Manager-Patient Access Operations-8110

Key Responsibilities

• Possesses knowledge of various types of insurance plans (PPO, POS, HMO, Medicare, and Medicaid.) and other payors.
• Possesses basic understanding of medical terminology.
• Plans, organizes, coordinates, implements, and controls the systems by which patients are registered for services and demographic, clinical, and billing information is developed and maintained.
• Ensures patient interactions are done courteously and efficiently so that patients may arrive at their point of service as quickly as possible.
• Maintains compliance with EMTALA, DNV, HIPAA, CMS and all other hospital and government regulations applicable to admissions operations.
• Engages with leadership and Human Resources (HR) on all employee management and human relations issues.
• Provides excellent customer service and adheres to Behavioral Expectations Agreement.
• Develops and revises position descriptions for all department positions.
• Interviews, selects, and hires new or replacement staff to fill approved positions.
• Schedules work hours and assignments for employees to meet the needs of the department’s customers.
• Administers hospital and department policies and procedures.
• Provides input to HR concerning pay scales, pay structures, to enable appropriate recruitment and retention of departmental staff.
• Completes employee performance evaluation and personnel action requests in a timely manner.
• Provides opportunities for self and staff development through orientation, in-service, education, and needed training.
• Maintains professional qualifications and remains abreast of current developments and trends in Admissions and Scheduling.
• Holds regular staff meetings to provide communication, direction, and education.
• Delegates duties, responsibilities, and special assignments.
• Communicates effectively with other hospital departments and services.
• Participates in the hospital’s committees and meetings as requested or needed.
• Assesses current volumes, and projects/plans for future service needs.
• Establishes operational goals and objectives and evaluates achievements at least annually.
• Ensures admission, transfer, discharge, and registration functions are performed effectively and efficiently throughout the facility.
• Ensures patient information is gathered correctly and completely to ensure timely and accurate billing.
• Randomly audits registrations and cash receipts and deposits using sampling techniques to ensure accuracy.
• Coaches employees for improvement, where necessary, based on predetermined parameters.
• Ensures that insurance authorizations are obtained as required and that financial counseling is effective during the admissions process allowing representatives to collect co-pays, set payment arrangements and/or offer financial assistance as needed.
• Develops and implements policies and procedures for the department and other de-centralized registration areas.
• Helps plan and control the department’s financial budget.
• Prepares policies and procedures for approval.
• Evaluates departmental performance according to current industry principles to maintain and improve the level of care and results of the patient.
• Oversees and supervises all aspects of patient billing.
• Establishes, maintains, and reviews quality control.
• Responsible for adding necessary and appropriate new services for overall good billing practices.
• Manages departmental safety and sanitation standards.
• Ensures safe and sanitary conditions.
• Provides supervision of the department’s preventative maintenance program and works with the appropriate hospital personnel to ensure that equipment is safe, operable and meets regulatory standards.
• Maintains knowledge of and compliance with regulating/accrediting agency requirements.
• Works “front line” duties when necessary.
• Maintains departmental records for all area of responsibility.
• Performs other duties as assigned by the Director of Patient Access Services or higher supervision.
• Documents system issues while assisting in the development of systems improvements.
• Plans, coordinates, and prepares reports as they relate to Revenue Cycle Management.
• Anticipates scheduling needs while maintaining adequate staffing for efficient operations.

  Qualifications

  • Education: Associates degree in Business and/or Health related field, or 2 years equivalent relevant work experience training.
  • Certification: BLS certification through the American Heart Association or American Red Cross.
  • Licensure: Valid Arizona Driver’s License.
  • Experience: Minimum of five (5) years patient access registration and insurance verification experience in a health care setting.
  • Experience: Minimum of (3) years supervisory experience in health care setting, however, demonstrated indirect leadership experience may be considered in lieu of this requirement provided it is a direct fit to the role, lead role, project management, or other leadership experiences.
  • Practical experience: With electronic health information systems including configuration, implementation, support, and optimization in an ambulatory and acute hospital setting.
  • Experience: Demonstrated experience in strategic planning, organization design and development.
  • Skills and Knowledge: Knowledge of healthcare revenue cycle; familiarity with information systems, knowledge of third-party payment methodologies, ICD, and CPT coding; ability to demonstrate knowledge of medical terminology and financial counseling.
  • Working knowledge: With MS Office (MS Word, Excel, PowerPoint, and Outlook).

  Preferences

  • Education: Bachelor’s degree in healthcare administration or related field.

  Special Position Requirements

  • Exposure Category: Category III: Expected duties do not have potential for exposure to blood, body fluids, or tissues.
  • Other Potential Hazard(s): Possible exposure to chemical substances.

  Work Requirements

  • Ability to sit for six to seven hours daily at a computer terminal.
  • Must be able to deal calmly and effectively with frustrated and/or angry clients.