patient access manager

サイネオス・ヘルス

<div><div><div>Updated: Today 
Location: Orange County, CA, United States 
Job ID: 16383-OTHLOC-ChcRYfw2
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</div></div><div>Description
The Virtual Reimbursement Manager (VRM) will be responsible for reactively supporting multiple accounts in a specified geographic region through the access process. The VRM will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, which may include sales, market access, and other collaboration partners. Responsibilities include ensuring understanding of coverage, access process and reimbursement services.
In this role, the VRM will demonstrate unwavering support and a consultative approach to help offices obtain insurance authorization and/or reimbursement of products for appropriate patients. The VRM will have a direct impact on a patient&rsquo;s ability to access the therapies they need.
Additional responsibilities include:<ul><li>
Manage daily activities that support appropriate patient access to our client&rsquo;s products in the provider offices</li><li>
Serve as payer expert for defined geography and able to communicate payer changes to key stakeholders in a timely manner</li><li>
Offer office education during the entire access process which may include formulary coverage/utilization management criteria, insurance forms &amp; procedures, benefits investigation, prior authorization, and appeals</li><li>
Educate offices using approved materials provided by the client</li><li>
Educate physician office staff on the use of our client&rsquo;s patient support services, including web based provider portals</li></ul>
Along with demonstrated initiative, resourcefulness and a results-oriented mindset, the ideal candidate has:<ul><li>
Bachelor&rsquo;s Degree</li><li>
Minimum two years of experience in public or private third party reimbursement or access arena or pharmaceutical industry in managed care or clinical support</li><li>
Demonstrated understanding of access, coverage and reimbursement issues in the retail channel, including commercial and federal health care program utilization management tools such as prior authorization, step edits, and denials</li><li>
Demonstrated ability to educate offices on access processes &ndash; including but not limited to:<ul><li>
Experience educating HCPs on client specific Patient Service programs (i.e. copay, bridge, patient assistance, etc.)</li><li>
Experience delivering educational presentations</li><li>
Advanced knowledge of medical insurance terminology</li></ul></li><li>
Knowledge of Centers of Medicare &amp; Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B &amp; D</li></ul>
The annual base salary for this position ranges from $140,000 to $150,000. The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate's qualifications, skills, competencies, and proficiency for the role. In addition, some positions may include eligibility to earn commissions/bonus based on company and / or individual performance.
At Syneos Health, we are dedicated to building a diverse, inclusive and authentic workplace. If your past experience doesn&rsquo;t align perfectly, we encourage you to apply anyway. At times, we will consider transferable skills from previous roles. We also encourage you to join our Talent Network to stay connected to additional career opportunities.
Why Syneos Health? Our ability to collaborate and problem-solve makes a difference in patients' lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our new and existing partnerships create a multitude of career paths and employment opportunities. Join our game-changing, global company dedicated to creating better, smarter, faster ways to get biopharmaceutical therapies to patients Experience the thrill of knowing that your everyday efforts are contributing to improving patients' lives around the world.
Work Here Matters Everywhere | How are you inspired to change lives?
Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled)
At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position will include a competitive compensation package, Health benefits to include Medical, Dental and Vision, Company match 401k, flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements. 
400005622</div></div></div></div><div></div>

