Director, Patient Access

Job Summary

Essential Functions

• All team members are expected to be knowledgeable and compliant with Prisma Health's purpose:  Inspire health.  Serve with compassion.  Be the difference.

• Develops and maintains an effective, visible and well-respected team by selecting, evaluating, coaching and managing the performance of qualified professionals. Tracks staffing levels and collaborates with department managers for cross training and support as needed.

• Performs random audits to ensure compliance with regulatory requirements, AIDET guidelines are upheld in all patient interactions and staff are adhering to patient experience expectations. Monitors the effectiveness of policies and procedures and makes recommendations to improve functions of the Revenue Cycle when needed.

• Oversees the central Patient Access Insurance Verification and Authorization teams.

• Oversees the teams responsible for the day-to-day registration operations, including Pre-Registration, POS registration, eCheck-in and Notice of Admission across the organization. Responsible for ensuring optimal registration workflows as well as optimal workflows for working claim edits and registration edit work queues.

• Oversees the central Financial Assistance team. Responsible for updating and maintaining the Financial Assistance Policy and patient application process. Collaborates with Access Health and other charity programs to ensure a consistent and efficient financial assistance program for patients across the organization.

• Oversees the teams responsible for patient estimates, pre-service collections and upholding NSA Estimate compliance across the organization. Responsible for ensuring quality estimates are being generated and maintaining optimal estimate work queue workflows.

• Assists in the preparation of the annual department operating budget and establishment of departmental goals. Ensures that department is operating within the fiscal constraints of the budget once established.

• Manages the relationship with Medicaid Eligibility vendors. Collaborates with ITS and the vendors to ensure the proper build is in place and performance expectations are consistently met.

• Analyzes payer denials and effectively leads the Prisma Health Denial Prevention program.

• Consults with and assists the IS department in implementing all Patient Access functions on Epic and any other appropriate systems. Collaborates and partners with the Organizational Development team on front-end operational workflows for front-end user training.

• Performs other duties as assigned.

Supervisory/Management Responsibilities

• Job has direct and/or indirect supervision of team members that may include final budget authority, hire/termination authority, performance appraisal responsibility and disciplinary authority. Job will be considered a member of management staff at Prisma Health or affiliate and will have direct reports.

Minimum Requirements

• Education - Bachelor's degree in Business Administration, Healthcare Administration, Accounting or related field of study.

• Experience - Five (5) years of experience with patient Access Services in Hospital or Practice Setting. Three (3) years management experience.

In Lieu Of

• In lieu of the education and experience requirements noted above, the following combination of education, training and/or experience may be considered an equivalent substitution: equivalent education and/ or experience as deemed appropriate by the Vice President, Revenue Cycle in collaboration and consultation with Human Resources and the Executive Director, Revenue Cycle. Ten years of relevant experience my substitute for a bachelor's degree.

Required Certifications, Registrations, Licenses

• NA

Knowledge, Skills and Abilities

• Knowledge of office equipment

• Computer skills (word processing, spreadsheets, database)

Work Shift

Location

Facility

Department