Director, Patient Access

Prisma Health•Greenville, SC

About The Position

Responsible for administering, coordinating, and reviewing system-wide patient access functions. Provides vision, leadership, and operational oversight, serving as an advisor to more than 550 Patient Access team members across the organization. Develops and supports Patient Access leaders while fostering team-building relationships and collaboration with Revenue Cycle team members to support a successful and compliant Revenue Cycle process. The role oversees patient access operations, including insurance verification and authorization, registration, financial assistance, patient estimates, and pre-service collections. It ensures regulatory and NSA Estimate compliance, effective workflows, quality estimates, and appropriate handling of claim and registration edit work queues. The Director also maintains the Financial Assistance Policy and patient application process, works with charity programs, manages Medicaid Eligibility vendor relationships, and leads the Denial Prevention program. The Director develops and evaluates staff, tracks staffing levels, supports cross-training, conducts audits, monitors policies and procedures, contributes to the annual operating budget and departmental goals, and ensures operations remain within budget. The role partners with Information Systems on implementation of Patient Access functions in Epic and other systems, and with Organizational Development on front-end operational workflows and user training. This management position has direct reports and may include budget, hiring, termination, performance appraisal, and disciplinary authority.

Requirements

Bachelor's degree in Business Administration, Healthcare Administration, Accounting, or a related field, or an accepted equivalent substitution.
Five years of experience with Patient Access Services in a hospital or practice setting, or an accepted equivalent substitution.
Three years of management experience, or an accepted equivalent substitution.
Knowledge of office equipment.
Computer skills, including word processing, spreadsheets, and databases.
Ten years of relevant experience may substitute for a bachelor's degree.
Equivalent education and/or experience may be considered as determined by the Vice President, Revenue Cycle in consultation with Human Resources and the Executive Director, Revenue Cycle.

Responsibilities

Administer, coordinate, and review system-wide Patient Access functions.
Provide vision, leadership, and operational oversight, and advise Patient Access team members across the organization.
Develop and support Patient Access leaders and promote collaboration with Revenue Cycle team members.
Select, evaluate, coach, and manage the performance of qualified professionals.
Track staffing levels and collaborate with department managers on cross-training and support.
Conduct random audits for regulatory compliance, AIDET adherence, and patient experience expectations.
Monitor policies and procedures and recommend improvements to Revenue Cycle functions.
Oversee central Patient Access Insurance Verification and Authorization teams.
Oversee day-to-day registration operations, including Pre-Registration, POS registration, eCheck-in, and Notice of Admission.
Ensure effective registration workflows and workflows for claim edits and registration edit work queues.
Oversee the central Financial Assistance team and maintain the Financial Assistance Policy and patient application process.
Collaborate with Access Health and other charity programs on a consistent and efficient financial assistance program.
Oversee patient estimates and pre-service collections, ensuring NSA Estimate compliance and effective estimate work queue workflows.
Assist with preparation of the annual department operating budget and establishment of departmental goals; ensure operations remain within budget.
Manage Medicaid Eligibility vendor relationships and collaborate with ITS and vendors to support appropriate system configuration and performance.
Analyze payer denials and lead the Prisma Health Denial Prevention program.
Consult with and assist the IS department in implementing Patient Access functions on Epic and other appropriate systems.
Partner with Organizational Development on front-end workflows for user training.
Perform other duties as assigned.