patient access manager

University of Miami

<div><p><b>Current Employees:
</b></p><p>If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet .
</p><p></p><div><div><p>The University of Miami/UHealth Department of Clinical Access has an exciting opportunity for a full-time Patient Access Manager.
</p><p></p><p><b>Core Job Summary:
</b></p><p></p><p>The Manager, Patient Access oversees the business operations of the Patient Access Department to ensure a smooth entry of patients to departmental services, while maintaining timely and accurate business information and guaranteeing payment of services rendered.
</p><p></p><p><b>Core Responsibilities:
</b></p></div><div><ul><li><p>Recruits, supervises, trains, and disciplines staff, and prepares performance reports.
</p></li><li><p>Manages day-to-day activities of personnel to ensure the timely registration of patients, accurate data entry of patient biographical and financial information, and proper payment collection.
</p></li><li><p>Reviews records to ensure that each patient was properly verified for insurance purposes and that proper information was written on each patient&rsquo;s chart prior to clinic date.
</p></li><li><p>Serves as department expert on registration, insurance verifications, and documentation guidelines.
</p></li><li><p>Ensures adequate staffing is maintained on a 24-hour basis.
</p></li><li><p>Assists in the development and implementation of the department&rsquo;s annual budget.
</p></li><li><p>Works with upper management to generate strategy and operational initiatives, and policies.
</p></li><li><p>Maintains current knowledge of rules and regulations and educates staff on any variations.
</p></li><li><p>Establishes and continuously assesses the effectiveness of the internal controls within the unit and compliance with University policies and procedures.
 </p></li><li><p>Ensures employees are trained on controls within the function and on University policy and procedures.<br>
</p></li></ul></div><p></p><div><p><b><i>This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or </i></b><b><i>responsibilities </i></b><b><i>as necessary.<br>
</i></b></p></div><p></p><div><p><b>CORE </b><b>QUALIFICATIONS
</b></p></div></div><p></p><div><div><p>Bachelor&rsquo;s degree in related field
</p></div><div><p>Minimum 3 year of relevant experience
</p></div><p></p><div><p><b>Knowledge, </b><b>Skills </b><b>and Attitudes:<br>
</b></p></div></div><p></p><div><div><ul><li><p>Knowledge of business and management principles
</p></li><li><p>Ability to direct, manage, implement, and evaluate department operations.
</p></li><li><p>Ability to establish department goals and objectives that support the strategic plan.
</p></li><li><p>Ability to effectively plan, delegate and/or supervise the work of others.
</p></li><li><p>Ability to lead, motivate, develop and train others.
</p></li><li><p>Knowledge of business and management principles
</p></li><li><p>Ability to direct, manage, implement, and evaluate department operations.
</p></li><li><p>Ability to establish department goals and objectives that support the strategic plan.
</p></li><li><p>Ability to effectively plan, delegate and/or supervise the work of others.
</p></li><li><p>Ability to lead, motivate, develop and train others.<br>
 </p></li></ul></div><p></p><div><p><b><i>Any appropriate combination of relevant education, experience and/or certifications may be considered.<br>
</i></b></p></div></div><p></p><p>The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.
</p><p></p><p>UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.
</p><p></p><p>The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.
</p><p></p><p><b>Job Status:
</b></p>Full time
<p></p><p><b>Employee Type:
</b></p>Staff</div>

Manager, Patient Access (H)