Virtual Reimbursement Manager

Summit Health

<div><h1 class="jobSectionHeader">About Our Company</h1>
We&rsquo;re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.
Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.
When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.
Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.<h1 class="jobSectionHeader">
Job Description</h1>
The Referral Operations Manager for the Access Center is responsible for ensuring patients referred from a Summit Health Location are scheduled for the appropriate follow-up care as part of our commitment to providing coordinate care. The manager will lead a team of Supervisors and agents ensuring all protocols are followed, all performance metrics are met, optimizing workflows and processes, managing time and attendance, and providing mentorship and direction and collaborating with the markets supported. Specifically, this manager will help ensure patients referred from a Summit Health location find and engage with the next necessary step in their care.
Duties and Responsibilities
The primary duties, responsibilities, and expectations of an Access Center Manager, Referrals are:<ul><li>
Provide oversight, management, coaching, development, and evaluation of the performance of the Supervisors on an ongoing basis following applicable performance standards.</li><li>
Scheduling of all Supervisors to ensure proper shift coverage.</li><li>
Driving care continuity for patients within Summit locations, ensuring patients are scheduled for their follow-up care as necessary.</li><li>
Handling of escalated patient and site concerns. Creating action plans that are effective in solving business issues for the department.</li><li>
Create and deliver presentations to the Access Center Leadership team when necessary.</li><li>
Understanding key informatics and metrics and utilizing data appropriately to manage labor, key operational goals, and site staff KPIs.</li><li>
Monitor employee engagement and designs programs in partnership with the Access Center leadership to maintain high employee engagement.</li><li>
Coordinate with vendor partner to drive vendor agent success.</li><li>
Maintain and exceed department goals for management and throughput.</li><li>
Attend regular meetings with the Clinical managers to review performance and address any concerns.</li><li>
Coordinates and collaborates with the Access Center Leadership and recruitment team to ensure all staff hires and needs are up to date for Access Center.</li><li>
Assist in reporting on department metrics back to Access Center leadership regularly.</li><li>
Enforce and audit policies and procedures related to the flow of information and systems used.</li><li>
Monitor phone volume and assist with calls when necessary.</li></ul>
Qualifications
A candidate&rsquo;s qualifications will include:<ul><li>
A bachelor&rsquo;s degree is preferred but not required.</li><li>
Minimum (3) Three years of experience as an Access/Call Center manager or comparable management experience.</li><li>
Strong and Clear communication skills.</li><li>
Working knowledge of EHRs &ndash; Electronic Health Records system is a plus.</li><li>
Call center, referral, and/or appointment scheduling experience in a healthcare environment is a must.</li><li>
Ability to analyze, review trends, and create action plans to mitigate areas of opportunity.</li><li>
Must exhibit passion for outstanding results and compassion for those we work with and serve.</li><li>
Happy and positive thinking, able to project this attitude around others.</li><li>
Be willing to travel to clinical/Corporate locations, if needed.</li><li>
Comfortable with constructive feedback and counseling management</li></ul>
This is an exempt position with the salary range of $86,000 - $94,000 based on experience and market.<h1 class="jobSectionHeader">
About Our Commitment</h1><h2 class="jobSectionHeader">
Total Rewards at VillageMD</h2>
Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD&rsquo;s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.<h2 class="jobSectionHeader">
Equal Opportunity Employer</h2>
Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.<h2 class="jobSectionHeader">
Safety Disclaimer</h2>
Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.</div>

Referral Operations Manager

Positive Impact Health Centers

<div>
 Job Type
 
 
 Full-time
 
 
 
 Description
 
 
 
 
 Are you seeking a career with a growing company, a place where you can make an impact in the community? Then Positive Impact Health Centers is the company for you.
 
 
 
 
 What makes us different? We offer our employees the following:
 
 
 
 <ul>
 <li>
 1 Health Wellness day per quarter
 </li>
 <li>
 Parental Leave
 </li>
 <li>
 Free parking at our locations/bus line accessibility
 </li>
 <li>
 Competitive Salary &amp; Benefits
 </li>
 <li>
 Automatic 3% Safe Harbor &amp; 2% Profit Sharing (Retirement Program)
 </li>
 <li>
 100% allotted for benefit elections for employees, 50% allotted for benefit elections for employees' spouse/dependents
 </li>
 <li>
 Credit Union
 
 
 </li>
 </ul>
 
 Positive Impact Health Centers
 
 (PIHC) is a community leader in providing HIV prevention, care and treatment services. The PIHC model of care assures that individuals with HIV have access to medical, pharmacy, dental, behavioral health, and social services, providing the best opportunity for patients to achieve high-quality health outcomes.
 
 
 
 JOB SUMMARY:
 
 The Medical Contact Center Manager will build and lead our patient access and communication hub. This role will oversee the launch, daily operations, and continuous improvement of our first contact center, ensuring patients experience timely, compassionate, and efficient support at every touchpoint. The Manager will lead and develop a high-performing team, implement best-in-class workflows and technologies, and partner closely with clinical and administrative departments to optimize scheduling, patient inquiries, and overall access to care. The ideal candidate combines strong leadership, operational expertise, and a patient-centered mindset to drive performance, quality, and an exceptional patient experience.
 
 
 
 
 This position description should not be interpreted as all-inclusive. It is intended to identify the major responsibilities and requirements of this position. The incumbents may be requested to perform job-related responsibilities and tasks other than those stated in this position description.
 
