Patient Access Manager (Full Time)

Summary/Objective

The Patient Access Manager is responsible for the day-to-day operation of the Admissions Center, including emergency room admissions and outpatient admissions.

Requirements

• High School diploma or GED
• Two to three years experience in a medical office or hospital admissions
• Knowledge of insurance processing
• Efficient with keyboarding and computer applications

Preferred:

• Three to five years experience in a medical office or hospital admissions
• Experience with hospital information systems and hospital insurance applications (TruBridge)

Responsibilities

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Plan, develop, organize, implement, evaluate, and direct the Patient Access department, its programs, and activities in accordance with current rules, regulations, and guidelines that conform to current standards of admission practice and operational policies while maintaining compliance with state and federal laws and regulations
• Develop, maintain, and periodically update written policies and procedures for the day-to-day function of the patient access department
• Communicate and interpret policies and procedures to patient access staff, and monitor staff practices and implementation
• Evaluate the work performance for all patient access personnel and implement discipline according to policies and procedures
• Ensure delivery of quality care and patient access supervision as evidenced by adequate services and staff coverage for the department
• Coordinate patient access services with all departments, as necessary
• Oversee patient access schedules to ensure they meet patient needs and regulatory and budgetary standards
• Participate in the recruitment and selection of patient access personnel and ensure sufficient staff are hired
• Oversee and supervise development and delivery of in-service education to equip patient access staff with sufficient knowledge and skills to provide quality care for patients
• Proactively develop positive employee relations; promote teamwork, mutual respect, and effective communications
• Monitor staff for compliance with facility policies on workplace safety
• Coordinate and/or develop ongoing quality assurance activities for patient access services to monitor compliance with standards and regulatory requirements; compile summary of findings for the Quality Assurance committee
• Participate in budget development for the patient access department
• Prepare staff for inspection surveys, instructing staff on matters of conduct and disclosure, being interviewed by inspectors, immediate corrections of problems noted by surveyors, and review and reinforce important standards previously cited
• Promote customer service and respond to and adequately resolve complaints or concerns from patients or families about patient access services
• Promote compliance with accident prevention procedures, safety rules, and safe work practices to prevent employee injury and illness and control workers’ compensation costs
• Ensure staff is trained in fire and disaster and other emergency procedures and evaluate performance during drills
• Ensure compliance with all hospital rules and regulations in accordance with set policies and procedures
• Oversee the work of the admissions team and ensure all representatives are provided with adequate training and resources needed
• Ensure department compliance with EMTALA, HIPAA, and Red Flag Rules
• Develop and review admission productivity reports and ensure that appropriate action is taken to meet productivity models
• Ensure complete and accurate registration of all patients
• Provide backup coverage and cross-training for pre-certification coordinator position
• Ensure timely pre-certification is obtained for hospital admissions, outpatient, surgery, and diagnostic imaging tests as required
• Sort, assemble, and post all patient charges and/or ensure that this is delegated to properly trained staff; ensure this task is completed accurately and timely
• Coordinate with supervisor to ensure cross-over functions between admissions and patient accounts flow smoothly
• Work admissions shifts as needed to ensure department coverage:
  • Interview incoming patient or representative and enter information required for admission into health information system
  • Obtain required signatures from patient and/or representative for consent of care and any other required documents per hospital policy and protocols; document how consent was obtained or not obtained from responsible parties
  • Enter, record, store, and maintain information in written and electronic form
  • Interview patient or representative to obtain and record individual and/or company insurance responsible for payment of bill
  • Explain hospital regulations, such as visiting hours and payment of accounts
  • Provide a smooth flow of patients through the admitting area/ER, directing or escorting patients as necessary to the appropriate department
  • Understand the functional status and physical needs of patients, staff, and visitors to the hospital and assist in those needs
  • Maintain a working knowledge of community services and resources available to all patients; refer patients as necessary to the appropriate agency or department
  • Record all emergency room patients seen on the electronic ER log related to each account
  • Accept payments and issue receipts, collect co-payments and deductibles, and reconcile petty cash drawer at the end of each shift
  • Process telephone communications in an efficient and courteous manner for patients, physicians, general public, and hospital staff
  • Page for medical staff, disaster and emergency codes as required by policy in a clear, distinct, and audible voice
  • Run a daily registration quality report before the end of each shift to check the accuracy of registrations and make corrections as necessary
  • Control visitor access to hospital after hours, clear any after-hours visitors with Charge Nurse, and issue visitor pass as appropriate
  • Foster high levels of customer service and release only appropriate patient information while ensuring HIPAA compliance is followed; refer all other medical information releases to HIM for processing
  • Ensure all patient information is safeguarded and kept confidential according to prescribed policies and procedures
• Analyze information and evaluate results to choose the best solutions available and solve problems as they arise
• Develop constructive and cooperative working relationships with others; ensure flow of communication within the department
• Participate in a wide variety of special projects and compile a variety of special reports

Skills

• Financial Management
• Ethical Conduct
• Leadership
• Technical Capacity
• Customer/Patient Focus
• Teamwork Orientation

Supervisory Responsibility

This position manages all employees of the patient access department and is responsible for interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, copiers, filing cabinets, and fax machines.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets, and bend or stand as necessary.

Schedule

This is a full-time, exempt position. Days and hours of work are Monday through Friday; hours are flexible based on job duties demand. Evening and weekend work may be required based on the needs of the position.

Travel

This position may require some travel.