Job Summary
Manager level position to ensure patients have access to hospital services. Works to align multiple departments towards Patient Access strategic priorities, solves complex operational issues, and works closely with other leadership as needed to maintain compliance in the operational standards of Revenue Cycle. Oversees Patient Financial Services, Hospital Scheduling, Pre-Services, Insurance Verification/Authorizations, Admitting/Registration, Hospital Operators and other related functions. Accountable for cost effective financial performance of all resources and training/development of staff. Directly responsible for day-to-day operations to include: planning, organizing, and directing of multiple Patient Access functional areas while providing amazing customer service to our patients.
Essential Functions
Leadership
- Provides leadership and administrative direction to all areas of Patient Access within the main hospital.
- Collaborates with executives, directors and managers to identify and solve departmental issues.
- Analyzes trends impacting overall Revenue Cycle, takes appropriate action to realign staff, and determine appropriate plans of action.
- Oversees Patient Financial Services, Hospital Scheduling, Pre-Services, Insurance Verification/Authorizations, Admitting/Registration, Hospital Operators and other related functions.
- Creates and maintains relationships with referring providers, both internal and external, and identifies/takes action on increasing referral flow.
- Conducts and documents regular staff meetings
- Demonstrate a positive demeanor and professionalism in both appearance and approach while having a strong commitment to customer satisfaction.
Operations Management
- Full understanding of Revenue Cycle Departments and maintains their alignment with regulatory and SJH policies.
- Is process focused to optimize processes and builds standardized workflows
- Develops and manages budgets, this includes the ability to analyze financial operating data to determine costs, remain within budget, and ensure cost effectiveness.
- Stays on task with the evolving integrated health care delivery systems, technological innovations, and an increasingly complex regulatory environment.
- Reports on departmental Key Performance Indicators such as admissions/registrations per FTE per month, Point-of-Service Cash Collections, error rates, denial rates, etc.
Business Partner
- Serves on various departmental and hospital-wide committees.
- Collaborates with administrative staff, and providers to optimize efficiency on a variety of related services ranging from inpatient care to outpatient follow-up care.
- Coordinates activities with clinics and ambulatory managers, administrative staff, advanced practitioners, and physicians to ensure SJH strategy is accomplished.
Quality Assurance
- Assists in the development of operating policies and procedures for Revenue Cycle.
- Provides timely and effective communication to the Revenue Cycle departments on any upcoming changes within the regulatory guidelines.
- Performs Root-Cause Analysis to fix issues and errors to ensure they don’t repeat including fixing denials that apply to Patient Access.
- Ensures accurate registrations and scheduling while assisting in the resolution of patient and provider complaints in a professional and timely manner.
Staff Development
- Plans and conducts meetings with Revenue Cycle leadership to discuss opportunities for staff engagement and development.
- Determines areas of opportunity to work towards best practices established by the hospital, HFMA, NAHAM, CMS, and other key organizations that influence the healthcare industry.
Problem Solving & Improvement Activities
- Autonomously applies sound judgment to solve operational problems, appropriately following up with team members to address. Influences the launch, development, implementation, and control of improvement projects.
- Adheres to and actively practices in SJH's Corporate Compliance Program, and participates in Performance Improvement activities.
Job Requirements
Minimum Education
Required: Healthcare Business Certification or related.
Preferred: Degree in related field. CHAM (Certified Healthcare Access Manager) credential.
Minimum Work Experience
Required: 3 years supervisory or management experience. 5 years experience in a hospital setting.
Functional Demands
Working Conditions
Busy healthcare office environment and/or Patient Accounting office setting. Work is varied in nature and is performed under frequent interruptions, with some stressful situations. Contact with people under wide variety of circumstances. Must be on-site at the SJH campus or other facilities to fulfill the responsibilities of this role.
Physical Requirements
Ability to push, pull, bend, and reach. 60-70% of day sitting at desk and/or computer. Intermittent standing and walking. Occasional lifting of up to 20 pounds.
Direct Reports: PFS Manager Patient Assistance, PFS Supervisor Patient Admissions, Operations Supervisor PFS, ER Supervisor PFS and PFS Scheduling Supervisor
Reports to: Director of Revenue Cycle
Internal & External Contacts: Physician Offices, Patients, Patient Accounting staff, Revenue Cycle staff, Administration and all other hospital departments. Insurance companies, Federal and State agencies.
Leadership Capabilities
Quality Decision Making
- Considers many factors and sources when making decisions
- Is correct and accurate with most of his/her solutions and suggestions when judged over time
- Is sought out by others for advice and solutions
Conflict Management
- Steps up to conflicts, seeing them as opportunities
- Negotiates tough agreements and settle disputes equitably
- Finds common ground and gains cooperation
Industry Acumen (Management)
- Knows how the healthcare industry works; understands financial models for successfully running a hospital
- Pays attention to current and possible future policies, practices, trends, developments in healthcare and how these could affect the organization
Systems Thinking
- Take a broad perspective to understanding how things work
- Able to see the connections, interdependencies, & relationships between departments, strategy, people, & processes
Managerial Courage (Management)
- Takes unpopular stands if necessary
- Encourages direct and tough debate, but isn't afraid to end it and move on
- Says what needs to be said without holding back
Building Effective Teams (Management)
- Allocates resources necessary to reach goals
- Creates strong morale and spirit in his/her team; creates a feeling of belonging
- Defines success in terms of the whole team