 
 
 
 
 Requirements
 
 
 
 
 ESSENTIAL FUNCTIONS:
 
 
 
 
 Duties And Responsibilities
 
 
 
 <ul>
 <li>
 Conducts Quality Assurance activities (e.g., call monitoring, guidance, database analysis) which focuses on the continuous development of the consistency in compliance and accuracy of both verbal and written communications.
 </li>
 <li>
 Utilizes tools to monitor patient calls and ensures team is providing excellent customer service.
 </li>
 <li>
 Demonstrates the ability to organize, manage and prioritize assigned work tasks
 </li>
 <li>
 Delivers efficient time management strategies when performing medical information activities following all required legal compliance standards.
 </li>
 <li>
 Ensures new hire training is comprehensive, up to date and completed within defined timelines, resulting in an employee&rsquo;s ability to work independently.
 </li>
 <li>
 Responsible for providing quality customer support through active listening, patience, empathy, and problem-solving skills even through complex situations
 </li>
 <li>
 Monitors call volume and related activities on a consistent basis; provides management with periodic reports to facilitate staffing/process decisions.
 </li>
 <li>
 Facilitates and assists team with key projects for the group and coordinates with interdisciplinary partners as required.
 </li>
 <li>
 Collaborates with other departments, including clinical staff, IT, and administrative teams, to streamline processes and enhance overall efficiency; Participate in interdisciplinary meetings and committees to drive process improvements and enhance patient outcomes.
 </li>
 <li>
 Oversee the day-to-day operations of the medical contact center, including managing incoming calls, emails, and other forms of communication.
 </li>
 <li>
 Lead and manage a team of contact center agents, providing guidance, support, and training as needed.
 </li>
 <li>
 Develop and implement policies, procedures, and protocols to ensure the highest quality of service delivery.
 </li>
 <li>
 Utilize strong leadership abilities to foster a positive work environment and promote teamwork and collaboration among contact center staff.
 </li>
 <li>
 Monitor and evaluate contact center performance metrics, such as call volume, response times, and customer satisfaction, and implement strategies for continuous improvement.
 </li>
 <li>
 Ensure compliance with HIPAA regulations and other relevant healthcare standards and guidelines.
 </li>
 <li>
 Handle escalated patient inquiries and complaints in a professional and timely manner.
 </li>
 <li>
 Provide regular reports and updates to senior management on contact center performance and key metrics.
 </li>
 <li>
 Stay informed about developments in healthcare technology, communication systems, and contact center best practices, and make recommendations for implementation as appropriate.
 </li>
 <li>
 Supervise, mentor, and empower a team of contact center agents to deliver high-quality service to patients and healthcare providers. Provide ongoing training, coaching, and performance feedback to ensure the team meets or exceeds performance goals.
 </li>
 <li>
 Manage all aspects of the medical contact center, including call routing, appointment scheduling, patient triage, and follow-up communication. Monitor call volume, response times, and service levels to ensure optimal performance and patient satisfaction.
 </li>
 <li>
 Champion a patient-centered approach to care delivery, ensuring that all interactions with patients and their families are conducted with empathy, professionalism, and respect. Address patient inquiries, concerns, and complaints promptly and effectively, escalating issues as needed to achieve resolution.
 </li>
 <li>
 Develop and implement strategic plans and initiatives to optimize the efficiency and effectiveness of the medical contact center operations.
 </li>
 <li>
 Maintain strict confidentiality guidelines, regarding all clients, conversations , referrals of work and information, based on PIHC&rsquo;s policies and procedures.
 </li>
 <li>
 Other duties as assigned
 
 
 </li>
 </ul>
 
 Knowledge, Skills, And Abilities
 
 
 
 <ul>
 <li>
 Excellent communication, interpersonal, and conflict resolution skills, with a demonstrated ability to interact effectively with diverse stakeholders.
 </li>
 <li>
 Experienced in working with culturally diverse populations
 </li>
 <li>
 Must have strong computer system skills.
 </li>
 <li>
 Must have ability to work in a fast-paced environment and attention to detail
 </li>
 <li>
 Ability to work as a team member and lead the Contact Center Team.
 </li>
 <li>
 Proficiency in Microsoft Office Suite and other relevant software applications.
 </li>
 <li>
 Experience with call center technologies and relevant EHR databases.
 </li>
 <li>
 Flexible, and detail-oriented, with a positive attitude, and a strong ability to multitask, prioritize projects, and communicate at all levels within the company.
 