AbbVie

<div><b>Company Description</b><p><b><br>
About AbbVie</b></p><p>
AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas including immunology, oncology and neuroscience - and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at www.abbvie.com. Follow @abbvie on LinkedIn, Facebook, Instagram, X and YouTube.</p><b><br>
Job Description</b><p><br>
The Field Reimbursement Manager (FRM) shares expertise and educates on Medical and Pharmacy benefits, Buy &amp; Bill and Specialty Pharmacy acquisition, payor policy, appropriate patient identification, clinical documentation, benefit investigation results, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation management, patient financial savings programs, patient tracking/retreatment, and the denial/appeal process for the approved indications for BOTOX&reg; Therapeutics. The FRM clarifies barriers that may impede or delay appropriate patient access to treatment and/or prevent optimal patient outcomes. The FRM may interact with healthcare providers, administrative staff, revenue cycle management, and institutional leadership.</p><br>
<p></p><ul><li>
Educate on the fundamentals of the BOTOX treatment process, appropriate reimbursement, and understanding the payer landscape</li><li>
Leverages advance problem-solving and analytical skills to identify access and reimbursement barriers while offering actionable insights to desired and approved care</li><li>
Uncover the root cause to access issues impeding or delaying proper treatment</li><li>
Monitor and provide updates on both Region and National Payers. Examples include changes or barriers in medical policy, Prior Authorization requirements, or product acquisition. Apply compliant methods to exchange critical information</li><li>
Work collaboratively and function as a liaison for information between various internal stakeholders such as: Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy groups.</li><li>
Provide customer feedback relating to approval requirements and access to care barriers with AbbVie stakeholders (Market Access, Center of Excellence, Sales, Marketing, Trade, Specialty Pharmacy, Senior Leadership)</li><li>
Educate accounts on need-based tools to support patient access. Examples include HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiatives</li><li>
Proficient in providing analytical and customized need-based solutions to problems in complex environments and matrix influenced health systems and practices</li><li>
Establish and maintain respectful working relationships with healthcare professionals and staff as well as business-oriented decision makers including C-Suite level executives within territory</li><li>
Demonstrates the ability to lead without authority and effectively communicate with diverse groups with sometimes different priorities</li><li>
Capable of influencing across functions to gain consensus on agreed upon patient solutions</li><li>
Ability to professionally deliver crucial conversations that may contain less than desirable information or facts</li><li>
Proactively engage in Field Input Teams offering innovative solutions to problems in a fast-paced changing environment</li><li>
Share customer challenges and suggest potential solutions to address obstacles</li><li>
Demonstrate effective planning, prioritization, follow up, and anticipates problems</li><li>
The employee conducts all work activities in compliance with all Abbvie internal requirements and with all applicable regulatory requirements</li></ul><br>
<b>
Qualifications</b><br>
<ul><li>
A minimum of 5&ndash;7 years of proven success in a health care related field</li><li>
Bachelor&rsquo;s degree required</li><li>
Preferred experience includes Previous Sales, District Management, Hospital, Managed Markets, Access and Reimbursement, or practice experience</li><li>
Knowledge of Lean Six Sigma principles is favorable</li><li>
Exposure to physician-administered injectables, CPT and/or J-code reimbursement, Specialty Pharmacy and Buy &amp; Bill acquisition, Benefit Verifications, Prior Authorizations, Claim Assistance, Appeals and payor policies, and HUB services</li><li>
Proven record of comprehensive work with accounts at all levels</li><li>
Payer/insurance coverage experience with Medicare, Medicare Advantage, Commercial and Medicaid plans</li><li>
Well-developed verbal and written communication skills, including in-person and virtual presentation skills of complex information and processes</li><li>
Proven and consistent competence of the following skills: Problem Solving, Gain Access, Resource Mastery, Tangible Results, Overcoming Adversity, Collaboration, and Managing Complexities</li><li>
Demonstration of key soft skills: Empathy, Critical Thinking, Curiosity, Persistence, Reliability, and Resourcefulness</li><li>
Strong history of leadership within current role</li><li>
Technology and analytical skills (Salesforce, virtual meetings, excel, report interpretation)</li><li>
A Valid Driver&rsquo;s License</li><li>
Ability to travel adequately to cover territory, attend training, and meetings. Some overnight travel may be required</li></ul><p><b>
This role is field-based and candidates should live within a reasonable distance from the primary city. Talent will be hired at a level commensurate with experience. This geography covers three states: IA, NE, and SD.</b></p><b><br>
Additional Information</b><p><br>
Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law:
</p><ul><li><p>The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of this posting based on the job grade for this position. Individual compensation paid within this range will depend on many factors including geographic location, and we may ultimately pay more or less than the posted range. This range may be modified in the future.
</p></li><li><p>We offer a comprehensive package of benefits including paid time off (vacation, holidays, sick), medical/dental/vision insurance and 401(k) to eligible employees.
</p></li><li><p>This job is eligible to participate in our long-term incentive programs.
</p></li></ul><p>Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole and absolute discretion unless and until paid and may be modified at the Company&rsquo;s sole and absolute discretion, consistent with applicable law.
</p><div></div><p>AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.</p><p>
US &amp; Puerto Rico only - to learn more, visit https://www.abbvie.com/join-us/equal-employment-opportunity-employer.html</p><p>
US &amp; Puerto Rico applicants seeking a reasonable accommodation, click here to learn more:</p><p>
https://www.abbvie.com/join-us/reasonable-accommodations.html</p></div>

