Senior Director, Patient Access

Healthcare Outcomes Performance Co. (HOPCo); Phoenix (AZ); On-site; USD 85,000 - 110,000; Full time

Job summary

The CORE Institute's Contact Center seeks a seasoned leader to supervise patient access operations, ensuring accurate pre-registration, benefit verification, pre-authorization, and registration processes while supporting revenue cycle goals.

Responsibilities include directing scheduling, auditing tasks, developing policies, training staff, generating performance reports, and coordinating with physicians, payers, and management to improve efficiency and compliance within Medicare, Medicaid, and

Qualifications

• Bachelor's degree required or equivalent years of experience in healthcare administration.
• Experience in hospital system patient access and revenue cycle management preferred.
• Knowledge of Medicare, Medicaid, commercial insurance, and payer regulations.

Responsibilities

• Directs management of patient access by establishing standards, systems, and processes to meet financial goals.
• Oversees scheduling management with trending, root cause analysis, and action planning to meet targets.
• Develops and administers department policies to improve quality and throughput of work.
• Performs strategic planning and presents information to physicians, management, payers, and patients.
• Audits and monitors scheduling, pre-registration, and authorization tasks.

Skills

Leadership

Scheduling management

Staff development

Problem solving

Communication

Education

Bachelor's degree in clinical informatics, management, Accounting, Finance, or Business Administration or related field

Tools

ShoreTel

Microsoft Office

Job description

The position is responsible for duties in support of providing leadership, managerial supervision, ensuring department is accurately processing patients through pre-registration, benefit verification, pre-authorization, registration process and resource support to improve the effectiveness of the CORE Institute's Contact Center department.

Essential Functions

• Responsible for directing the management of patient access by establishing and maintaining standards, systems, and effective processes, address identified needs and ensures achievement of established financial goals.
• Responsible for scheduling management including trending, root cause analysis, and action planning to ensure targets are being met.
• Develops, implements and administers department policies and procedures in a consistent and timely manner to improve the quality and quantity of work processed. Makes recommendations for improvement and ensures policies are communicated and administered consistently.
• Perform strategic planning, effectively presents information, and responds to questions from physicians, management, payers, and patients.
• Develops and manages processes to audit and monitor scheduling, pre-registration, and authorization tasks.
• Work collaboratively with all internal and external customers and departments to ensure timely and accurate patient registration and processing related to all aspects of the patient and revenue cycle process.
• Understands and stays abreast of payer requirements and changes within the industry. Provides training and oversight to staff to assure that these requirements are executed.
• Prepares departmental performance reports by collecting, analyzing, and summarizing data and trends.
• Supervise and appraise the performance of direct reports on an ongoing basis, provide training and resources to ensure direct reports continue to develop skills and knowledge of job-related functions, and ensure the same is done for staff reporting to the direct reports.
• Provide tools for Team Leads to sustain, develop, enforce, and report department standards and metrics; recommend actions for improvement.
• Assists the SVP with reviewing the performance of the team regularly to ensure metrics and standards are well within pre established goals and objectives.
• Assists with developing, implementing, and administering the annual department budget and initiating corrective actions to significant variances.
• Attends required meetings and participates in committees as requested. The job holder must demonstrate current competencies for the job position.
• Maintains in-depth knowledge of Medicare, Medicaid, commercial insurance and managed care plans to ensure compliance with payer regulations, plan documents, as well as billing compliance with Federal and State law.
• Conduct regular meetings with the team, to help ensure the implementation of Patient Access plans, programs, and projects strictly adhere to prescribed deadlines and schedules.

Education

• Bachelor's degree in clinical informatics, management, Accounting, Finance, or Business Administration or related field or equivalent years of experience.

Experience

• Five years in hospital system environment operating in patient access, surgery scheduling, and centralized scheduling models.
• Two to five years of management experience in a call center environment.
• Extensive knowledge of Patient Access and Revenue Cycle Management experience is preferred.

Knowledge

• Knowledge of the health care field and call center operating policies and procedures.
• Knowledge of insurance plans and medical billing.
• Knowledge of supervision and staff development.
• Knowledge of computer systems and Microsoft applications and Contact Center phone systems such as ShoreTel.

Skills

• Skill in exercising initiative, judgment, problem-solving, and decision-making daily.
• Skill in developing and maintaining effective relationships with staff, management, and the public.
• Skill in organizing workflow to achieve department goals and objectives.
• Skill in training, supervising, and mentoring staff.

Abilities

• Ability to function in a leadership role and develop train and mentor staff.
• Ability to work closely with clinic staff, management, and providers.
• Ability to communicate verbally and in writing.
• Ability to research issues and prepare comprehensive reports.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment.
• Some travel within the community.

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching are required.
• Manual dexterity using a calculator and computer keyboard.

Organizational Requirements

• HOPCo Mission, Vision, and Values must be read and signed.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.