 
 </li>
 </ul>
 
 Minimum Qualifications
 
 
 
 <ul>
 <li>
 Professional degree or certification in nursing, public health administration, health care administration, business administration, or related field
 
 
 </li>
 </ul>
 
 Experience
 
 
 
 <ul>
 <li>
 Minimum of five (5) years of clinical experience in various healthcare settings
 </li>
 <li>
 Prefer at least two (2) years of experience in a leadership or management role within a contact center or customer service environment.
 </li>
 <li>
 Maintain current licensure, as well as current CPR
 
 
 </li>
 </ul>
 Salary Description
 
 
 $55,000 - $70,000
</div>

Contact Center Manager

RWJBarnabas Health

<div>Req #: 0000253503
 
Category: Revenue Cycle and Patient Access
 
Status: Per Diem
 
Shift: Night
 
Facility: Clara Maass Medical Center
 
Department: Nursing Supervisors
 
Pay Range: $59.31 - $77.11 per hour
 
<div><div>Location:
</div><div>1 CLARA MAASS DRIVE, BELLEVILLE, NJ 07109</div> 
</div> 
<div>Job Title: Nursing Supervisor
Location: Clara Maass Medical Center
Department Name: Nursing Supervisors
Req #: 0000253503
Status: Hourly
Shift: Night
Pay Range: $59.31 - $77.11 per hour
Pay Transparency:
The above reflects the anticipated hourly wage range for this position if hired to work in New Jersey.
The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience.
Business Acumen / Operational Effectiveness
Directs patient care in a manner which ensures that: Standards of patient care and regulatory agencies are met; the nursing process forms the basis for delivery of patient care; Patients, significant others and associates are treated with dignity, respect and compassion,
Provides nursing administrative coverage as neededEnsures staffing levels meet patient requirements,
Demonstrates managerial and clinical judgment in reviewing staff assignments and assigning appropriate level of staff,
Makes nursing rounds to oversee the quality of care given and patient satisfaction,
Communication
Establishes, monitors and enhances communication channels that enables open communication,
Holds regular meetings to ensure timely and accurate two-way communication between teams, departments, functions and business entities,
Provides and maintains effective communication with the community, medical staff, hospital and departmental management and staff,
Keeps the Nurse Manager informed through accurate written and verbal communication,
Receives report form Nurse Manager / Shift Manager; gives an accurate and concise report to the oncoming Shift Manager/Nurse Manager focusing on personnel and patient care issues,
Leadership
Develops and implements policies and procedures that guide and support the provision of services,
Promotes staff effectiveness/competency through goal setting, role modeling and provision of learning opportunities,
Promotes quality of patient care through the following: Develops/revises plan for patient care delivery in assigned areas; Identifies and corrects actual/potential problems; Recommends/selects appropriate indicators to measure performance; Implements and enforces the national patient safety goals; Communicates QA &amp; PI findings as required; Ensures the provision of Patient Family education,
Maintains clinical knowledge and acts as a clinical resource in the care of unit specific patient populations,
People Management
Determines the qualifications and competence of department personnel who provide patient care services and who are not licensed independent practitioners,
Provides for orientation, in-service training and continuing education of all persons in the department,
Coordinates and assures the effective use of personnel and supplies,
Evaluates care rendered by private duty, and agency staff; documents and makes recommendations / comments as necessary,
Communicates all evaluations to the Staffing Coordinator for the permanent file on the agency staff,
Personal Learning / Self-Management
Operates with a high degree of autonomy and authority while working within the framework of CMMC s philosophy and policies,
Maintains professional affiliations and enhances professional growth and development to keep abreast of the latest trends in hospital/department/administration services,
Participates in on-going education to seek out and apply new professional and technical concepts, seeks additional certifications as appropriate,
Equal Opportunity Employer</div> 

