PATIENT ACCESS MANAGER - A NOMC ADMISSIONS
Status: Full Time
Shift: Varies as needed
Exempt: Yes
Summary:
Under the supervision of the Patient Access Director, the PA Manager oversees and is responsible for the overall planning, organizing, implementing and day to day operations of Patient Access, Scheduling, Insurance Verification/Authorization, Financial Clearance, and Pre-Service collections. Provide support to maintain a positive and pleasant working environment for staff.Ensure that the above staff provides efficient services that will promote positive customer experiences.
Other information:
Experience, Knowledge and Skill:
1. Previous Experience Required:
At least two years of supervisor/management experience required. Excellent written and verbal skills and an outgoing personality are preferred.Public speaking and presentation skills and strong customer service background required. Previous experience in financial planning and accountability preferred. Previous experience with Joint Commission surveys preferred.
2.Specialized or Technical Education Required:
Effective August 1, 2018, Bachelor’s Degree in health care/business related field required.A minimum of 2 years of healthcare experience for every year of required education may be substituted for degree.Working knowledge of revenue cycle functions/patient access required.Analytical skills are necessary for problem solving. Intermediate or higher computer skills required.Must be able to promote positive public relations with Administration, patients, co-workers, and any other persons entering the Patient Access/Admissions areas. Must have good visual acuity to determine quality of work.Must have ability to promote confidence, respect and support from hospital administration, co-workers, patients and all others with whom one may come in contact. Certified in Healthcare Access Management (CHAM) by the National Association of Healthcare Access Management preferred.
PHYSICAL EFFORT REQUIRED:
Strength:Light
Push:Occasionally
Pull:Occasionally
Carry:Occasionally
Lift:Occasionally
Sit:Frequently
Responsibilities:
Provides comprehensive oversight in the day-to-day operations of all aspects of Patient Access at all locations assigned, including, but not limited to the management of Patient Access Associates, Patient Access Assistants, Clinical Order Analyst, and Patient Access Analyst as directed by the Patient Access Director, including but not limited to rotating call for nights, weekends, and holidays.
Patient Access Manager is responsible for the oversight of scheduling, insurance verification, and registration of all NOMC patients excluding scheduling for surgery patients.
Provides decision-making for patient flow / access areas and personnel and involves chain of command, when needed.
Personnel / Staffing: Provides direct personnel supervision inclusive of, but not limited to the following: personnel staffing and coverage, staff workflow, personnel time off, competency, auditing the quality of work performed, licensure standards, time and attendance processes, position placement and training.
Ensures the financial integrity of North Oaks by
• Obtaining prices for outpatient services and consults with Patient Financial Services for prices on Surgeries, Heart Catheterization and other high dollar procedures.
• Communicates price quotes to patients as needed.
• Monitors up front collections for departments with Director and provides reports on collections to leadership as indicated.
• Holds staff accountable for following policies and procedures including those for cash collections, posting and deposits.
• Ensures deposits are made timely.
Provides back-up support to Patient Access as indicated by patient census, scheduledprograms / services and personnel availability.
Actively works Epic work queues to expedite patient billing.
Provides oversight of departmental staff and processes and recommends changes as needed on a daily basis including reducing staff, increasing staff or sending cross trained staff to an area of need and manages staff based on fluctuations in the workload.
Maintains knowledge on all payer rules and regulations, EMTALA, Epic updates, Medical Necessity, Advance Beneficiary Notices, Medicare Secondary Payer Questionnaire, ICD 9/10, CPT codes and all other rules, regulations and processes that impact patient access.
Utilizes advanced knowledge of the Revenue Cycle and Patient Access functions and processes to assist staff with complex and/or unusual situations or issues.
Monitors and advises Patient Access Director /Chief Financial Officer regarding follow up on all patient inquiries / complaints, and reports all issues and resolution to the Patient Access Director.
