Department
Patient Access
Job Summary
Assist with establishing policies, procedures, standards, and departmental objectives. Supervises department personnel and assigned functions of referral and patient access clerks. Supervises the work of office staff members. Reports to the Patient Access Manager. OSHA Bloodborne Pathogens Class III.
Job Qualifications
- Education: High school graduate or equivalent. Associate or bachelor’s degree preferredÂ
- Personal job-related skills: Leadership and management abilities with effective oral and written communications skills. Knowledge of referral authorizations processes
- Licensure, registry or certification: None required
- Prior Work Experience: Three years in healthcare.Â
- Technical Training: Must have strong computer skills with office programs, knowledge of electronic records and billing practices is preferred.
- Physical and Mental Requirements:Â Duties of position require intermittent, walking, sitting, standing and lifting up to 40 pounds.
Essential Duties and Responsibilities
- Plans, organizes, and directs the day-to-day programs of assigned areas and services.
- Develops long and short-term goals for staff individually and departmentally.
- Review ADP for staff requests, monitor and address time and attendance issues
- Analyzes data and prepares required periodic and statistical reports as requested by
administration. - Collaborates with referring physicians and their staff to make sure that all requirements are met for insurance coverage, and that all patients are taken care of in a timely manner.
- Develops and maintains expertise on insurance requirements relating to referral management.
- Confirms and obtains eligibility of patient benefits with insurance companies, receives authorization, estimations, medical necessity, ABNs, and collections.
- Supervise and monitor referral clerks to ensure the accuracy and timely worked referrals, serves as a primary resource and hands-on for arranging, working, and scheduling and/or pre-registration all aspects of referrals.
Prioritizes work to ensure that urgent referrals are handled expeditiously, and routines are handled on a first come, first serve basis with any assistance from performing departments. - Schedules referral appointments for consultation by specialist, diagnostic procedure, or surgical procedures internal or external; assist departments with referral issues.
- Work daily activities related referrals and patient access; provides education and information to staff as it relates to referral and patient access.
- Answers questions from patients, staff, and providers with courtesy and understanding.
- Ensures that proper documentation is forward to consulting physicians and facilities performing procedures as required. Copies of documentations are retained in the patient’s medical records.
- Maintains current knowledge of policies, procedures and regulations issued by local, state, and federal agencies.
- Assist with analyzing referral and patient access denials.
- Reviews insurance for completeness, accuracy, and compliance with established standards relating to referral management processes.
- Participates in the coordination of internal procedures to ensure compliance with rules and directions established by regulating agencies as related to all aspects of referral management.
- Assist with the evaluate and determine present and projected needs for office systems and data.
- Works well with the team to undertake special projects as needed.
- Backup to Patient Access Manager.
- Performs other duties as assigned by Management.
- Supervises department functions and department personnel.
- Assist with initiates departmental policies, procedures, and practices consistent with professional standards, legal/regulatory requirements and institutional goals and practices.
- Communicates hospital policies and procedures to subordinates and serves as a liaison between employees and management.
- Assists PFS Director and manager with departmental budget preparation.
- Assists with the selection of new hires, develops, evaluates and disciplines assigned employees in compliance with hospital policy.
- Establishes daily work schedules for employees.
- Supervises the duties performed by employees of assigned areas.
- Meets with employees routinely to review questions and concerns related to the duties performed.
- Communicates performance expectations to staff.
Other Significant Requirements
- Consistently maintains confidentiality of patient records
- Adheres to and supports organizational policy and procedures
- Demonstrates courteous, compassionate and efficient service to our customers, both internal and external
- Works cooperatively, effectively and respectfully with others.
- Represents the organization in a professional manner at all times.
- Performs other position-appropriate duties as required in a competent, professional and courteous manner
Benefits
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
- On Demand Pay