 
RWJBarnabas Health is an Equal Opportunity Employer</div>

Per Diem Nursing Supervisor (RN) Nights

Keystone Health

<div>At Keystone Health, we aspire for you to feel empowered and fulfilled as you work towards our shared mission of delivering heartfelt care. Earn a living where your heart truly belongs.<h2 class="jobSectionHeader">
Case Manager</h2>
Full-Time | Monday&ndash;Friday | Occasional Weekend Hours for Events 
Keystone Enabling Services is seeking a compassionate, resourceful, and community-focused Case Manager to support patients and families in navigating healthcare and social service systems. This role is ideal for someone who is passionate about advocacy, care coordination, and helping individuals overcome barriers to care.
What You&rsquo;ll Do<ul><li>
Partner with providers, care teams, and community organizations to support patients&rsquo; social, emotional, and environmental needs</li><li>
Connect patients and families with community resources and support services</li><li>
Provide short-term care coordination and patient-centered education</li><li>
Help reduce barriers to care and improve access to essential services</li><li>
Support individuals from many different cultural and socioeconomic backgrounds with empathy and professionalism</li><li>
Collaborate across interdisciplinary teams to promote positive patient outcomes</li><li>
Maintain accurate documentation within the electronic health record (EHR)</li></ul> 
What Makes You Successful<ul><li>
Strong communication, relationship-building, and active listening skills</li><li>
Ability to work independently while collaborating effectively with a team</li><li>
Skilled at managing multiple priorities in a fast-paced environment</li><li>
Comfortable navigating difficult conversations and resolving conflict professionally</li><li>
Adaptable, organized, and motivated to improve processes and patient experiences</li><li>
Committed to equitable, culturally responsive care and community support</li></ul> 
Skills &amp; Experience We&rsquo;re Looking For<ul><li>
At least one year experience supporting individuals through healthcare, community, or human services</li><li>
Knowledge of community resources, care coordination, or patient advocacy</li><li>
Familiarity with EHR systems and Microsoft Office applications</li><li>
Bilingual communication skills are a plus, but not required</li></ul> 
Education &amp; Background<ul><li>
Bachelor&rsquo;s degree in Social Work, Human Services, or a related field</li><li>
Equivalent combinations of education, training, and relevant experience will also be considered</li></ul>
Keystone Health is an Equal Opportunity Employer</div>

Case Manager

Hope Christian Health Center

<div>Description:

JOB SUMMARY: The Care Manager plays a vital role in delivering comprehensive, patient-centered care within an integrated health team at a Federally Qualified Health Center (FQHC). This position supports patients with complex medical, behavioral, and social needs by coordinating services, promoting health education, and facilitating access to appropriate care. The Care Manager works collaboratively with primary care providers, behavioral health providers, community health workers, and other team members to ensure high-quality, culturally competent, and equitable care.
DUTIES AND RESPONSIBILITIES:
Care Manager Duties:
Care Coordination<ul><li>
Develop, implement, and monitor individualized care plans in collaboration with patients and the care team.</li><li>
Coordinate care transitions, including hospital discharges, specialty referrals, and community resource connections.</li><li>
Provide care through in-person visits, telephone, and telemedicine to ensure continuity.</li><li>
Proactively conduct outreach to patients who may benefit from services, introducing available programs and supports.</li><li>
Facilitate communication between patients, families, and interdisciplinary team members.</li></ul>
Patient Education and Advocacy<ul><li>
Deliver health education and coaching to support chronic disease management and preventive care.</li><li>
Advocate for patients and collaborate with community health workers to address social determinants of health.</li><li>
Assist in issuing medical equipment and supplies, ensuring proper documentation and follow-up.</li></ul>
Data and Quality Improvement<ul><li>
Document care management activities and track patient outcomes in the electronic health record (EHR).</li><li>
Partner with the Population Health Manager to analyze reports related to patient outcomes, care gaps, and required data metrics.</li><li>
Participate in quality improvement initiatives and population health strategies.</li><li>
Contribute to the development and refinement of care coordination workflows and reporting tools.</li></ul>
Other Duties:<ul><li>
Promotes and demonstrates Hope values of: Gospel motivation, Prayer, Excellence, Stewardship, Patience, Thankfulness, Humility, Service, Dignity through Relationship and Hospitality and Joy</li><li>
Primarily onsite in a clinical setting with occasional community outreach or home visits.</li><li>
May require flexible hours to meet patient needs.</li><li>
Complies with HIPAA and protects patient information.</li><li>
The Care Manager ensures compliance with all 19 Health Resources and Services Administration (HRSA) Health Center Program Requirements.</li><li>
The Care Manager is also expected to actively participate in and support quality improvement activities and the clinical practice team efforts emphasizing the importance of the individual patient and putting the patient&rsquo;s needs first.</li><li>
Other duties as assigned.</li></ul>
Requirements:

