The Access Associate Senior, PAU helps support pre-certifications for inpatient admission and pre-authorization for all outpatient diagnostic tests. This job requires the application and interpretation of policies and procedures and the use of independent judgment in a medical setting. The purpose is to achieve the goals and to meet the denial rates set by Patient Access the Medical Center and HSF to ensure minimum loss of revenue and maximum payment for services. The ability to maintain a working knowledge of carrier contracts/changes and departmental policies and procedures is required.

Job Description -

Team Members are expected to follow Standard Operating Procedures based on role within the Pre-Arrival Unit. Depending on the team member assignment, all or some of the following responsibilities are included in job expectations.

General Expectations:

• Identifies opportunities for improvement and communicates appropriately before problems arise whenever possible.
• Provides input on development, revision and implementation of work area procedures to ensure efficient operations and compliance with regulatory standards.
• Constantly and consistently evaluates processes, identifies opportunities for improvement and offers constructive ideas and solutions; actively participates in solutions and implementation.
• Maintains privacy during all interactions.
• Completes requests for service and associated tasks following established timelines.
• Initiates contact with patient and family and/or insurance carriers to ascertain pre-certification/pre-authorization information.
• Ensure communications are customer oriented, appropriate and professional. Documents should be professional in appearance and current.
• Abstracts appropriate health data into EMR
• Takes ownership of resolving insurance carrier conflicts for patients and communicates with team and management.
• Utilizes electronic medical record functionality (e.g., InBasket, telephone encounters, prescription requests, pools, letters, and documentation only) per department process guidelines. Documentation should be complete and accurate.
• Collaborates with appropriate Clinic Triad team (Medical Director, Access and Clinic Managers) to review requested schedule changes to ensure they meet clinic needs.
• Analyzes information supporting pre-certifications and/or authorizations with insurance carriers service area contacts and workmans compensation carriers.
• Demonstrates skill in the proficient use of PC and UVA software systems to ensure that all pre-certification/pre-authorization information is entered into required computer systems in an accurate and timely manner.
• Demonstrates the skills of effective communication decision-making and organization to ensure efficient job performance and job success.
• Demonstrates ability to adhere to policies and procedures.

Customer Service & Patient Experience:

• Serves as a role model for the ASPIRE values while maintaining and expanding patient relationships. Prioritizes tasks to meet customer needs.
• Demonstrates exceptional customer service both for in-person and telephone activities.
• Maintains a positive attitude when speaking with customers and internal and external service representatives.
• Optimizes listening skills to address customer requests and needs.
• Ensures communication with patient is in the patients preferred language
• Describes individual role and accepts personal responsibility for how it affects and enhances the work of the group and impact to Patient Experience.

In addition to the above job responsibilities, other duties may be assigned.

MINIMUM REQUIREMENTS

Education: High School Graduate or Equivalent required. Associates degree preferred.

Experience: 2 years relevant experience required. Access Associate fully cross-trained to cover multiple specialties will be considered in lieu of the 2 years relevant experience.

Licensure: None required.

PHYSICAL DEMANDS

Job requires sitting for prolonged periods; Repetitive motion: (computer and mouse use). Proficient communicative skill across spoken, writing domains, adequate auditory and visual skills; Attention to detail and ability to write legibly and compose messages clearly and concisely.

Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance

• Paid Time Off, Long-term and Short-term Disability, Retirement Savings

• Health Saving Plans, and Flexible Spending Accounts

• Certification and education support

• Generous Paid Time Off

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report Best Hospitals guide rates UVA Health University Medical Center as High Performing in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Childrens is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVAs commitment to non-discrimination and equal opportunity employment.