalates issues when needed.
          • Identifies and communicates key issues and trends to Operations Coordinators.
          • Assesses and communicates staff development needs to Operations Coordinator to support periodic individual evaluations of staff.
          • Develops, coordinates, presents and participates in staff education and training programs including new system deployment and go-live support.
          • Provides material and helps develop agendas for routine staff meetings. Maintains customer service objectives.
          • Assumes delegated responsibilities in the absence of the Operations Coordinator.
          • Assist Operations Coordinator/Manager with responsibilities that include interviewing, hiring, training, progressive discipline, dismissals, performance appraisals, and employee relations.
          • Assist Operations Coordinator/Manager on the development and implementation of policies and procedures as needed to support Service Center functions.
          • Ensures staff has access to necessary policies, procedures, training and other resources necessary to complete their responsibilities, and that policies and procedures are updated as necessary.
          • Works with Operations Coordinator/Manager on enforcing Productivity and Quality standards; conducting regular audits of staff performance, with documented feedback; monitoring agent performance including service level, calls answered, contact quality, errors, attendance.
          • Performs other duties as assigned.AA/EOE.QualificationsRequired:
            • Minimum of two years experience in customer service or patient relations.
            • Excellent interpersonal and verbal communication skills.
            • Excellent problem solving skills.
            • Received favorable annual performance reviews if internal applicant in the past one to two years.
            • Ability to read and communicate effectively in English.
            • Basic Computer Skills.
            • Ability to type 40 wpm.
            • Excellent verbal and written communication skills.
            • Ability to multi-task.
            • Customer Service Oriented.
            • Excellent organizational, time management, analytical, and problem solving skills.Preferred:
              • Bachelors degree.
              • Healthcare Finance and/or Healthcare Insurance Knowledge.
              • Experience in a healthcare setting, especially patient scheduling and/or registration.
              • Coding Certification.
              • Certified Healthcare Associate Designation (NAHAM).
              • Two - four years of progressive experience in a revenue cycle setting.
              • Financial aptitude, business orientation or experience/knowledge of hospital based patient management/patient accounting systems.
              • Knowledge of medical terminology.
              • Epic experience.Equal OpportunityNorthwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.
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Keywords: Northwestern Medicine, South Bend , Access Team Lead, Financial Clearance, Full Time, Days, Accounting, Auditing , Chicago, Indiana