Mgr-Patient Access Operations

Inspire health. Serve with compassion. Be the difference.

Job Summary

Accountabilities

• Develops and implements efficient registration processes to support an optimal patient experience aligning people, processes and technology. This includes processes for collecting demographic and financial information to facilitate timely payment, discussing the patient estimate and collecting patient balances due. A further responsibility includes provisions for recording information in the system that supports the clinical team with health equity and social determinates of healthcare. This information is subject to review by The Joint Commission and DHEC. Includes education for team members that outlines specific workflows to be followed. Conducts account reviews to ensure processes are followed and timely feedback is provided to team members. Proficient with resolving Patient and Account work queues assigned to Patient Access. - 35%
• Ensures adequate processes are implemented for the provision of documents and forms as required by regulation; in some instances, patient signatures are required. Compliance regarding documents and forms is subject to review by CMS, DHEC and the Joint Commission. These forms/documents include but are not limited to Advance Directives, Lewis Blackman Patient Safety Act, Notice of Privacy Practices, Patient Rights and Responsibilities, Permission to Treat, Limited Visitation Policy, Medicare Admission Questionnaire, Medicare Important Message and Medicare Outpatient Observation Notice. Lack of compliance can create a regulatory finding or jeopardize the organization's participation with CMS. - 20%
• Collaborates with clinical departments, Patient Financial Services and other personnel as appropriate to lead and manage change initiatives designed to transform and improve Patient Access processes. Supports the use of technology as available to automate workflow and reduce errors. Integrates with Campus Leadership to foster relationships and ensure Patient Access is included as part of the campus team. - 15%
• Maintains a working knowledge of third-party payment requirements, including (as applicable) Medicare, Medicaid, managed care organizations, private insurers, and worker's compensation carriers. Provides timely education to inform team members of relevant changes and developments in payor requirements. Proactively pivots to meet the changing needs of payor requirements to maximize cash flow for the organization. - 10%
• Leads team in developing departmental goals and objectives. Provides regular feedback to team members regarding current departmental progress toward goals and objectives. Leads to ensure the development of plans for continuous improvement in operations and/or financial performance. Ensures annual performance reviews are completed in a timely manner to include effective feedback for the team member. - 10%
• Recruits and selects the most qualified candidates within constraints of the budget. Develops and maintains work schedules within budgeted parameters. Educates team members on policies and procedures of department and Prisma Health, either directly or through subordinates. Establishes standards of performance and monitors for compliance. Recommends and develops improvement plans to enhance team member development. - 5%
• Ensures appropriate utilization of Prisma Health progressive corrective action policy for team members with performance, behavior, or irregular attendance patterns. Includes appropriate documentation of verbal counseling, warnings/reprimands, suspensions and for-cause terminations. Reviews personnel actions for compliance with Federal/State laws and regulations and Prisma Health policies. Demonstrates excellent rapport and the ability to encourage open communication with team members and resolve interdepartmental problems and conflicts. - 5%
• Performs other duties assigned.

Supervisory/Management Responsibility

• Job has direct and/or indirect supervision of employees that may include final budget authority, hire/termination authority, performance appraisal responsibility and disciplinary authority. Job will be considered a member of management staff at Prisma Health and will have direct reports.

Minimum Requirements

• Bachelor's Degree - Healthcare Management, Business, Accounting, Finance or another Business-related field
• 5 years - Patient Access, Patient Financial Services, or Healthcare Finance. Two (2) years previous leadership or management experience preferred.

In Lieu Of

• High school diploma plus eight (8) years of banking/finance, billing/collections, healthcare admissions, insurance or credit/collections including four (4) years related healthcare and four (4) years supervisory experience; or associate degree in business or related field with six (6) years banking/finance, billing/collections, healthcare admissions, billing, insurance or credit/collections including three (3) years related healthcare and three (3) years supervisory experience.

Required Certifications, Registrations, Licenses

• NA

Knowledge, Skills and Abilities

• Ability to foster an environment that focuses on an optimal patient experience through accountability, collaboration, team member participation, and effective communication, both written and oral.
• Knowledge of office equipment (fax/copier)
• Proficient computer skills including word processing, spreadsheets and database

Work Shift

Location

Facility

Department

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.