Patient Access Manager

Working under the supervision of the Director of Patient Financial Services, the Manager is responsible for the coordination and supervision of all the functions and activities related to Billing Specialists, Patient Access Representatives and Schedulers. This individual aids in monitoring and setting goals, priorities, and performance standards for Patient Access and BO functions including: billing, scheduling, pre-registration, insurance verification, prior authorization, financial clearance, admission, and registration. This individual will be involved in departmental and interdepartmental process improvement teams to eliminate waste and improve efficiency. The position requires the ability to independently plan, schedule, organize and respond appropriately on a wide variety of subjects and situations. The ability to perform the duties of the employees supervised is required. As hospital reimbursement is dependent upon the activities of the patient access functions accuracy is expected and timely completion of duties and follow-up is critical.

EDUCATION, CREDENTIALS & EXPERIENCE REQUIREMENTS:

• Bachelor’s degree in business, healthcare or related field
• Minimum of five years of experience in a hospital or medical office setting

JOB SPECIFIC COMPETENCIES:

Management

• Supervises operations of the business offices/patient access in each area in a cost efficient and customer service oriented manner and manages, monitors and is accountable for the AR for each of these areas.
• Directs and coordinates the credit and collection activities for Patient Access/ Business Office areas. Monitors outside collection agency efforts.
• Directs and coordinates the billing and follow-up activities for the Patient Access/Billing Office areas.
• Oversees RHC billing and record-keeping.
• Develop staffing schedules and assure staffing needs are met. Implement alternative staffing patterns as needs arise, taking into consideration performance requirements and restrictions.
• Interview and make hiring decisions to maintain adequate staffing in the department.
• Review and approve employee’s time in an accurate and timely manner. Maintain accurate employee attendance files. o Involve employees in solution finding and decision-making.
• Encourage and commend employees for excellent performance.
• Provide timely performance improvement feedback and coaching. Discipline staff when warranted by inappropriate employee behavior or inadequate work performance.
• Provides education and orientation to the staff and maintains individual growth in the position. Conducts timely training assessments, reclassification exams, and performance reviews. Solicit feedback from other staff and managers as appropriate.
• Respond to employee questions/concerns on an individual basis as needed.
• Conduct team meetings to apprise associates of changes and to address broader-based program area issues and initiatives.
• Development and implementation of policies and procedures for each area to effectively manage cash flow, control patient accounts receivables, to comply with regulations governing billing practices and to enhance the overall business office operations.
• Develop, recommend and implement policies and procedures for the department, focusing on continuous process improvement and waste elimination.
• Monitor adherence to policies and established procedures. Propose methods which assure effective execution of program responsibilities.
• Update policy and procedure manuals as required. Apprise employees of changes.

Operational Duties

• Assists in developing corporate direction for managed care initiatives and evaluates and revises third party billing procedures based on working knowledge of all third-party payers through coordination with PHO.
• Evaluates and implements hospital-wide policies regarding departmental revenue procedures for patient charges.
• Effectively communicates reimbursement and other business office issues to the various department directors in coordination to maximum reimbursement.
• Gathers, prepares and reports data for fiscal, statistical and planning purposes.
• Establish goals and benchmark standards to improve business office operational efficiency.
• Successfully passes all DNV accreditation surveys without recommendations.
• Keeps the CFO fully informed of all significant development and events.
• Create and implement methodologies to improve and measure the patient experience. Ensure that patient experience and service standards are met.
• Use reports and dashboards to monitor the daily productivity of the department and individuals.
• Assist each area with meeting operational key performance indicators and industry benchmarks.
• Produce reports, monitor work queues, and provide recommendations for improvement in patient access to ensure patient information is complete and accurate for billing and clinical purposes.
• Gather and analyze departmental and program specific productivity and quality of service statistics. Ensure quality audits are regularly performed to promote quality and identify root causes of issues.
• Work collaboratively with Clinic Managers, Central Scheduling, Patient Access, Patient Financial Services, and other HAMC departments on issues relating to patient scheduling, registration, admission, insurance verification, referrals and reimbursement issues. Represent the department in meetings and on committees relating to these issues.
• Serve as the acknowledged expert and information source for staff. Keep abreast of scheduling, insurance, referral, and billing requirements. Request system enhancements as needed to facilitate accurate scheduling and registration.
• Serve as an escalation point for patient issues and questions. Assist employees with complex and disgruntled patient situations requiring intervention from a higher authority.
• Participate in process improvement teams as assigned.
• Assist with application implementation, upgrades, enhancements, and usability testing.
• Assure equipment is in working order. Recommend the purchase of new equipment as required.
• Monitor departmental budget and assists in projecting monthly/annual expenditures.
• Ensure awareness, understanding, and compliance with all applicable federal, state, and agency laws and regulations.

Training

• Oversee the education of patient access employees, including new employee orientation, competency assessments, and ongoing education programs across all areas of responsibility.
• Keep accurate records of personnel training schedules as well as training checklists.
• Train and delegate appropriate training responsibilities for new and current associates. Schedule and facilitate cross-training of associates.
• Observe and modify training schedules as needed to include new methodologies and concepts. Conduct training review sessions.
• Actively seek and schedule associate development opportunities, including those outside the department that would be beneficial for staff members to attend.
• Monitor trainee progress and trainer effectiveness via regular meetings.
• Identify focus areas for competency assessments. Provide training opportunities addressing areas highlighted by these assessments.
• Participate in training/development programs as agreed upon with the Access Services leadership.

OTHER DUITIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

MISSION STATEMENT:

QUALITY HEALTHCARE: In our continuing effort to enhance the quality of life for the communities we serve, the Hospital Authority of Miller County is committed to the delivery of superior, safe, cost-effective healthcare through the provisions of education prevention, diagnosis and treatment.