Patient Access Manager

Appalachian Regional Healthcare (ARH); Middlesborough (KY); On-site; USD 70,000 - 90,000; Full time

Job summary

Appalachian Regional Healthcare (ARH) in Middlesborough, KY seeks a Patient Access Manager to oversee registration, scheduling, pre-authorization, and billing operations. You will lead a team to ensure compliant, efficient patient access, with a focus on accuracy, policy development, and customer service.

The role requires 5+ years in patient access (2+ in supervision) and a strong background in EHRs, billing, and regulatory requirements.

Qualifications

• Bachelor's degree in Business, Finance, or related field is preferred.
• Minimum of 5 years of experience in patient access or related field, with at least 2 years in supervisory/management.
• High school diploma required.

Responsibilities

• Oversees registration, scheduling, pre-authorization, referrals, switchboard, financial counseling, and eligibility.
• Develops policies for compliance and best practices in patient access.
• Monitors performance metrics and implements efficiency improvements.
• Supervises and trains patient access staff.
• Resolves patient inquiries and complaints related to access services.
• Collaborates with healthcare professionals to optimize resource use.
• Completes charge reconciliations and billing tasks; follows up on accounts.
• Reviews denials related to authorizations and eligibility.
• Tracks and manages appeals for front-office functions.
• Verifies authorizations for scheduled services when needed.
• Establishes point-of-service collection goals for staff.
• Assists departments with charge adjustments as needed.
• Manages return-to-client files and resolutions with Meduit.
• Conducts quality assurance on consent forms and insurance documents.
• Supports other departments with claim resolution as required.
• Manages PAD functions as needed.

Skills

Healthcare regulations

Insurance requirements

EHR systems

Practice management software

Leadership

Communication

Interpersonal skills

Problem-solving

Education

Bachelor's degree in Business, Finance, or Related Field

High School Diploma

Job description

Overview

The Patient Access Manager is responsible for managing and overseeing the efficient functioning of patient access services in a healthcare facility or hospital. The Patient Access Manager works in collaboration with other healthcare professionals to ensure patients receive timely, efficient, and effective services.

Responsibilities

• Oversees all registration, pre-registration, scheduling, pre-authorization/pre-certifications, referrals/orders, switchboard, financial counseling, and insurance/benefits eligibility team.
• Develop policies, standards, and procedures for patient access services to ensure compliance with regulatory requirements and best practices.
• Monitor and analyze departmental performance metrics to identify areas for improvement and implement changes to optimize efficiency and quality of services.
• Supervise and train the patient access staff, ensuring they understand policies and procedures and have access to necessary resources for optimal job performance.
• Respond to and resolve patient complaints and inquiries related to patient access services.
• Collaborate with other healthcare professionals to ensure resources are utilized effectively to meet patient needs.
• Completes charge reconciliation, late charge additions, and unfinalized review of billing.
• Completes billing for clients and follows up on these accounts.
• Review denials that are specific to authorizations, eligibility, registration, needing more information, etc. that are assigned by the Central Billing Office and Meditech.
• Complete and track all appeals that are related to front office functions.
• Verify that all scheduled services have authorizations, as needed.
• Establish point-of-service collection goals for the registration staff.
• Resolve assigned tasks.
• Resolved assigned account checks.
• Assist hospital departments with removing and adding charges.
• Work the return to client file as assigned by the Meduit for resolution.
• Check and work mail.
• Quality Assurance checks of consent forms, cards, and insurances are verified.
• Assist other departments as needed with claim resolution.
• Work the assigned PAD functions, as needed.

Education

High School Diploma Required

Experience

Bachelor's Degree Business, Finance, or Related Field Preferred

4-6 years experience.

Minimum of 5 years of experience in patient access or related field, with at least 2 years of supervisory or management experience required.

Knowledge, Skills, & Abilities

• Knowledge of healthcare regulations, insurance requirements, privacy standards, and facility policies.
• Experience with electronic health record (EHR) systems, practice management software, and patient data management tools.
• Excellent organizational, leadership, communication, problem-solving, and interpersonal skills.
• Ability to work collaboratively with other healthcare professionals, patients, families, and caregivers.
• Strong attention to detail, accuracy, and quality control.