MGR. Patient Access Insurance Referrals and Authorizations

General Description:

The Patient Access Manager is responsible for the daily operations of all functions and serves as the liaison between the Service Center and the facility. The Patient Access Manager integrates the department's services with the hospital's primary functions, develops/implements policies and procedures that guide or support service, assesses and improves department performance, and ensures orientation and continuing education of departmental staff. As the leader, this person may recommend resources/space needed by the department and may participate in the selection of outside services. Serves as a key promoter of the Service Center, which strives to meet and exceed the needs of its customers.

Essential Responsibilities: Responsibilities listed in this section are core to the position.  Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position. 

• Performs patient registration function when needed to ensure wait times are kept to a minimum.
• Ensures QA on registrations for all areas of Registration; maintains Quality Assurance (QA) statistics and reports.
• Provides continuous training for and communicates changes to existing employees.
• Prepares payroll and completes monthly work schedules as needed to ensure adequate staffing levels.
• Follows-up on patient complaints promptly.
• Implements and promotes excellent customer service.
• Works closely and professionally with outside agencies on special projects.
• Interviews, hires, evaluates, and counsels Patient Access staff members.
• Performs evaluations in a timely manner.
• Trains new employees in all aspects of their assigned job.
• Supervises and maintains the productivity of employees; effectively manages and directs all areas of registration to ensure quality, productivity, and customer service.
• Reviews the quality of patient registration documents daily.
• Works closely with fellow managers to ensure all procedures regarding patient accounts are completed in a thorough and timely manner.
• Completes monthly reports to the Director (HFMA, Collections etc.)
• Responsible for Dept Operations Report, Full Time Equivalent (FTE) and Operating budgets.
• Ensures all personnel policies are followed.
• Develops and maintains a Patient Access Policy and Procedure Manual.
• Maintains a clean MPI on Meditech and works closely with Medical Records on a daily basis.
• Monitors and maintains Daily Preservice Log, BILL45, and Alpha Census according to established Business Office standard.
• Acts in the capacity of Director in his/her absence.
• Contributes to A/R goals for patient registration.
• Conducts monthly staff meetings and in-services for all responsible areas.
• Works closely with Market Financial Coordinator for updates and testing for Meditech.
• Assumes on-call responsibilities to ensure adequate staff and problem solving.
• Updates collection system and requests rebill if appropriate.
• Works closely and professionally with Nursing and Ancillary Departments in an effort to maintain teamwork approach.
• Recommends sufficient number of qualified/competent staff.
• Determines staff qualifications and competence. Develops and maintains accurate initial and annual competency checklists, and initiates completion of initial and annual competency attestation forms.
• Actively seeks ways to control costs without compromising patient safety, quality of care of the services delivered.
• Attends in-service presentations, and completes mandatory education week including, but not limited to, infection control, patient safety, quality improvements, MSDS and OSHA Standards.
• Demonstrates knowledge of occurrence reporting system and utilizes system to report potential patient safety issues.
• Leads, develops, coaches, and effectively manages the team to ensure deliverables and performance metrics are met.  Develops team to accomplish results through training, development, performance management and recognition.

General Responsibilities:

• Performs other duties as assigned.

Minimum Qualifications:

Education: Bachelor's Degree required.

Experience:  3 to 5 years of progressive leadership experience required with at least 1 year experience in Patient Access.

Licensure/Certifications/Registrations Required: None required.

Knowledge, Skills and Abilities:

• Organization - proactively prioritizes needs and effectively manages resources.
• Communication - communicates clearly and concisely.
• Leadership - guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services.
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
• Tactical execution - oversees the development, deployment and direction of complex programs and processes.
• Policies & Procedures - articulates knowledge and understanding of organizational policies, procedures and systems.
• PC skills - demonstrates proficiency in Microsoft Office applications and others as required.
• Financial management - applies tools and processes to successfully manage to budget.