Patient Access Manager (Full Time)

Summary/Objective:

The Patient Access Manager is responsible for the day-to-day operation of Admissions Center;

emergency room admissions and outpatient admissions.

Required Education And Experience:

• High School diploma or GED.
• Two to three years experience in a medical office or hospital admissions
• Knowledge of insurance processing
• Must be efficient with keyboarding and computer applications.
  
  

Preferred:

• Three to five years experience in a medical office or hospital admissions
• Experience with hospital information systems and hospital insurance applications (TruBridge)
  
  

Essential Functions:

Reasonable accommodations may be made to enable individuals with disabilities to perform

the essential function.

• Plan, develop, organize, implement, evaluate, and direct the Patient Access department, as well as its programs and activities, in accordance with current rules, regulations, and guidelines that conform to current standards of admission practice and operational policies while maintaining compliance with state and federal laws and regulations.
• Develop, maintain, and periodically update written policies and procedures for the day-today function of the patient access department.
• Communicates and interprets policies and procedures to patient access staff, and monitors staff practices and implementation.
• Evaluates the work performance for all patient access personnel and implements discipline according to policies and procedures.
• Ensures delivery of quality care and patient access supervision as evidenced by adequate services and staff coverage for department.
• Coordinates patient access services with all departments, as necessary.
• Oversees patient access schedules to ensure they meet patient needs and regulatory and budgetary standards.
• Participates in the recruitment and selection of patient access personnel and ensures sufficient staffs are hired.
• Oversees and supervises development and delivery of in-service education to equip patient access staff with sufficient knowledge and skills to provide quality care for patients.
• Proactively develops positive employee relations; promotes teamwork, mutual respect, and effective communications.
• Monitors staff for compliance with facility policies on workplace safety.
• Coordinates and/or develops on-going quality assurance activities for patient access services to monitor compliance with standards and regulatory requirements. Compiles summary of findings for the Quality Assurance committee.
• Participates in budget development for the patient access department.
• Helps prepare staff for inspection surveys, instructing staff on matters of conduct and disclosure, being interviewed by inspectors, immediate corrections of problems noted by surveyors. Reviews and reinforces important standards previously cited.
• Promotes customer service and responds to and adequately resolves complaints or concerns from patients or families about patient access services.
• Promotes compliance with accident prevention procedures, safety rules, and safe work practices to prevent employee injury and illness and control workers’ compensation costs.
• Assures staff is trained in fire and disaster and other emergency procedures and evaluates performance during drills.
• Ensures compliance with all hospital rules and regulations in accordance with set policies and procedures.
• Oversees the work of the admissions team and ensures all representatives are provided with adequate training and resources needed.
• Ensures department compliance with EMTALA, HIPAA, and Red Flag Rules.
• Develops and reviews admission productivity reports and ensures that appropriate action is taken to ensure productivity models are met.
• Ensures complete and accurate registration of all patients.
• Provides backup coverage and cross training for pre-certification coordinator position.
• Ensures timely pre-certification is obtained for hospital admissions, outpatient, surgery, and diagnostic imaging tests as required.
• Sorts, assembles, and posts all patient charges and/or ensures that this is delegated to properly trained staff. Ensures this task is completed accurately and timely.
• Coordinates with supervisor to ensure cross-over functions between admissions and patient accounts flows smoothly.
• Works admissions shifts as needed to ensure department coverage:
• Interviews incoming patient or representative and enters information required for
  
  

admission into health information system.

• Obtains required signatures from patient and/or representative for consent of care
  
  

and any other required documents per hospital policy and protocols. Documents

how consent was obtained or not obtained from responsible parties.

• Enters, records, stores, and maintains information in written and electronic form.
• Interviews patient or representative to obtain and record individual and/or company
  
  

insurance responsible for payment of bill.

• Explains hospital regulations, such as visiting hours and payment of accounts.
• Provide a smooth flow of patients through the admitting area/ER, directing or
  
  

escorting patients as necessary to the appropriate department.

• Understand the functional status and physical needs of patients, staff, and visitors to
  
  

the hospital and assists in those needs.

• Maintain a working knowledge of community services and resources available to all
  
  

patients. Refer patients as necessary to the appropriate agency or department.

• Records all emergency room patients seen on the electronic ER log related to each
  
  

account.

• Accepts payments and issues receipts, collects co-payments and deductibles, and
  
  

reconciles petty cash drawer at the end of each shift.

• Processes telephone communications in an efficient and courteous manner for
  
  

patients, physician, general public, and hospital staff.

• Pages for medical staff, disaster and emergency codes as required by policy. Pages
  
  

should be done in a clear, distinct, and audible voice.

• Run a daily registration quality report before the end of each shift to check the
  
  

accuracy of registrations and make corrections as necessary.

• Controls visitor access to hospital after hours, clears any afterhours visitors with
  
  

Charge Nurse, and issues visitor pass as appropriate.

• Fosters high levels of customer service and releases only appropriate patient
  
  

information while ensuring HIPAA compliance is followed. Refers all other medical

information releases to HIM for processing.

• Ensures all patient information is safeguarded and kept confidential according to
  
  

prescribed policies and procedures.

• Analyze information and evaluate results to choose the best solutions available and
  
  

solve problems as they arise.

• Develop constructive and cooperative working relationships with others; ensure flow
  
  

of communication within department.

• Participates in a wide variety of special projects and compile a variety of special reports.
  
  

Competencies:

• Financial Management
• Ethical Conduct
• Leadership
• Technical Capacity
• Customer/Patient Focus
• Teamwork Orientation
  
  

Supervisory Responsibility:

This position manages all employees of the patient access department and is responsible for:

interviewing, hiring, and training employees, planning, assigning, and directing work; appraising

performance, rewarding and disciplining employees; addressing complaints and resolving

problems.

Work Environment:

This job operates in a professional office environment. This role routinely uses standard office

equipment such as computers, phones, copiers, filing cabinets, and fax machines.

Physical Demands:

The physical demands described here are representative of those that must be met by an

employee to successfully preform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk or hear. This

is largely a sedentary role; however, some filing is required. This would require the ability to lift

files, open filing cabinets, and bend or stand as necessary.

Position Type/Expected Hours Of Work:

This is a full time, exempt position. Days and hours of work are Monday through Friday; hours are

flexible based on the job duties demand. Evening and weekend work may be required based on

the needs of the position/job duties.

Travel:

This position may require some travel.

Required Education And Experience:

• High School diploma or GED.
• Two to three years experience in a medical office or hospital admissions
• Knowledge of insurance processing
• Must be efficient with keyboarding and computer applications.