Other Duties
Provides comprehensive oversight in the day-to-day operations of all aspects of Patient Access. A Patient Access Manager may be assigned the responsibility for all Patient Access functions at any NOMC location. They may be responsible for the Patient Access Associates located at all NOMC locations as assigned. A Patient Access Manager may be assigned to assist with training and monitoring staff in other departments who perform registration functions but they do not report directly to Patient Access. A Patient Access Manager may be assigned to Centralized Scheduling (excluding Surgery and Heart lab) for all NOMC procedures. The Patient Access Manager may be responsible for insurance verification and verification of authorization for all procedures at any NOMC location. The Patient Access Manager may be responsible for the Patient Access Associates located at any NOMC location. A Patient Access Manager may be assigned to oversee all PA Associates and registration functions in the Emergency Department.A PA Manager Provides decision-making for patient flow / access areas and personnel and involves chain of command, when needed. Personnel / Staffing: Provides direct personnel supervision inclusive of, but not limited to the following: personnel staffing and coverage, staff workflow, personnel time off, competency, auditing the quality of work performed, licensure standards, time and attendance processes, position placement and training. Assist Patient Access Director and Patient Access Trainer in developing and maintaining training programs to cross train Patient Access Associates to all areas within Patient Access. Oversees/Manages departmental staff and processes and recommends changes as needed on a daily basis including reducing staff, increasing staff or sending cross trained staff to an area of need. Oversees/Manages staff based on fluctuations in the workload. Assists Patient Access Director with recommending alternative methods of providing services to reduce departmental operating costs. Provides leadership to maximize the effectiveness of the work performed daily. Articulates department as part of the Revenue Cycle Team. Coordinates department activities with the revenue cycle departments to ensure appropriate flow of accounts. Ensures the financial integrity of North Oaks by obtaining prices for outpatient services and consults with Patient Financial Services for prices on Surgeries, Heart Catheterization and other high dollar procedures. Communicates price quotes to patients as needed. Monitors up front collections for departments with Director and provides reports on collections to leadership as indicated. Holds staff accountable for following policies and procedures including those for cash collections, posting and deposits. Ensures deposits are made timely. Includes staff in decision making for formulating department policy. Plans and strategizes with other members of the team to resolve revenue cycle problems. Provides assistance to the Patient Access Director in the following competency and compliance areas: Joint Commission Compliance, Patient Safety, Personnel Annual Competency and Continuing Education, HIPAA, Legal Compliance, Epic workflow and others as directed by North Oaks Health System administration. Provide back-up support to Patient Access as indicated by patient census, scheduled programs / services and personnel availability. Actively works Epic work queues daily to expedite patient billing.Assist the Patient Access Director in providing timely and accurate dashboard to the Chief Financial Officer as needed. Assists in the development and delivery of well-positioned products and services within the operational objectives of the Patient Access areas. With the assistance of front line staff, provides and implements ideas for improvement as it relates to Patient Access operations and measures ongoing effectiveness. Assist the Patient Access Director in all areas related to compliance, including review of appropriate bulletins and education of staff. Maintains knowledge on all payer rules and regulations, EMTALA, Epic updates, Medical Necessity, Advance Beneficiary Notices, Medicare Secondary Payer Questionnaire, ICD 9/10, CPT codes and all other rules, regulations and processes that impact patient access. Monitors inventory and supply requisitions. Orders and maintains supply inventory for department within budget. Monitors and advises Patient Access Director /CFO regarding follow up on all patient inquiries / complaints. Reports all issues and resolution to the Patient Access Director. Processes Patient Survey responses as indicated. Responds to all patient complaints within set time limits. Assists the Patient Access Director, as requested, in areas of physician support and special requests as it relates to Patient Access. Attends to and maintains established hospital and department policy and meetings. Consistently participate in hospital and community programs, committees and related functions. Maintain professional affiliations and consistently strive to enhance professional growth and development. Follow North Oaks Health System Legal Compliance Program and federal and state regulatory guidelines. Perform all other duties as required or directed by Departmental Administration. Utilizes advanced knowledge of the Revenue Cycle and Patient Access functions and processes to assist staff with complex and/or unusual situations or issues. Serves as lead for specified projects and/or technical initiatives, to increase productivity, efficiency and effectiveness. Makes recommendations to Director for initiatives, based on knowledge and research of best practices for area. Performs timely coaching of staff and performance reviews.