Outpatient Operations Lead

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Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.

At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care-and your career.

CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means.

A Brief Overview
The Lead PSR is responsible for supervisor coverage and leadership for the Patient Service Representatives and other operational staff. The Lead PSR assures staff adherence to all enterprise policies and procedures that have been developed to ensure effective and efficient quality service to patients and families. This role is responsible for supervising and covering for all functions related to greeting patients and families, scheduling, registration, collecting, entering and verifying insurance information, answering phones, obtaining/validating insurance referrals and authorizations as needed per insurance guidelines, cash collections and reconciliation, insurance verification and financial counseling. Responsibilities may include working with medical records, following HIPPA guidelines, oversee appointment confirmation, review/approve time off and perform payroll functions, and process reimbursements and credentialing packets. Other duties and administrative support and projects as required.

Schedule:

• Monday - Friday: 6AM - 2:30PM

• No weekends required

What you will do

• Provide welcoming, prompt and respectful customer service which includes scheduling appointments, inform of delays, address family complaints and escalate as necessary.
• Oversee appointment confirmation and enter diagnosis codes according to pre-established practice guidelines.
• Perform EPIC functions such as check in, check out, enter demographic and insurance information while ensuring accuracy, run daily eligibility verifications, enter and make daily edits to provider EPIC templates.
• Answer phones promptly with minimal downtime between calls, accurately verifies and documents contact information and messages, provide appropriate information to callers as warranted. Communicate in a courteous, caring manner to all customers as needed. Check voicemails.
• Perform administrative tasks such as sort and deliver mail, faxes, medical records and other correspondence; photocopies and faxed documents. Oversee/order office supplies.
• Lead and facilitate team huddles and meetings.
• Reconciliation of daily services to include collection and processing of payments received, reimbursements, create and/or obtain insurance referrals and authorizations needed.
• Daily maintenance of patient records following HIPPA guidelines.
• Enter provider templates and make daily edits as needed to provider schedules.
• Coordinate daily eligibility verifications, reconcile drawers and make cash deposits, order supplies and other clerical duties as assigned.
• Supervise staff, maintain PSR staff schedules, supervise day to day activities and participate in interviews and PSR evaluations, oversee PSR onboarding process, provide ongoing training and coaching, organize and lead PSR meetings, assist Supervisor(s) with productivity, and office/departmental coverage.
• Other areas of responsibility may include, payroll edit functions, answer billing inquiries, work/oversee necessary billing ques, attending billing meetings, process credentialing packets, attend and participate in monthly PL meetings. Work various appointment recall, waitlists, value-based care and other reports. Complete After Hours Program Physician on-call schedule as needed.
• Additional patient support duties may include: Respond to all traumas, resuscitations and codes, coordinate with Social Work, Nursing, and Case Managers to assist w/ newborn coverage. Emergency, Sitter and Admissions duties as needed.
• If located in an area where 24/7 coverage is needed, will need to rotate shifts.
• ED/Admissions specific tasks as assigned include: SART paperwork processing, Nurse Call communications, Trauma B-line and arrivals.

Education Qualifications

• High School Diploma / GED Required

Experience Qualifications

• At least three (3) years patient services representative experience in a role that consisted of health care, registration, physician billing, medical records, medical office work and relatable customer service. Required

Skills and Abilities

• Basic knowledge of medical and billing terminology. Solid conflict resolution skills.
• Basic knowledge HIPAA regulations.
• Intermediate proficiency with electronic medical record software preferred.
• Intermediate proficiency with Microsoft Suite.
• Excellent verbal and written communications skills.
• Excellent interpersonal skills.
• Excellent organizational skills.
• Strong time management skills.
• Ability to maintain confidentiality and professionalism.
• Ability to work independently with minimal supervision.
• Ability to work with and relate to people at all levels.

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. Learn more.

EEO / VEVRAA Federal Contractor | Tobacco Statement

SALARY RANGE:

Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.

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At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click here for more information regarding CHOP's Compensation and Benefits.