Field Reimbursement Manager - Botox Therapeutic

Beth Israel Lahey Health

Chestnut Hill, MA &bull; Beth Israel Lahey Health &bull; Full-time &bull; Day
<br><div><p><b>When you join the growing BILH team, you're not just taking a job, you&rsquo;re making a difference in people&rsquo;s lives.</b></p>
<p></p>
<p>This position is on-site primarily based in Chestnut Hill with occasional coverage to Dedham and Boston. The hours are 9:30am &ndash; 6:00pm, Monday-Thursday and 7:00am &ndash; 3:30pm on Friday.</p>
<p>
Working in Patient Access and as a member of the Beth Israel Lahey Health (BILH) System Services team, you can have a career that allows you to grow and advance while making a difference in people&rsquo;s lives. We use a coordinated approach to delivering administrative and operational services across our entire healthcare system. By leveraging resources across the organization, we&rsquo;re able to provide high-quality, high-value care to the patients and the communities we proudly serve. The Patient Access Representative ensures that the patient experience in accessing healthcare at BILH is efficient and welcoming, and that patient confidentiality is respected and patient safety is preserved. Performs a variety of functions to support an accurate, safe, and customer-focused registration process, either electronically, telephonically or in person. The Patient Access Representative ensures that all proper patient financial and demographic information is obtained and processed so BILH is fully reimbursed for clinical services provided. The Patient Access Representative handles patient questions and requests accurately and efficiently, ideally with first-call resolution, or by making appropriate referrals to other departments, based on the original purpose of the question and any other questions or requests subsequently disclosed by the patient. Extensive training including Electronic Health Record (EHR) is provided. Our team works in a fast-paced, collaborative environment, helping our patients navigate their healthcare journey.</p>
<p></p>
<p><b>Job Description:</b></p>
<p><b>
Essential Duties &amp; Responsibilities including but not limited to:</b></p>
<p>
Registration:</p>
<p>
1. Registers patients presenting for visits. Explains the registration process to patients and responds to patient questions.</p>
<p>
2. Processes patient co-payments, co-insurance, deductibles, and balances due. Safeguards cash, checks and receipts and reconciles cash drawer at the end of each business day. Assists patients with Kiosk check-in as needed.</p>
<p>
3. Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results.</p>
<p>
4. Instructs patients and obtains signatures on consent forms, financial forms, and other documents required by the clinical department; distributes documents to patients; scans, processes, and records receipt of all documents collected during registration encounter.</p>
<p>
5. Counsels patients regarding non-covered services, obtaining signatures on Advance Notice Beneficiaries (ABNs), consents and waivers.</p>
<p>
6. Monitors patient waiting area for a smooth, efficient registration flow. Advises patients of potential delays and takes steps to ensure a pleasant patient experience.</p>
<p>
7. Responds to patient concerns and potential patient safety issues accordingly. Recognizes health conditions that are a possible risk to others and adheres to appropriate established procedures to help contain risk.</p>
<p>
8. Assures a neat, orderly registration desk and patient waiting area, securing all confidential patient information.</p>
<p>
Scheduling:</p>
<p>
9. Initiates patient scheduling activities by prioritizing and accessing a variety of sources, including patient phone calls and digital messaging, orders, scheduled order work queues.</p>
<p>
10. Utilizes a variety of information sources to schedule, reschedule, and cancel patient appointments. Information sources include online questionnaires, offline materials, and subgroup searches.</p>
<p>
11. Establishes working relationships with staff of assigned clinical departments. Understands and correctly applies unique clinical department scheduling protocols.</p>
<p>
12. Remains current on scheduling protocols and applies judgment, or seeks management assistance, to ensure safe patient care when clinical department scheduling protocols do not meet patient needs.</p>
<p>
13. Ensures all required key patient scheduling and registration information is captured and verified. Key information includes referring physician information, insurance coverage, demographics, and contact information.</p>
<p>
14. Identifies and communicates to Patient Access management issues that may impact the timeliness and accuracy of patient appointments and subsequent patient care.</p>
<p>
15. Strictly follows confidentiality and equipment security and safeguarding guidelines when working in a remote setting. Maintains productivity, quality, and accuracy levels and communicates regularly with the Supervisor and Manager. Pre-Registration:</p>
<p>
16. Efficiently registers patients, capturing and verifying all required information in order to identify the patient, contact the patient, and receive proper reimbursement for services on initial claim submission.</p>
<p>
17. Ascertains, creates, and assigns the guarantor for each patient, including personal/family relations, workers compensation insurance, third parties, behavioral health, or others as required.</p>
<p>
18. Identifies records and verifies patient insurance coverage using real-time eligibility (RTE); reviews the insurer&rsquo;s response to each verification request and takes appropriate action based on this response.</p>
<p>
19. Applies the appropriate guarantor and insurance to each patient visit.</p>
<p>
20. Communicates financial clearance status to patients. Advises patients of contract status, self-pay status, and payment responsibility and schedules patients with Financial Counseling as needed.</p>
<p></p>
<p><b>Minimum Qualifications:</b></p>
<p>
Education: High school degree or equivalent. Associate&rsquo;s degree preferred.</p>
<p>
Licensure, Certification &amp; Registration: None</p>
<p></p>
<p>Experience: 1-3 years related work experience. Experience with computer systems required, including web-based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint, or Access.</p>
<p></p>
<p>Skills, Knowledge &amp; Abilities: Able to work successfully in a fast-paced, multi-task environment, where some independent decision-making is necessary. Able to process electronic information and data accurately and efficiently.</p>
<p>
Preferred Qualifications &amp; Skills:</p>
<p>
&middot; Call Center and/or telephone customer service experience &middot; Strong typing skills 40+wpm. Knowledge of medical terminology &middot; Bilingual written and verbal communication skills &middot; Familiar with EHR Software</p><br>
<p></p>
<p></p>
<p><b>Pay Range:
</b></p><p>$20.50 &ndash; $27.59</p>
<p>
The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.</p>
<p></p>
<h2 class="jobSectionHeader"><b>As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.</b></h2>
<p></p>
<h2 class="jobSectionHeader"><b>More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.</b></h2>
<p></p>
<h2 class="jobSectionHeader"><b>Equal Opportunity Employer/Veterans/Disabled</b></h2></div><p></p>
<br><div><h3 class="jobSectionHeader"><b>Job details</b></h3>
<ul><li><div><b>Employment:</b> Full-time</div></li>
<li><div><b>Hours/Week:</b> 40</div></li>
<li><div><b>Shift:</b> Day</div></li>
<li><div><b>Category:</b> Patient Access</div></li>
<li><div><b>Pay Range:</b> $20.50 - $27.59</div></li>
<li><div><b>FLSA:</b> Non-Exempt</div></li>
<li><div><b>Req ID:</b> JR90093</div></li></ul></div>

