Manager-Patient Access Operations-8110

Staff Position Description

Position Title: Manager of Patient Access Operations Position Code: MgrPAOM-8110

Department: Patient Access Safety Sensitive: Yes

Reports to: Director of Patient Access Services Exempt Status: Yes 

 

Position Purpose:

All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision to be among the kindest, highest quality health systems in the country.

Key Responsibilities [List of material responsibilities and essentials duties which must be completed in achieving the objectives of the position]

Quality Improvement

· Possesses knowledge of various types of insurance plans (PPO, POS, HMO, Medicare, and Medicaid.) and other payors.

· Possesses basic understanding of medical terminology.

· Plans, organizes, coordinates, implements, and controls the systems by which patients are registered for services and demographic, clinical, and billing information is developed and maintained.

· Ensures patient interactions are done courteously and efficiently so that patients may arrive at their point of service as quickly as possible.

· Ensures the design of these systems always provides for timely, courteous, and accurate behavior of staff at all times.

· Monitors and evaluates the quality of the department and other de-centralized departments and takes appropriate action based on the findings.

· Engages with leadership and Human Resources (HR) on all employee management and human relations issues.

· Provides excellent customer service and adheres to Behavioral Expectations Agreement.

· Develops and revises position descriptions for all department positions.

· Responsible for interviewing, selecting, and hiring new or replacement staff to fill approved positions.

· Deals effectively, courteously, and professionally with reporting staff, peers, and superiors, as well as with patients and visitors.

· Maintains compliance with EMTALA, DNV, HIPAA, CMS and all other hospital and government regulations applicable to admissions operations.

· Effectively utilizes positive reinforcement to motivate staff and instill confidence.

· Effectively utilizes employee improvement and corrective action methods, when necessary.

· Schedules work hours and assignments for employees to meet the needs of the department’s customers.

· Administers hospital and department policies and procedures.

· Provides input to HR concerning pay scales, pay structures, to enable appropriate recruitment and retention of departmental staff.

· Responsible for coaching, delivering corrective action, and addressing employee complaints and grievances.

· Completes employee performance evaluation and personnel action requests in a timely manner.

· Provides opportunities for self and staff development through orientation, in-service, education, and needed training.

· Maintains professional qualifications and remains abreast of current developments and trends in Admissions and Scheduling.

· Holds regular staff meetings to provide communication, direction, and education.

Leadership

· Effectively delegates duties, responsibilities, and special assignments.

· Plans to meet the needs of the department’s customers.

· Communicates effectively with other hospital departments and services.

· Participates in the hospital’s committees and meetings as requested or needed.

· Assesses current volumes, and projects/plans for future service needs.

· Establishes operational goals and objectives and evaluates achievements at least annually.

· Must be available to work hours and days as needed based on departmental/system demands.

· Must be “on-call” as needed.

Financial Performance

· Ensures admission, transfer, discharge, and registration functions are performed effectively and efficiently throughout the facility.

· Ensures patient information is gathered correctly and completely to ensure timely and accurate billing.

· Randomly audits registrations and cash receipts and deposits using sampling techniques to ensure accuracy.

· Coaches employees for improvement, where necessary, based on predetermined parameters.

· Ensures that insurance authorizations are obtained as required and that financial counseling is effective during the admissions process allowing representatives to collect co-pays, set payment arrangements and/or offer financial assistance as needed.

Operations

· Develops and implements policies and procedures for the department and other de-centralized registration areas.

· Helps plan and control the department’s financial budget.

· Prepares policies and procedures for approval.

· Evaluates departmental performance according to current industry principles to maintain and improve the level of care and results of the patient.

· Oversees and supervises all aspects of patient billing.

· Establishes, maintains, and reviews quality control.

· Responsible for adding necessary and appropriate new services for overall good billing practices.

· Manages departmental safety and sanitation standards.

· Ensures safe and sanitary conditions.

· Provides supervision of the department’s preventative maintenance program and works with the appropriate hospital personnel to ensure that equipment is safe, operable and meets regulatory standards.

· Maintains knowledge of and compliance with regulating/accrediting agency requirements.

· Works “front line” duties when necessary.

· Maintains departmental records for all area of responsibility.

· Performs other duties as assigned by the Director of Patient Access Services or higher supervision.

· Documents system issues while assisting in the development of systems improvements.

· Plans, coordinates, and prepares reports as they relate to Revenue Cycle Management

· Anticipate scheduling needs while maintaining adequate staffing for efficient operations.

Qualifications [Statements regarding minimum educational and experience qualifications, required proficiencies with specialized knowledge, computer proficiencies, military service, required certifications, etc.]

Education: Associates degree in Business and/or Health related field, or 2 years equivalent relevant work experience training.

Certification: BLS certification through the American Heart Association or American Red Cross

Licensure: Valid Arizona Driver’s License

Experience:

· Minimum of five (5) years patient access registration and insurance verification experience in a health care setting

· Experience in healthcare customer service

· Minimum of (3) years supervisory experience in health care setting, however, demonstrated indirect leadership experience may be considered in lieu of this requirement provided it is a direct fit to the role, lead role, project management, or other leadership experiences

· Practical experience with electronic health information systems including configuration, implementation, support, and optimization in an ambulatory and acute hospital setting

· Demonstrated experience in strategic planning, organization design and development

Skills and Knowledge:

· Knowledge of healthcare revenue cycle

· Familiar with information systems, knowledge of third-party payment methodologies, ICD, and CPT coding.

· Ability to demonstrate knowledge of medical terminology and financial counseling

· Position requires fluency in English, both written and oral communication skills

· Working knowledge with MS Office (MS Word, Excel, PowerPoint, and Outlook)

Preferences [Preferred attributes for the position which are not absolutely required in the minimum qualifications (i.e., multi-lingual, master’s degree)]

Education: Bachelor’s degree in healthcare administration or related field

Special Position Requirements [Optional section: any travel, security, risk, hazard or related special conditions which apply to the position]

Exposure Category: Category III: Expected duties do not have potential for exposure to blood, body fluids, or tissues.

Other Potential Hazard(s): Possible exposure to chemical substances

Work Requirements [Optional section: work requirements for physical or other important issues which relate to the job]

· Ability to sit for six to seven hours daily at a computer terminal

· Must be able to deal calmly and effectively with frustrated and/or angry clients

Date Staff Position Description Created / Revised: 12/19/2022