Patient Access Manager - FT - Days
Under direction of Director, Manager will coordinate and manage the daily activities of the Insurance Verification processes and the Pre Registration processes; ensures the timely completion of insurance verification and collections to prevent patient delay and denials. This position requires being familiar with Medicare, Medicaid, commercial, workers compensation, and liability third party payers authorization and verification processes. Understanding of up front collection process to ensure all guidelines are adhered to.
- High school diploma/GED is required
- Understand insurance benefits and medical terminology
- Previous supervisory experience (3 yrs) in Patient Accounting , Business Office preferred
- Ten years (10 yrs.) healthcare experience required,
- Hospital experience, preferred
- Healthcare certification, preferred
- Excellent customer service skills
- Microsoft office suite computer skills required, Excel knowledge preferred
- Good written and verbal communication skills, required
- Ability to read, write and speak English required
- Ability to communicate clearly and concisely with all levels of management
- Bilingual - English/Spanish
- Communicates clearly and concisely and is able to work effectively with other employees, patients and external parties
- Demonstrates proficiency in Microsoft Office applications, be able to type at least 35 WPM, and good working knowledge of Excel is required.
- Medical Terminology, ICD-9 Codes, CPT Codes, HCPCS code, Modifier knowledge preferred.
- Able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly and spell correctly.
- Requires reasoning ability, good independent judgment and organizational skills.
- Requires working with frequent interruptions.
- Must project a professional image.
- Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices
- Demonstrates high quality Service Excellence, positive customer service and telephone etiquette by treating all customers with dignity and respect; utilizing age specific skills and knowledge.
- Ensures patient confidentiality requirements are met in accordance with HIPAA policies and procedures
- Manages and coordinates the daily activity of the Insurance verifiers and Pre Registration staff either directly or through subordinate supervisors and/or lead personnel.
- Monitors and ensures that productivity reports are completed at 95% or greater at the end of the week
- Performs and maintains QA on for all areas. Includes trending and analysis of the data, as well as the development and implementation of action plan for education.
- Review Aeos dashboard and reports on volume of accounts pending tasks or departmental review for employee accountability and increase workflow.
- Review the Inpatient –Outpatient Procedure report and coordinates with Case Management for assistance
- Monitors and reports on the unbilled report weekly
- Monitors and reports on the Inpatient High dollar report weekly
- Monitors and reports during the denials committee findings and actions of denials by department
- Meets with Director regularly to effectively communicate and resolve issues, set and prioritize goals and improve processes.
- Works closely with peers to ensure all procedures regarding patient’s accounts are completed in a thorough and timely manner.
- Develops and recommends long and short range goals and specific actions to maximize results in the department.
- Cooperates and assists staff to foster productive teamwork.
- Hires, trains, evaluates and participates in disciplinary actions and grievance responses to staff
- Manages all employees with equal standards, efficiently and professionally.
- Responsible for payroll activities for staff. (Timecards, PTO requests, etc.,)
- Responsible for the orientation of new employees.
- Coaches and counsels staff as necessary provides written documentation of coaching and/or counseling sessions as appropriate.
- Recommends termination of employees as necessary. Maintains appropriate documentation to support such recommendations.
- Performs employee's performance evaluations in a timely manner.
- Ensures all personnel policies are followed.
- Recommends changes in department policies and procedures to the Director.
- Leads in a way that motivates employees.
- Provides employees with guidance and supervision, but gives them sufficient opportunity to carry out their assignments and make decisions.
- Creates an atmosphere conducive to employee development by personal example and by encouraging and praising initiative, imagination and resourcefulness.
- Accurately performs basic mathematical calculations, balance and reconcile figures, punctuate properly and spell correctly.
- Document clearly and concisely all patient benefit information on accounts through the patient accounting system (Pre-cert screen, account notes section of Paragon and ORM schedule).
- Demonstrates proficiency of personal computers and Microsoft Office applications and other software as required.
- Has appropriate follow up and contact with physician office if necessary.
- Other duties as assigned.
LINES OF REPSONSIBILITES:
Supervisor, Manager, Director.