General Summary:
- Under management, accountable for day-to-day functions of all insurance reimbursement areas and teams
- Ensure proper reimbursement on patient accounts, identifying error trends and reporting to leadership as needed
- Coordinate with insurance payers and interpret contracts to ensure proper reimbursement on patient accounts
- Ensure team success in meeting and exceeding accuracy and productivity goals set by PA/PFS department
- Specifically take responsibility for patient satisfaction and employee engagement scores, meeting goals
- Perform managerial duties in absence of manager
- Actively participate in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all
- Adhere to compliance plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies
Knowledge and Skills Required:
- Ability to use discretion when discussing personnel/patient related issues that are confidential in nature
- Ability to be responsive to ever-changing matrix of hospital needs and act accordingly
- Self-motivator, quick thinker
- Proficiency in performance of basic math functions
- Capable of communicating professionally and effectively in English, both verbally and in writing
Education and Experience Required:
- Three (3) years experience in patient access/patient financial services department or related area (registration, finance, collections, customer service, medical office, contract management)
- At least six (6) months team lead or supervisory experience
Preferred Education and Experience:
- Minimum (2) years college degree (business, healthcare or health services administration, health information management, communications, finance, accounting, public administration, human resources, management, or marketing)
- (2) or more years in patient access/patient financial services department or related area as defined above
Preferred Licensure or Registration:
- Certified Patient Access Representative or Certified Patient Account Technician
Principal Duties and Job Responsibilities:
- Demonstrate core values of integrity, compassion, balance, excellence, stewardship, and teamwork as outlined in the organization’s Performance Excellence Program
- Coordinate with insurance payors to ensure proper reimbursement on patient accounts
- May be required to participate in conference calls, review accounts receivable reports, and/or create reports to compile issues in order to expedite resolution of accounts
- Responsible for examining and interpreting contracts to ensure patient accounts are properly reimbursed
- Trend and report any issues to leadership or as requested
- Review quality assurance reports with appropriate leadership and staff
- Create, prepare and update various weekly and monthly reports as assigned by management within specified time frame
- Analyze and review statistical reports when requested by leadership
- Specifically take responsibility for patient satisfaction and employee engagement scores
- Promote an atmosphere of open communication for staff at all times
- Assist customer service with patient concerns/questions to ensure prompt and accurate resolution is achieved
- Present written and verbal directions to employees to ensure well-informed status in performance of their job requirements as indicated, and provide feedback for employee performance evaluations
- Identify problems proactively to expedite resolution, offering training whenever needed
- Provide continuing education of all team members on process and A/R requirements
- Provide team members with tools and training needed to assist in meeting productivity and accuracy goals
- Conduct interviews for open positions
- Oversee new hire training to successfully meeting 90 day standards
- Required to constantly ensure a high level of team productivity by proactively assigning and directing workload distribution amongst all team members
- Enable staff to meet goals and deadlines by monitoring time management of staff
- Limit use of overtime
- Document employee performance and attendance
- Adhere to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account