QUALIFICATIONS:<ul><li>
Registered Nurse (RN) with a current state license in Nevada - required</li><li>
Valid AHA Certified Basic Life Support (BLS) certification- required</li><li>
Bilingual in Spanish (depending on patient population) - preferred</li><li>
Minimum of 2 years of clinical nursing experience, preferably in primary care, community health, or care management - preferred</li><li>
Experience working in an integrated care setting or with underserved populations - preferred</li><li>
Proficiency in EHR systems and care coordination platforms, and data management.</li><li>
Experience with data reporting and population health tools preferred.</li></ul>
Education:<ul><li>
Bachelor&rsquo;s degree in Nursing - required</li></ul>
KEY COMPETENCIES FOR SUCCESS:<ul><li>
Faith to believe that Hope is a ministry of God, exemplifying the love of Christ, and held and directed by the Holy Spirit.</li><li>
Ability to operate general office machinery (computers, calculators, copy/fax machine, telephones, etc.)</li><li>
Excellent communication skills, both written and verbal.</li><li>
Demonstrated passion for community health care.</li><li>
Proven leadership, teambuilding, and organizational skills.</li><li>
Proven ability to maintain integrity in a fast paced and high-demand environment.</li><li>
Proven ability to manage performance goals.</li><li>
Ability to interact with people from all ethnic backgrounds, ages, and lifestyles; ability to understand and respond appropriately, effectively, and sensitively to special populations.</li></ul>
TYPICAL PHYSICAL DEMANDS:
Occasional standing, walking, lifting, reaching, kneeling, bending, stooping, pushing, pulling, and lifting and/or moving up to 25 pounds. Frequent sitting. Manual dexterity. Proficient reading, eyesight, and vision for close work. Ability to communicate by speaking and hearing in person or on the phone. Ability to travel to various locations.</div>

Care Manager

Beth Israel Lahey Health

Milton, MA &bull; Beth Israel Lahey Health &bull; Full-time &bull; Day
 <div>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.

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.

Job Description:

Essential Duties &amp; Responsibilities including but not limited to:

Registration:

1. Registers patients presenting for visits. Explains the registration process to patients and responds to patient questions.

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.

3. Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results.

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.

5. Counsels patients regarding non-covered services, obtaining signatures on Advance Notice Beneficiaries (ABNs), consents and waivers.

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.

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.

8. Assures a neat, orderly registration desk and patient waiting area, securing all confidential patient information.

Scheduling:

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.

10. Utilizes a variety of information sources to schedule, reschedule, and cancel patient appointments. Information sources include online questionnaires, offline materials, and subgroup searches.

11. Establishes working relationships with staff of assigned clinical departments. Understands and correctly applies unique clinical department scheduling protocols.

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.

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.

14. Identifies and communicates to Patient Access management issues that may impact the timeliness and accuracy of patient appointments and subsequent patient care.

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:

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.

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.

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.

19. Applies the appropriate guarantor and insurance to each patient visit.

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.

Minimum Qualifications:

Education: High school degree or equivalent. Associate&rsquo;s degree preferred.

Licensure, Certification &amp; Registration: None

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.

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.

Preferred Qualifications &amp; Skills:

&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 


Pay Range:
$20.50 &ndash; $27.59

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.

<h2 class="jobSectionHeader">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.</h2>

<h2 class="jobSectionHeader">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.</h2>

<h2 class="jobSectionHeader">Equal Opportunity Employer/Veterans/Disabled</h2></div>
 <div><h3 class="jobSectionHeader">Job details</h3>
<ul><li><div>Employment: Full-time</div></li>
<li><div>Hours/Week: 40</div></li>
<li><div>Shift: Day</div></li>
<li><div>Category: Patient Access</div></li>
<li><div>Pay Range: $20.50 - $27.59</div></li>
<li><div>FLSA: Non-Exempt</div></li>
<li><div>Req ID: JR95960</div></li></ul></div>

Patient Access Representative; 8am-4:30pm M-F

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