Patient Access Rep, 9:30am-6:00pm, Chestnut Hill

Inizio Engage

<p></p><div><div><div><p><b>Virtual Access and Reimbursement Manager</b></p></div><p></p><div><p>
Inizio Engage has a long-standing partnership with a leading Biotechnology company, across Commercial, Patient Solutions and Medical Affairs businesses.</p></div><p></p><div><p>
The Virtual Access and Reimbursement Manager will provide education to HCPs staff of enrolled patients in HUB or specialty pharmacy network who have been prescribed our client&rsquo;s product. They will engage healthcare providers, and their staff to communicate and educate on patient benefit coverage, prior authorization processes, general payer policy criteria and affordability programs supporting the initiation of the products. They will have a solid understanding of the local, regional and national payer landscape. They will have understand of multiple data sets and actions will be influenced b the status of the patient in the journey to Rx fulfillment. There may be a possibility for the Individual to conduct an in-person HCP office interactions with staff, as determined by business needs.</p></div><p></p><div><p>
This is your opportunity to join Inizio Engage and represent a top biotechnology company!</p></div><p></p><div><p><b>
What&rsquo;s</b><b> </b><b>in it for you?</b></p></div><div><ul><li><p>
Competitive compensation</p></li></ul></div><div><ul><li><p>
Excellent Benefits &ndash; accrued time off, medical, dental, vision, 401k, disability &amp; life insurance, paid maternity and bonding time benefits, employee discounts/promotions</p></li></ul></div><div><ul><li><p>
Generous performance-driven Incentive Compensation package</p></li></ul></div><div><ul><li><p>
Competitive environment with company wide recognition, contests, and coveted awards</p></li></ul></div><div><ul><li><p>
Exceptional company culture</p></li></ul></div><div><ul><li><p>
Recognized as a Top Workplace USA 2021</p></li></ul></div><div><ul><li><p>
Awarded a &ldquo;Great Place to Work&rdquo; award in 2022, 2023 &amp; 2024</p></li></ul></div><div><ul><li><p>
Fortune Best Workplaces in Biopharma 202, 2023 &amp; 2024
</p></li></ul></div><p></p><div><p><b>What will you be doing?</b></p></div><div><ul><li><p>
Engage healthcare providers and appropriate office staff to educate on access to prescribed treatments within the specialty pharmacy and HUB channel, including addressing questions about initial access, insurance approval and reauthorizations pertaining to the initiation of product.</p></li></ul></div><div><ul><li><p>
Educate HCP office staff about prior authorization &amp; appeals process, how to access related forms, and high-level information about submission procedures and reauthorization requirements.</p></li></ul></div><div><ul><li><p>
Work compliantly and proactively to identify and resolve patient access and reimbursement issues, within assigned geography. Assigned geography may be adjusted based on zone and national volume.</p></li></ul></div><div><ul><li><p>
Provide appropriate factual process information to HCP office utilizing Personal Health Information (PHI), with appropriate patient consent.</p></li></ul></div><div><ul><li><p>
Serve as reimbursement expert for patient support services team for assigned geography/plans.</p></li></ul></div></div><div><div><ul><li><p>
Utilize approved resources and call guides/FAQs to provide education and answer questions as needed.</p></li></ul></div><div><ul><li><p>
Conduct ongoing payer policy reviews and contribute local, regional and national policy insights to Field Access Managers and client leadership.</p></li></ul></div><div><ul><li><p>
Virtually manage assigned accounts and align with Field Access and Reimbursement team, sales teams as well as specialty pharmacy and HUB team on ongoing support needs.</p></li></ul></div><div><ul><li><p>
Document call details with attention to data integrity to ensure compliance with program policies and business rules.</p></li></ul></div><div><ul><li><p>
Navigate CRM platform in daily interactions and learn internal team processes (when available).</p></li></ul></div><div><ul><li><p>
