Patient Access Manager

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Shift

POSITION PURPOSE :

Provides oversight and direction of the daily operations in the Patient Access Department. This includes being accountable for the Registration, Pre-Certification, Central Scheduling, the Information Center/Switchboard and Financial Counseling. These daily operations include but are not limited to hiring, firing, scheduling, budgeting, evaluating staff, data management, planning, training and project implementation. Analyzes and reports critical measures. Being able to work directly with the medical staff, nursing and clinical and non-clinical personnel is critical to this position.

ESSENTIAL FUNCTIONS :

• Provides leadership and direction to the patient access staff on a day-to-day basis to facilitate a team atmosphere and efficient operations. Motivates staff to meet department goals.
• Responsible for evaluating, providing counseling and discipline to, and hiring/firing decisions for the patient access staff.
• Responsible for the planning and management of the patient access budget.
• Keep abreast of all scheduling, preadmission, admitting, concurrent review and reimbursement billing procedures of third party and private insurance payers. Continually review the status quo and environmental conditions in order to proactively meet new change and demands.
• Suggests and implements procedures to reduce costs, improve efficiency and increase/improve our range of service. Reviews and measures operations, output, services, and staff performance to determine the extent to which plans, goals and objectives are being achieved. Reports department measures on a monthly basis to the Director.
• Incorporates operating systems and feedback loops to ensure that operations are accurate and thorough. Resolves operational issues in a manner so that problems are not recurring. Adjusts to changing environment in order to keep operations running smoothly.
• Maintains and improves patient/customer relations through new programs and refinement in current methodology. Responds to patient and/or physician complaints. Understands and meets the needs of the customer. Always taking into consideration the customer’s feedback, which would indicate customer satisfaction.
• Builds and maintains the team unity relative to all Patient Access and Patient Accounting. Establishes and communicates clear objectives and priorities; programs and schedules workload to meet target deadlines; assigns and delegates responsibilities to facilitate goal accomplishment. Provides backup, support, and understanding required to establish team unity.
• Be a liaison between the staff and the ancillary departments, nursing units and physicians communicating the customers’ needs and seeing that they are met.
• Manage Medical Necessity/LMRP functions on the front end by verifying its contents, educating the staff and ensuring compliance of its usage. Communicates with HID and Patient Accounts in regards to any changes or updates.
• Maintain an effective financial counseling service for patients. This service should educate patients regarding financial responsibilities as well as options available for account resolution including the CGH Charity Care program and other governmental and non-governmental agencies.

SPECIALIZED KNOW-HOW & REQUIREMENTS:

• Bachelor’s degree in Business or Healthcare or a Registered Nurse preferred. Minimum educational requirement of an Associate's Degree.
• CHAM (Certified Healthcare Access Manager) preferred.
• HIM certification (Certified Coding Specialist or Certified Coding Specialist-Physician) preferred.
• Two years of supervisory experience in Central Scheduling, Registration, or Patient Access preferred.
• Knowledge and understanding of current Medicare regulations applicable to each of these areas strongly preferred.
• In depth knowledge of medical necessity, ABN’s, pre-authorization, insurance verification and up front collections preferred.

Thank you for your interest in a career at CGH Medical Center.