Analysis Skills, Best Practices, Billing, Billing Records, Co-Payments, Communication Skills, Customer Escalations, Data Entry, Demographics, Disability Insurance, Diversity, Documentation, Establish Priorities, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, High School Diploma, Insurance, Insurance Documentation, Leadership, Life Insurance, Medical Billing, Mentoring, Onboarding, Organizational Skills, Patient Care, Patient Education, People Management, Problem Solving Skills, Process Improvement, Project Tracking, Quality Assurance, Regulations, Regulatory Compliance, Reimbursement, Service Delivery, Surgical Procedures, Team Player, Third-Party Payer, Time Management, Training/Teaching, Trend Analysis, User Interface/Experience (UI/UX)
Welcome to Surgical Institute of Reading
At Surgical Institute of Reading (SIR), we build relationships that create better care. We partner with physicians and healthcare systems to provide first-class surgical solutions. Our commitment to clinical excellence and operational efficiency allows us to deliver exceptional surgical services that improve patient outcomes. SIR is proud of our inclusive culture—we embrace diversity and value the contributions of every individual. A diverse workforce, combined with an inclusive environment, strengthens our ability to serve diverse patient and physician populations.
Patient Access Lead at Surgical Institute of Reading
Performs advanced clerical and analytical functions for patient billing, including verification of insurance information, resolution of complex issues, and oversight of verification workflows to ensure a clean billing process. Serves as a resource and lead for the Insurance Verification team, providing guidance, training, and quality review. Reviews financial obligations with patients and families and ensures proper documentation is forwarded to the billing department. Prequalifies third-party coverage of scheduled procedures and follows up on accounts requiring further evaluation. Promotes consistency, accuracy, and efficiency in verification processes while supporting a collaborative team environment.
Essential Job Duties and Responsibilities
Insurance Verification & Patient Financial Counseling
- Maintains patient demographic and insurance information with a high level of accuracy.
- Determines patient qualification for coverage by third-party payers and communicates status to patient or family member.
- Reviews patient deductibles, copays, coinsurance, and out-of-pocket obligations; documents clearly in billing systems and tracking tools.
- Counsels patients regarding facility charges, insurance coverage, and expected costs.
- Discusses financial obligations, including payment expectations and reimbursement processes.
- Provides written estimates upon request and documents communication appropriately.
- Assists patients in establishing payment plans when needed.
- Communicates pertinent updates between physicians, clinical staff, insurance companies, and patients.
Workflow Oversight & Quality Assurance
- Serves as the lead resource for Insurance Verifiers, answering questions and resolving escalated or complex cases.
- Reviews verification work for accuracy, completeness, and compliance with payer requirements.
- Identifies trends, errors, and workflow inefficiencies; provides recommendations for improvement.
- Assists in prioritizing daily workloads to ensure timely verification of scheduled procedures.
- Monitors work queues, aging accounts, and outstanding verifications to minimize billing delays.
Training & Team Support
- Provides onboarding, training, and ongoing support to Insurance Verifiers.
- Develops and updates training materials, reference guides, and process documentation.
- Reinforces performance expectations, best practices, and department standards.
- Acts as a liaison between front-end staff, scheduling, and business office functions.
Documentation & Coordination
- Ensures all required financial and insurance documentation is complete and forwarded to the billing department.
- Enters insurance referrals and ensures authorization requirements are met.
- Completes data entry of patient cost sheets and verification tracking tools.
- Reviews and obtains required patient signatures on financial forms.
Reporting & Process Improvement
- Reports regularly to leadership on workflow status, productivity, and barriers.
- Assists in developing and updating departmental procedures, forms, and manuals.
- Supports audits, compliance reviews, and process improvement initiatives.
Compliance & Confidentiality
- Maintains strict confidentiality and adheres to all HIPAA guidelines and regulations.
Other Duties
- Performs other job-related duties as assigned.
Qualifications
- High School diploma or equivalent required; Associate degree preferred.
- Minimum of 2–3 years of insurance verification experience required.
- Strong knowledge of third-party payer requirements, authorizations, and eligibility processes.
- Previous lead, senior, or mentoring experience preferred.
- Strong problem-solving, organizational, and communication skills.
Benefits
USPI offers the following benefits, subject to employment status:
- Medical, dental, vision, disability, and life insurance
- Paid time off (vacation & sick leave) – Starting PTO accrual is 15 days per year.
- 401k retirement plan
- Paid holidays
- Health savings accounts, healthcare & dependent flexible spending accounts
- Employee Assistance program, Employee discount program
- Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
Who We Are
At USPI, we create relationships that create better care. We partner with physicians and health care systems to provide first class ambulatory solutions throughout the United States. We are committed to providing surgical services in the most efficient and clinically excellent manner.
USPI is committed to, and proud of our inclusive culture. An inclusive culture, in our view, is respectful of differences and nurtures and supports the contributions of each individual, while also embracing and leveraging diversity. A diverse workforce, combined with an inclusive culture, makes USPI stronger and better able to meet the needs of our diverse patient and physician population.
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United Surgical Partners International
Strength in Numbers
United Surgical Partners International (USPI) and Tenet have combined forces to create the nation’s largest ambulatory surgery provider. Our combined network of exceptional surgical and imaging facilities includes approximately 20 imaging centers, and over 265 short-stay surgical facilities. Together, our partnerships include 50 health systems and more than 4,000 physicians.
Nationwide Experience
Our partners deliver high quality ambulatory solutions in safe, efficient and caring USPI facilities in communities of every size across 29 states. Our physician partners are focused on providing quality patient care, in part because they are invested in their USPI facility. We provide the infrastructure and support they need to perform their best. This is one of the advantages of partnering with USPI.
Quality Patient Services
We share a vision with our physician and health system partners. Our goal is to provide the quality of healthcare services we would insist upon for our own families. Since our founding in 1998, this goal has helped us grow exponentially. Today, our strategic joint venture with Tenet establishes USPI as one of the nation's leading providers of ambulatory solutions.
Operating Excellence
Our size and experience in developing and operating ambulatory facilities and strategic vision allow our facilities to achieve both high patient satisfaction and solid financial results. Moreover, because we engage physicians in the governance and growth of the facility, we also achieve excellent clinical outcomes.