Patient Access Director, JH - UMC

UofL Health - Louisville, KY

Full-time - Manager

Louisville, KY

About the position

The Director of Patient Access provides leadership, direction, and administrative guidance to Pre-Access and all Registration areas within the University of Louisville Hospital and James Graham Brown Cancer Center; scheduling, written orders, insurance verification, medical necessity, authorizations, and all points of registration entry. Individual must promote a culture to provide very good service to patients, physicians, department staff, and ancillary areas with the expectation to achieve improved patient and team member satisfaction. Participates in establishing policies, procedures and accountability to meet best in class metrics and operates within the CMS guidelines and accreditation standards of quality performance standards. Designs a revenue producing mindset and aligns department goals to create a positive patient financial experience.

Responsibilities

• Demonstrates working knowledge of regulatory agency standards, federal and state regulations and statutes, HIPAA, hospital and department policies and 'must haves' regarding confidentiality, patient identification, and capturing of patient information no matter where the registration occurs.
• Oversee and achieve success in departmental operations based on staffing, census, regulatory changes, budgetary and administrative controls and market/industry changes.
• Responsible for the overall development, implementation and monitoring of consistent operational processes in each area of the Patient Access Department.
• Provides leadership to management team and employees of the Patient Access Department, including the growth/mentoring of leaders and ensures staff engagement are committed to strategy, mission and goals of the department.
• Utilize benchmarking data to improve departmental outcomes.
• Communicate proactively and positively with Patient Access leadership to ensure personal growth in knowledge and skill set.
• Develop and motivate Patient Access team members by evaluating, updating, and effectively communicating staff competencies for each department position.
• Understand and be able to speak to all aspects of Patient Access, from technology, processes and regulations.
• Investigate denials to determine specific issues and patterns that need to be addressed.
• Develop goals and objectives, which support organizational goals and objectives, including communication of expectations and progression towards the departmental goals.
• Stays abreast and communicates payor changes to management/department staff.
• Identify areas hindering performance, including technology and/or processes.
• Implement process improvement initiatives continuously focused on meeting metrics and proactively identifying areas of opportunity by working collaboratively, professionally and fostering positive relationships with both internal and external peers.
• Develop and implement action plans as identified.
• Oversees the hiring, orientation, training, coaching, counseling, and terminations as deemed necessary for the department.
• Prepares and conducts evaluations for Patient Access leadership.
• Reviews and accurately approves employee payroll on a bi-weekly basis.
• Participate and motivate the leadership to ensure processes are in place so all patient registrations are complete prior to the discharge of a patient.
• Oversees and closely monitors compliance of CMS guidelines; Medicare Secondary Payor questionnaire, Medicare Outpatient Observation Notice, and Important Message from Medicare notice.
• Oversees and closely monitors authorizations are obtained and medical necessity is checked on scheduled procedures prior to service (minimum 24-48 hours).
• Oversees the screening of self-pay patients for Medicaid eligibility and understands the importance of uncompensated care to the organization.
• Create and maintain a patient collection (Point of Service Collections) strategy (what patients can expect to pay).
• Directs the healthcare assistance (charity) program and ensures guidelines are consistently followed.
• Ensures quality assurance audits are executed and written analysis is provided to leadership.
• Guide the process of the insurance master and job aids to align with correct 'clean' claim submission.
• Operates the department in a cost-effective manner by developing budgetary objectives for operational costs, maintaining departmental operations within established budgetary guidelines, correlating departmental volumes with expenses when monitoring budget, and identifying opportunities to lower departmental costs.
• Oversee the review, revision and implementation of Patient Access policies and procedures at a minimum of once every two years or as needed.
• Assists with complex registration discrepancies.
• Collaborates with other revenue cycle leaders and Patient Experience leaders to improve customer service, efficiency and effectiveness of the department.
• Model all Core Behavioral and Organizational standards, including routinely Rounding on staff.

Requirements

• Bachelor's degree in Business, Education or other related degree or absolutely must have proven 4-5 years of prior leadership experience in Patient Access hospital leadership with knowledge and success in all areas of the department.
• Certified Healthcare Access Manager (CHAM) preferred.
• Minimum of 4-5 years of prior leadership experience in a healthcare setting, required.
• Strong customer service and communication skills.
• Critical thinking skills.

Nice-to-haves

• Demonstrate excellent communication, organizational, computer, written and oral communication skills.
• Demonstrate strong Microsoft Office knowledge skills.
• Must possess working knowledge of data requirements for a complete and compliant registration.
• Strong time management and critical thinking skills.
• Ability to foresee projects from start to finish as well as identify trends in financial data.