Maintain confidentiality of Patient Health Information (PHI) and act in compliance with all laws, regulations, and company policies.</p></li></ul></div><div><ul><li><p>
Triage appropriate escalations to the Field Access Manager team in accordance with the program design and business rules.</p></li></ul></div><div><ul><li><p>
Comply, take, and attend all required training.</p></li></ul></div><div><ul><li><p>
Adhere to all Inizio and client policies, procedures, business rules, and call guides, as well as applicable laws.</p></li></ul></div><p></p><div><p><b><br>
Requirements</b></p></div><div><ul><li><p>
BS/BA Degree Required</p></li></ul></div><div><ul><li><p>
Proven success operating in a virtual environment</p></li></ul></div><div><ul><li><p>
3+ years of relevant experience in &ndash; reimbursement and patient access, market access, specialty pharmacy, or physician/system account management.</p></li></ul></div><div><ul><li><p>
Experience engaging HCP staff in a support role to educate on access pathways and product requirements.</p></li></ul></div><div><ul><li><p>
Experience navigating payer reimbursement process for oral medications.</p></li></ul></div><div><ul><li><p>
Experience with specialty products acquired through specialty pharmacy networks.</p></li></ul></div><div><ul><li><p>
Patient-centric and service-oriented mindset, with a high degree of emotional intelligence and empathy.</p></li></ul></div><div><ul><li><p>
Exceptional customer and patient engagement skills, attention to detail, and the ability to think comprehensively is a must.</p></li></ul></div><div><ul><li><p>
Exemplary interpersonal and listening skills.</p></li></ul></div><div><ul><li><p>
Strong communication (written and verbal), and presentation skills.</p></li></ul></div></div><div><div><ul><li><p>
High enthusiasm with a drive to success within a team &ndash; demonstrated ability to reach common goals in collaboration with multiple therapeutic specialists, sales leadership, market access, and patient support services colleagues.</p></li></ul></div><div><ul><li><p>
Highly organized with excellent attention to detail and the ability to multi-task in engaging both patients and providers.</p></li></ul></div><div><p><br>
</p></div><div><p><b>About</b><b> </b><b>Inizio</b><b> </b><b>Engage</b><br>
Inizio Engage is a strategic, commercial, and creative engagement partner that specializes in healthcare. Our passionate, global workforce augments local expertise and diverse mix of skills with data, science, and technology to deliver bespoke engagement solutions that help clients reimagine how they engage with their patients, payers, people and providers to improve treatment outcomes. Our mission is to partner with our clients, improving lives by helping healthcare professionals and patients get the medicines, knowledge and support they need.
</p></div><div><p>We believe in our values: <b>We empower everyone/We rise to the challenge/We work as one/We ask what if/We do the right thing</b>, and we will ask you how your personal values align to them.</p></div><p></p><div><p>
To learn more about Inizio Engage, visit us at: https://inizio.health/</p></div><div><p>
Inizio Engage is proud to be an equal opportunity employer. Individuals seeking employment at Inizio are considered without regards to age, ancestry, color, gender, gender identity or expression, genetic information, marital status, medical condition (including pregnancy, childbirth, or related medical conditions), mental or physical disability, national origin, protected family care or medical leave status, race, religion (including beliefs and practices or the absence thereof), sexual orientation, military or veteran status, or any other characteristic protected by federal, state, or local laws. Further, pursuant to applicable local ordinances, Inizio will consider for employment qualified applicants with arrest and conviction records.</p></div><p></p><div><p>
Inizio Engage is an equal opportunity employer M/F/V/D. We appreciate your interest in our company, however, only qualified candidates will be considered.</p></div></div></div>

