Manager - Patient Access Operations - Full Time

Quality Improvement

• 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.

• Ensures the design of these systems always provides for timely, courteous, and accurate behavior of staff at all times.

• Monitors and evaluates the quality of the department and other de-centralized departments and takes appropriate action based on the findings.

• 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.

• Responsible for interviewing, selecting, and hiring new or replacement staff to fill approved positions.

• Deals effectively, courteously, and professionally with reporting staff, peers, and superiors, as well as with patients and visitors.

• Maintains compliance with EMTALA, DNV, HIPAA, CMS and all other hospital and government regulations applicable to admissions operations.

• Effectively utilizes positive reinforcement to motivate staff and instill confidence.

• Effectively utilizes employee improvement and corrective action methods, when necessary.

• 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.

• Responsible for coaching, delivering corrective action, and addressing employee complaints and grievances.

• 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.

Leadership

• Effectively delegates duties, responsibilities, and special assignments.

• Plans to meet the needs of the department’s customers.

• 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.

• Must be available to work hours and days as needed based on departmental/system demands.

• Must be “on-call” as needed.

Financial Performance

• 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.

Operations

• 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

• Anticipate scheduling needs while maintaining adequate staffing for efficient operations.

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 in healthcare customer service

• 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

• Demonstrated experience in strategic planning, organization design and development

Skills and Knowledge:

• Knowledge of healthcare revenue cycle

• Familiar with information systems, knowledge of third-party payment methodologies, ICD, and CPT coding.

• Ability to demonstrate knowledge of medical terminology and financial counseling

• Position requires fluency in English, both written and oral communication skills

• Working knowledge with MS Office (MS Word, Excel, PowerPoint, and Outlook)

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

• 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