Manager, Patient Access

Osf Saint Francis Medical Center   •  

Rockford, IL

5 - 7 years

Posted 236 days ago

This job is no longer available.

Managers are primarily responsible for and must demonstrate knowledge and expertise in one of the below Revenue Cycle areas of focus.   However, Revenue Cycle Managers are expected to have general knowledge in all areas of focus. Managers are responsible for assisting with the overall departmental planning, trend analysis and evaluation of the department’s performance and providing regular performance updates to the Patient Access Services Director and are responsible for supervising assigned Patient Access Services staff. 

 

These positions will report to the Patient Access Services Director and are responsible for the administration and management of all personnel and functions of scheduling, pre-registration, outpatient registration, emergency room registration, inpatient and same day admissions, discharge, financial clearance (insurance eligibility, benefits verification, authorization/referral management, payor notification, pre-service/point of service cash collections) and financial counseling functions.  

Primary responsibilities include ensuring the collection of comprehensive and accurate demographic and financial data to optimize timely billing and collection of accounts receivable, supervising and monitoring personnel daily, communicating regularly with staff and supervisor to keep abreast of issues and to provide evaluations/feedback, carrying out organizational policies and procedures, recruiting/retaining/training staff, and establishing unit goals and objectives.

 

 

Hub Manager Focus:

  • (Scheduled only) Pre-Registration: Collecting full and complete demographic and financial dataset from the patient or responsible party for entry into the computer system.
  • Financial Clearance: Completing all necessary functions to expedite patient processing and reduce the financial risk to the organization by performing:
  • Insurance Verification: Validating active insurance coverage
  • Benefits Verification: Confirming benefits for services including exact coverage, effective date of the policy, coverage limitations / requirements, and patient liabilities
  • Authorization / Pre-certification: Gaining payor authorization / certifications for a patient
  • Referral Management: Securing a referral from the Primary Care Physician (PCP)
  • Payor Notification: Notifying the payor of an inpatient admission or discharge
  • (Scheduled only) Pre-service Cash Collections: Collecting patient payment obligations prior to time of check-in
  • Manual cash posting: Posting of cash amounts to host system, including balancing of cash drawers, and ensuring accurate posting to the general ledgers
  • Cash Reconciliation: Reconciliation of cash between patient accounting system and transaction records
  • Spoke Manager Focus:
  • Scheduling: Scheduling patient appointments appropriately as required.  Enters orders into the electronic medical record ensuring that data is complete and accurate. Maintaining scheduling templates, including holiday schedules, as required.
  • Registration / ED Registration: Collection of full and complete demographic and financial dataset from the patient or responsible party for entry into the computer system. This event occurs at the time of service (for walk-ins, ED, etc.)
  • Financial Clearance: Completing all necessary functions to expedite patient processing and reduce the financial risk to the organization by performing:
  • Insurance Verification: Validating active insurance coverage
  • Benefits Verification: Confirming benefits for services including exact coverage, effective date of the policy, coverage limitations / requirements, and patient liabilities
  • Authorization / Pre-certification: Gaining payor authorization / certifications for a patient
  • Referral Management: Securing a referral from the Primary Care Physician (PCP)
  • Payor Notification: Notifying the payor of an inpatient admission or discharge
  • Financial Counseling: Working with patients who have, or potentially have high liabilities, and assisting them with identifying possible alternate funding sources, arranging acceptable payment plans, or screening them for sponsorship assistance
  • Point of Service Cash Collections: Collection of patient payment obligations at time of check-in
  • Manual cash posting: Posting of cash amounts to host system, including balancing of cash drawers, and ensuring accurate posting to the general ledgers
  • Cash Reconciliation: Reconciliation of cash between patient accounting system and transaction records

Qualifications

 

REQUIRED QUALIFICATIONS:

  • Five years of progressively more responsible health care management experience.   

  • Working knowledge of the principles and fundamentals related to budgeting, accounting, record keeping and business writing, as well as knowledge of general administrative procedures such as payroll, vendor management, purchasing, are required.

  • Requires strong knowledge of scheduling, registration, financial clearance and financial counseling processes with particular focus on payor financial requirements.

  • Requires knowledge of hospital operations and patient flow so as to be able to identify and analyze potential sources of error or patient dissatisfaction.

  • Requires knowledge of healthcare accounts receivable management concepts, including in-depth knowledge of the state and federal reimbursement and regulatory environment so as to ensure compliance with State and federal regulations regarding patient and insurance billing issues.

  • Requires up-to-date knowledge and understanding of Federal compliance and OIG initiatives that impact the healthcare industry.

  • Requires understanding of current and future trends/practice in Patient Access Services.

    Requires knowledge of information systems and software used in Patient Access Services, and of equipment used in performing assigned duties.

  • Requires basic knowledge of medical terminology.

  • Requires excellent customer service skills, interpersonal ability and demonstrated leadership skills to regularly interact with Administration, medical staff, nursing personnel, all other hospital professionals, and external health care professionals.

  • Requires analytical ability to complete high-level problem-solving, develop and provide direction in the implementation of short and long-term departmental goals; provide administrative direction to personnel in the resolution of problems or difficult tasks.

  • Must possess supervisory skills for accepting responsibility, making decisions, directing, delegating and supervising personnel.

  • Excellent communication and organizational skills required. 

  • Must possess ability to investigate, analyze and resolve departmental issues. 

  • Must possess ability to work efficiently and accurately, and to organize and plan work. 

  • Requires process improvement skills and the ability to develop and execute a plan of action.    

     

PREFERRED QUALIFICATIONS:

  • Bachelor's Degree (BA or BS) or Associates Degree with emphasis in Business or Health Administration is preferred.

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