Hybrid Access & Reimbursement Manager

Guidehouse

<div><p>Job Family:</p>
Admitting Representative<p><br>
Travel Required:</p>
None<p><br>
Clearance Required:</p>
None<p>
What You Will Do:</p><p>
The Patient Access Lead, in partnership with the Patient Access Supervisor, Manager and Director are responsible for the proactive oversight, of client relationships and strategic initiatives, to ensure quality measures in front-end patient intake operations are consistently met.
</p><p>This role provides guidance to frontline staff, ensures operational practices are in compliance with State and Federal healthcare regulations (including but not limited to HIPAA, EMTALA and NSA) and serves as one of the communication links between Patient Access and our client&rsquo;s administrative and clinical partners.
</p><p>The Lead is a Subject Matter Expert (SME), dedicated to maintaining high &ndash; quality data integrity and engages the Patient Access Trainer on developing and putting to practice standardized operating procedures that keep the team informed of evolving workflow updates and or operational compliance requirements.</p><p>
Core Responsibilities:</p><p>
Operational Leadership &amp; Communication</p><ul><li>
Team Guidance: Leads a team of Patient Access Representatives, providing daily guidance to ensure tasks like registration, insurance verification, and financial counseling are completed accurately.</li><li>
Strategic Alignment: Establishes and monitors key performance indicators (KPIs) such as wait times, point-of-service collections, and clean claim rates.</li><li>
Stakeholder Liaison: On occasion, communicates with hospital leadership, clinical departments (ER, Surgery, Imaging, Case Management, Patient Safety and Compliance), and external payers to resolve complex patient account issues or process bottlenecks.</li></ul><p>
Compliance, Innovation &amp; Quality</p><ul><li>
Regulatory Oversight: Monitors departmental compliance with State and Federal laws impacting patient intake operations, ensuring all staff adhere to patient privacy practices and billing guidelines.</li><li>
Process Improvement: Acts as an SME to identify &ldquo;pain points&rdquo; in the claim journey; proposes and implements enhancements to the registration workflow to improve the overall patient experience.</li><li>
Complex Problem Solving: Resolves moderately complex issues involving mismatched patient identities, coordination of benefits (COB), or operational opportunities for improvement that impact procedure/service authorization matters.</li></ul><p>
Talent Management and Training</p><ul><li>
Staff Development: Responsible for ensuring staff training compliance requirements are met, delegating, and reviewing the work of junior staff to ensure a high level of data quality and professional patient interaction.</li><li>
Resource Creation: Is aware of where to obtain Educational Learning Resources (ELRs) and &ldquo;tip sheets&rdquo; for various workflows completed in the hospital&rsquo;s software (EHR/EMR) systems.</li><li>
Project Oversight: May manage specific departmental projects, such as the implementation of new check-in technology (Epic My Chart), a new financial clearance workflow, within defined budget parameters and or the expansion of registration services to auxiliary departments/service lines.</li></ul><p>
Core Responsibilities in Detail</p><ul><li>
Provide Lead cross-departmental support in ED, Mother Child Health, Same Day Surgery, Pre-Registration, Outpatient Registration (Main Admitting), PBX Communications.</li><li>
At the discretion of upper management, lead meetings with client clinical and or administrative leadership.</li><li>
Assist client&rsquo;s effort of neutralizing multi-million dollar impact by 1. Minimizing Do Not Bill days 2. Accelerate claim adjudication by addressing Claim Edit and DNB Workqueues trends.</li><li>
Analyze opportunity for improvement patterns and trends, categorize root-causes per technology, workflow and or isolated vs. systemic causes.</li><li>
Partner with leadership on establishing Quality Assurance measures that address and minimize the impact of trended opportunities rooted in workflow.</li><li>
Escalate to client&rsquo;s IT leadership opportunities categorized and rooted in technology.</li><li>
Provide staff guidance to assure quality in registration, admissions, insurance verification and PBX Communication operations which include but are not limited to:</li><li>
Client Software application - TempTrak monitoring of temperature, pressure, and humidity across hospital equipment and environments, ensuring regulatory compliance and maintaining accurate records.</li><li>
Monitoring of software applications and tools which identify fire locations within the client&rsquo;s facility.</li><li>
Adherence to client&rsquo;s crisis and emergency management plan activation requirements associated with PBX.</li><li>
Monitor and partner with upper management on productivity, quality, and service standard findings.</li><li>
Generate reports and or Electronic Health Record Dashboards which demonstrate performance metrics.</li><li>
