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
