Director of Clinic Patient Access

Mercyhealth Wisconsin and Illinois•Janesville, WI

2d•$96,464 - $154,342

About The Position

Essential Duties and Responsibilities Develops policies and procedures and revises as needed to put in place and maintain proper workflow within the revenue cycle, focusing on system-wide, front-end clinic operations; Assures compliance with regulatory requirements and that processes are in place to verify the System is meeting those requirements to ensure payment; Audits and monitors all clinic Patient Access processes overall and individual partner performance to assure compliance with department policies and procedures; Keeps up to date on changes imposed by Medicare, Medicaid and Commercial Insurances as well as Federal and Wisconsin and Illinois State laws impacting healthcare; Reviews data and develops reports and other tools to identify areas for improvement and to set and track benchmarks based on industry standards; Meets or speaks with patients who may have special needs, requests or financial concerns to assist with problem resolution; Meets goals and objectives set by Director related to clinic Patient Access functions, especially related to registration accuracy and point of service collections; Works with system-wide clinic and other department leadership to educate and promote efficiencies in the Patient Access processes; Sets priorities and problem solves situations appropriately and independently; Supervises, hires, trains and evaluates staff and monitors their production; Conducts employee reviews, presenting and discussing pertinent review findings and recommendations with partner. When deficiencies are noted, monitors partner performance to assure that corrective action is taken; Responds to partner and patient issues regarding Patient Access; Manages special projects related to improved processes within Patient Access for clinic services (if applicable) Ensures the Director(s) are informed of any unusual and significant issues that may affect patient satisfaction, timeliness of services, reimbursement or general patient flow; Other duties and projects as assigned. Culture of Excellence Behavior Expectations To perform the job successfully, an individual should demonstrate the following behavior expectations: Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals. Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions. Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals. Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.

Requirements

Bachelor's Degree in related field or Associate's Degree in related field with completion of Bachelor's Degree within 24 months; MHA or MBA highly desired.
Minimum of 3-5 years experience in applicable healthcare fields of patient access and revenue cycle operations.
Supervisory experience with proven ability to oversee subordinates.
Thorough knowledge of Centers for Medicare and Medicaid (CMS) and Joint Commission (JCAHO) regulations affecting and/or driving Patient Access processes.
Expert knowledge of insurance plans and coverage requirements
Ability to think independently.
Must use good judgment extensively.
Very high degree of analytical and trouble-shooting skills required.
Ability to take initiative by identifying problems, conceptualizing resolutions to the problems and implementing change.
Solid understanding of the information systems used in the billing and collection process.

Nice To Haves

MHA or MBA highly desired.
Epic Certification

Responsibilities

Develops policies and procedures and revises as needed to put in place and maintain proper workflow within the revenue cycle, focusing on system-wide, front-end clinic operations
Assures compliance with regulatory requirements and that processes are in place to verify the System is meeting those requirements to ensure payment
Audits and monitors all clinic Patient Access processes overall and individual partner performance to assure compliance with department policies and procedures
Keeps up to date on changes imposed by Medicare, Medicaid and Commercial Insurances as well as Federal and Wisconsin and Illinois State laws impacting healthcare
Reviews data and develops reports and other tools to identify areas for improvement and to set and track benchmarks based on industry standards
Meets or speaks with patients who may have special needs, requests or financial concerns to assist with problem resolution
Meets goals and objectives set by Director related to clinic Patient Access functions, especially related to registration accuracy and point of service collections
Works with system-wide clinic and other department leadership to educate and promote efficiencies in the Patient Access processes
Sets priorities and problem solves situations appropriately and independently
Supervises, hires, trains and evaluates staff and monitors their production
Conducts employee reviews, presenting and discussing pertinent review findings and recommendations with partner. When deficiencies are noted, monitors partner performance to assure that corrective action is taken
Responds to partner and patient issues regarding Patient Access
Manages special projects related to improved processes within Patient Access for clinic services (if applicable)
Ensures the Director(s) are informed of any unusual and significant issues that may affect patient satisfaction, timeliness of services, reimbursement or general patient flow
Other duties and projects as assigned