Director Patient Access Services

Summary

The Director of Patient Access Services (PAS) is responsible for planning and directing the activities for all patient access and registration services. This includes, but is not limited to central scheduling, pre-registration, financial counseling, insurance verification/authorization, admission, outpatient registration, upfront and point-of-service cash collection.

This position is responsible for ensuring that key performance indicators for PAS functions (both centralized and decentralized) are consistently developed, measured and achieved.

Essential Duties and Responsibilities

• Oversee facility operations of Patient Access functions (e.g., pre-registration, benefit verification, pre-authorization, admission/registration, service pre-payment, etc.) to ensure daily operations are maintained according to standard.

• Provide ongoing operational analysis and support to all access/registration areas to effectively maintain best practice processes, policies and procedures, including but not limited to Pre-Services, Registration, Upfront/PCS Collections and Registration Quality Assurance Management.

• Implement Patient Access process improvement initiatives as needed to improve workflows for patient access and to achieve departmental, hospital and corporate goals.

• Maintain enhanced physician practice, patient and staff relations, creating an environment conducive to maximizing internal and external customer satisfaction.

• Manage personnel responsible for supervision of all staff in assigned Patient Access Areas. Leads the development and implementation of all necessary reporting, monitoring standards and processes associated with assigned revenue cycle areas and establishes benchmarks for best practice operational efficiency.

• Stay abreast of regulatory requirements and company compliance policies, ensuring timely staff education. Inform staff of relevant changes and developments in payer requirements.

• Ensure quality review measurements are in place.

• Foster collaborative relationships with other department managers, senior leadership and staff to facilitate the strategic planning and development of Patient Access operations.

• Develop specific objectives, budgets, and performance standards for each area of responsibility.

• Assist with identifying capacity issues that create barriers to patient flow.

• Interface with external entities such as third-party payers, regulatory agencies, other health care institutions, vendors, patients and families.

• Assure compliance with Advanced Beneficiary Notification (ABN), Medicare as a Secondary Payer Questionnaires (MSPQ), Advanced Directives, Patient Bill of Rights, medical necessity, observation status and other regulatory guidelines.

Summary of Other Job Responsibilities/Expectations

• Inform CFO of any significant issues in the Patient Access area (e.g., Pre-registration delays, pre-authorization backlogs, etc.)

• Attends in-service presentations, and complete mandatory education week including, but not limited to, infection control, patient safety, quality improvements, MSDS and OSHA Standards.

• Demonstrates knowledge of occurrence reporting system and utilizes system to report potential patient safety issues.

Supervisory Responsibilities

• Reports to: Chief Financial Officer (CFO)

• Supervises: Patient Access and Registration Staff, collaborates with department managers who also have PAS responsibilities

• Responsibilities: (i.e., Budget)

Qualifications

• Demonstrated success in managing day-to-day operations of a large-scale, high-volume patient access functions.

• In depth knowledge of general business concepts including financial management and accounting principles and practices.

• Demonstrated track record of meeting department goals without an adverse impact on employee morale or customer satisfaction.

• Ability to plan, direct, and control the affairs of admitting and registration department.

• Ability to establish rapport and cooperation between staff in patient financial services, utilization review, HIM, hospital management, IT, payers and all other departments that impact patient access functions.

Education and Experience

• Minimum Required Education: Bachelor's Degree in related field or must be actively pursuing degree and have equivalent relevant experience.

• Preferred Education: Masters

• Experience: Extensive experience with Medicare, Medicaid, managed care and commercial payor requirements. Strong knowledge of compliance requirements for Patient Access-related activities, including, but not limited to federal, state and accrediting regulatory agencies. 10+ Years Healthcare Business, Finance and/or Revenue Cycle experience in acute care hospital or related organization.

• Minimum 5 years management experience

• Employee should be competent in position within 90-days of employment

Certificates, Licenses, Registrations

Healthcare Access Management Certification, (CHAM), Healthcare Financial Management Association Certification, (CHFP) or Healthcare Financial Management Association-Certified Revenue Cycle Representative, (CRCR) or other related certification preferred.