Partner with upper management on workflow design, development, orientation and implementation.</li><li>
Support upper management in the maintenance of and staff&rsquo;s adherence to standardized operating procedures.</li><li>
Address patient escalations real-time and or engage upper management when appropriate.</li><li>
Provide front-line operational support when coverage gaps are present and or during patient high census.</li><li>
Analyze daily operations and patient census across the various services lines and present upper management with staff reassignment recommendations when optimization opportunities are present.</li><li>
Ensure staff adherence to State and Federal meal and rest break requirements.</li><li>
Partner with upper management in the development of workflow standards to address operational opportunities for improvement.</li><li>
In partnership with the Patient Access Trainer, assist in ensuring GH New Joiners are assigned a department preceptor and help facilitate GH New Joiner interdepartmental training.</li></ul><p>
In partnership with upper management, lead hospital emergency and crisis response and mitigation plans.</p><ul><li>
Ensure staff conduct aligns with GH Code of Conduct expectations and exemplifies behaviors of excellence that facilitate a positive work environment.</li><li>
Adhere to and help ensure staff adherence to both GH and client learning and development assignments and initiatives.</li><li>
Lead audit/root-cause investigative findings meeting with client/hospital clinical leadership and or client administrative leadership.</li><li>
Provide coaching of Patient Access best practices to client&rsquo;s decentralized patient access/patient intake leaders and or areas that do not fall within Guidehouse Leadership reporting structure.</li><li>
Provide mentorship and non-disciplinary coaching to front-line staff.</li><li>
Support Supervisory functions if and when the Supervisor is unavailable (excluding disciplinary discussions with front-line staff).</li><li>
Work under minimal supervision, effectively manage time and competing priorities.</li><li>
Apply knowledge of Microsoft Word, Excel and or Power Point to present data and or construct summary of audit, root-cause and or investigative findings.</li><li>
Consistently demonstrate excellent customer service and service recovery when escalations present themselves.</li><li>
Effectively apply knowledge of medical terminology and revenue cycle terminology.</li><li>
Offer flexibility to support operational needs, including occasional coverage for areas that run 24/7.</li><li>
Co-lead planning and implementation of client software application activations (e.g. implementing an EHR or payment processing system).</li><li>
Performs all other duties as assigned.</li></ul><p><br>
What You Will Need:</p><ul><li><p>
Education High School Diploma required; University degree or vocational certification in Healthcare Administration preferred.</p></li><li><p>
4-8 years of experience in Customer Service, Patient Access, Medical Billing and or Healthcare Revenue Cycle.</p></li></ul><p><br>
What Would Be Nice To Have:
</p><ul><li><p>Technical Skills Advanced proficiency in Electronic Health Records (Epic, Cerner, etc.) and data analysis.</p></li><li><p>
Expertise Robust knowledge of medical terminology, insurance verification, and federal healthcare mandates.</p></li><li><p>
Soft Skills Ability to assess priorities in a high-volume, high-stress environment and provide empathetic leadership.</p></li></ul><p>
#LI-DNI</p>
The annual salary range for this position is $65,000.00-$108,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.<p><br>
What We Offer:</p><p>
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.</p><p>
Benefits include:</p><ul><li><p>
Medical, Rx, Dental &amp; Vision Insurance</p></li><li><p>
Personal and Family Sick Time &amp; Company Paid Holidays</p></li><li><p>
Position may be eligible for a discretionary variable incentive bonus</p></li><li><p>
Parental Leave</p></li><li><p>
401(k) Retirement Plan</p></li><li><p>
Basic Life &amp; Supplemental Life</p></li><li><p>
Health Savings Account, Dental/Vision &amp; Dependent Care Flexible Spending Accounts</p></li><li><p>
Short-Term &amp; Long-Term Disability</p></li><li><p>
Tuition Reimbursement, Personal Development &amp; Learning Opportunities</p></li><li><p>
Skills Development &amp; Certifications</p></li><li><p>
Employee Referral Program</p></li><li><p>
Corporate Sponsored Events &amp; Community Outreach</p></li><li><p>
Emergency Back-Up Childcare Program</p></li></ul><p>
About Guidehouse</p><p>
Guidehouse is an Equal Opportunity Employer&ndash;Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.</p><p>
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.</p><p>
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.</p><p>
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.</p><p>
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse&rsquo;s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant&rsquo;s dealings with unauthorized third parties.</p><p>
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.</p></div>

