Patient Access Manager

Patient Access Manager  

General Summary: 

As Patient Access Manager, this position will lead the department in delivering superior care to every patient on every visit. The position will assist the Revenue Cycle Director with policies and procedures of all Patient Access functions and serve as the liaison between the Hospital Practices and the facility.  The position will be responsible for the management and daily operations of the patient access areas in the Hospital.  This position will be responsible for staying abreast of third-party payer regulations relating to coordination of benefits, monitoring Inpatient Medicare patients for accurate levels of care and eligibility, and evaluating staff accuracy in the collection of demographics and insurance eligibility. 

Supervise Patient Access Staff and Hospital Switchboard Staff: 

• Responsible for hiring, orientation and training of and evaluate staff; provide ongoing training/development opportunities and other continuing education to self and staff regarding excellent customer service, HIPAA privacy, new insurances, Medicare secondary payer test, rules around motor vehicle or medical insurance, rules around worker comp accounts, and practicing the Speare Memorial Hospital Mission.  

• In conjunction with Director, coaches, counsels and provides corrective action to staff as necessary.  Initiate personnel actions in accordance with Human Resources policies and organizational philosophy and values. 

• Submits completed staff performance evaluations effectively and timely to the Revenue Cycle Director.   

• Responsible for ensuring there is coverage for absent Registrars and Switchboard Operators. 

• Works with the Revenue Cycle Director to foster an environment of collaboration, cooperative relationships, and open communication both within all departments and the practices of the Speare family. 

• Ensures that the admissions, registration, and financial counseling areas provide customer friendly, timely, and accurate collection of demographic, insurance, and financial assistance information. 

• Develops patient interview processes that capture accurate demographic, financial, clinical, and insurance verification.  Works with the Revenue Cycle Director to develop accountability reporting and benchmark measures for staff performance. 

• Develops and ensures that inpatient and outpatient pre-authorizations and prior notices are completed to avoid payer denials. 

• Develops and ensures that inpatient admissions and changes in levels of care for inpatients are transmitted to payers to avoid payer denials of service – position works with Care Management/UR Department. 

• Monitors workflow of unit to ensure all accountabilities and responsibilities are handled thoroughly and timely.  

• With Revenue Cycle Director develop and implement a plan to increase point of service collections, financial assistance services, and scheduled preregistrations, including a benchmark and reporting for all Registration/Check Out areas. 

• Promote and ensure high standards of departmental operations within the Revenue Cycle  Departments. 

• Review with Revenue Cycle Director to promote new and innovative services and systems through new products/services, and equipment.  

• Develop, implement and maintain Revenue Cycle Departmental policies and procedures in conjunction with other relevant hospital policies. 

Fiscal Responsibilities: 

• Assists Director with development and maintenance of the departments’ annual operating budgets, ensuring that operations are managed within established guidelines.  Including plans and budgets for capital equipment expenditures. 

• Understands and assists Revenue Cycle Director in the maintenance and preparation of quarterly variance reports. 

Quality Assurance Responsibilities: 

• In conjunction with Director, assess, design, develop, implement and evaluate department quality management activities according to hospital / industry guidelines and in accordance with organizational objectives that result in the improvement of patient care or organizational processes.   

• Prepares quarterly reports on a timely basis using appropriate methods, including setting goals, measuring processes/outcomes, and analyzing results, implementing action for improvement and evaluating outcomes to determine if goals have been met.  Promotes quality management activities within own department.  

Information/Communication Responsibilities: 

• Holds staff meetings on a regular, routine basis. 

• Effectively conducts and participates in meetings, committees, task forces, etc. 

• Involves appropriate people in decision-making processes. 

• Uses multiple methods of communication effectively (verbal, e-mail, other written communication, etc.) 

Supervisor Leadership Skills & Abilities: 

• Promote flexibility and quality in cooperation with all departments of the hospital. 

• Pursues activities, which further professional growth and development, including seminars, reviewing professional publications, establishing personal networks, benchmarking state of the art practices and participating in professional societies. 

• Serves as a role model to staff.   

• Serves on Revenue Cycle Coordination committee. 

• Demonstrates independent judgment and critical thinking skills while also acknowledging when it is appropriate to seek guidance.  

• Develops departmental and individual performance goals in alignment with SMH strategic plan. 

• Meets hospital customer service standards and develops departmental customer service standards to enhance the level of customer service provided.  Fosters and models a commitment to customer service, builds customer confidence and increases customer satisfaction. 

• Complies with hospital and departmental policies, procedures, regulations and standards as related to job. 

• Demonstrates hospital’s stated mission and values of teamwork, respect and communication with co-workers, patients, families and visitors. 

• Actively and appropriately participates in problem-solving identification and resolution, both intra- and inter-departmentally. 

• Meets department customer service standards and strives to enhance the level of customer service provided.      

Qualifications: 

• Education  

Preferred:  Associates or Bachelor’s degree in business or related field.  

Required: High School Graduate  

• Work Experience 

Required: 3-5 years’ experience in a health care setting, preferably a hospital setting for patient registration or patient accounts area and a minimum of two years of supervisory experience.   

Required: Two years of supervisory experience. 

• Other Skills/Knowledge 

Required: Knowledge of third party billing practices and state and federal regulations regarding patient billing, customer service, communications, leadership, fine motor, typing, and computer skills. 

Required: Experience with an EHR system, extensive knowledge of registration tasks, including collections.