Patient Access Lead

Optum

<div><p>Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind <b>Caring. Connecting. Growing together.</b></p><p></p><p><br>
The Patient Access Center (PAC) Analytics team exists to monitor and improve patient scheduling and access across Kelsey-Seybold.</p><p></p><p><b><br>
Primary Responsibilities:</b></p><ul><li>
The PAC Data Analyst provides actionable insights through analysis of scheduling patterns, service levels, patient utilization, and financial modeling-including utilization metrics, payer mix, and reimbursement structures-to identify access gaps, inefficiencies, and opportunities for improvement</li><li>
Along with historical analysis to inform future performance, insights, and guidance, this role requires experience in the healthcare industry with a solid understanding of provider scheduling, appointment workflows, visit types, and patient access metrics, enabling the analyst to create accurate reports, dashboards, and analyses that support leadership decision-making</li><li>
Partners with clinical, operational, and business teams to enhance patient experience, optimize capacity management, evaluate campaign effectiveness, and drive initiatives that improve access and overall operational performance</li><li>
The Data Analyst I provides patient access data, reporting and other actionable information to the PAC Management Team and other departments regarding the business units, process, products and/or service lines as directed by the manager. Responsibilities related to this position include:<ul><li>
Creating/producing access reports, analysis required to understand the key drivers of the relevant business unit or service line</li><li>
Helping to develop the systems and processes that are the foundation for reporting and analysis</li></ul></li></ul><p></p><p><br>
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.</p><p><b>
Required Qualifications:</b></p><ul><li>
Experience in data analysis, decision support, medical economics, healthcare informatics, or managed healthcare or equivalent combination of education and experience to demonstrate ability to succeed in healthcare analytics</li></ul><p></p><p><b><br>
Preferred Qualifications:</b></p><ul><li>
Demonstrated ability to analyze and report on business units, products or service lines
</li><li>Experience in the healthcare industry with understanding of data in healthcare organizations (including provider scheduling, appointment workflows, visit types, patient access metrics, and an understanding of financial modeling within healthcare operations such as utilization metrics, payer mix, and reimbursement structures)</li><li>
Demonstrated analytical/modeling skills with ability to convert raw data into actionable business insights</li></ul><p></p><p><br>
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.</p><p>
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.</p><p></p><p><i><br>
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.</i></p><p></p><p><i><br>
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.</i></p><p></p><p><i><br>
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</i></p></div>

Patient Access Center Data Analyst I - Kelsey Seybold - Patient Access Center - Remote

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