Patient Access Manager (Full Time)

Monroe County Hospital•Forsyth, GA

12d•Onsite

About The Position

The Patient Access Manager is responsible for the day-to-day operation of the Admissions Center, including emergency room admissions and outpatient admissions. This role involves planning, developing, organizing, implementing, evaluating, and directing the Patient Access department, its programs, and activities in accordance with current rules, regulations, and guidelines. The manager ensures the delivery of quality care, supervises staff, coordinates services with other departments, and oversees patient access schedules to meet patient needs and regulatory standards. Responsibilities also include staff recruitment, training, performance evaluation, and fostering positive employee relations. The role involves managing the department's budget, ensuring compliance with EMTALA, HIPAA, and Red Flag Rules, and developing admission productivity reports. Additionally, the manager ensures complete and accurate patient registration, timely pre-certification, and proper processing of patient charges. The position requires working admissions shifts as needed, including interviewing patients, obtaining necessary signatures, entering information into the health information system, explaining hospital regulations, and providing backup coverage for the pre-certification coordinator. The manager also handles payments, reconciles cash drawers, processes telephone communications, pages for medical staff and codes, runs daily quality reports, controls visitor access after hours, and ensures patient information is safeguarded and confidential.

Requirements

High School diploma or GED.
Two to three years experience in a medical office or hospital admissions.
Knowledge of insurance processing.
Must be efficient with keyboarding and computer applications.

Nice To Haves

Three to five years experience in a medical office or hospital admissions.
Experience with hospital information systems and hospital insurance applications (TruBridge).

Responsibilities

Plan, develop, organize, implement, evaluate, and direct the Patient Access department, as well as its programs and activities, in accordance with current rules, regulations, and guidelines that conform to current standards of admission practice and operational policies while maintaining compliance with state and federal laws and regulations.
Develop, maintain, and periodically update written policies and procedures for the day-today function of the patient access department.
Communicates and interprets policies and procedures to patient access staff, and monitors staff practices and implementation.
Evaluates the work performance for all patient access personnel and implements discipline according to policies and procedures.
Ensures delivery of quality care and patient access supervision as evidenced by adequate services and staff coverage for department.
Coordinates patient access services with all departments, as necessary.
Oversees patient access schedules to ensure they meet patient needs and regulatory and budgetary standards.
Participates in the recruitment and selection of patient access personnel and ensures sufficient staffs are hired.
Oversees and supervises development and delivery of in-service education to equip patient access staff with sufficient knowledge and skills to provide quality care for patients.
Proactively develops positive employee relations; promotes teamwork, mutual respect, and effective communications.
Monitors staff for compliance with facility policies on workplace safety.
Coordinates and/or develops on-going quality assurance activities for patient access services to monitor compliance with standards and regulatory requirements.
Compiles summary of findings for the Quality Assurance committee.
Participates in budget development for the patient access department.
Helps prepare staff for inspection surveys, instructing staff on matters of conduct and disclosure, being interviewed by inspectors, immediate corrections of problems noted by surveyors.
Reviews and reinforces important standards previously cited.
Promotes customer service and responds to and adequately resolves complaints or concerns from patients or families about patient access services.
Promotes compliance with accident prevention procedures, safety rules, and safe work practices to prevent employee injury and illness and control workers’ compensation costs.
Assures staff is trained in fire and disaster and other emergency procedures and evaluates performance during drills.
Ensures compliance with all hospital rules and regulations in accordance with set policies and procedures.
Oversees the work of the admissions team and ensures all representatives are provided with adequate training and resources needed.
Ensures department compliance with EMTALA, HIPAA, and Red Flag Rules.
Develops and reviews admission productivity reports and ensures that appropriate action is taken to ensure productivity models are met.
Ensures complete and accurate registration of all patients.
Provides backup coverage and cross training for pre-certification coordinator position.
Ensures timely pre-certification is obtained for hospital admissions, outpatient, surgery, and diagnostic imaging tests as required.
Sorts, assembles, and posts all patient charges and/or ensures that this is delegated to properly trained staff.
Ensures this task is completed accurately and timely.
Coordinates with supervisor to ensure cross-over functions between admissions and patient accounts flows smoothly.
Works admissions shifts as needed to ensure department coverage: a. Interviews incoming patient or representative and enters information required for admission into health information system. b. Obtains required signatures from patient and/or representative for consent of care and any other required documents per hospital policy and protocols. Documents how consent was obtained or not obtained from responsible parties. c. Enters, records, stores, and maintains information in written and electronic form. d. Interviews patient or representative to obtain and record individual and/or company insurance responsible for payment of bill. e. Explains hospital regulations, such as visiting hours and payment of accounts. f. Provide a smooth flow of patients through the admitting area/ER, directing or escorting patients as necessary to the appropriate department. g. Understand the functional status and physical needs of patients, staff, and visitors to the hospital and assists in those needs. h. Maintain a working knowledge of community services and resources available to all patients. Refer patients as necessary to the appropriate agency or department. i. Records all emergency room patients seen on the electronic ER log related to each account. j. Accepts payments and issues receipts, collects co-payments and deductibles, and reconciles petty cash drawer at the end of each shift. k. Processes telephone communications in an efficient and courteous manner for patients, physician, general public, and hospital staff. l. Pages for medical staff, disaster and emergency codes as required by policy. Pages should be done in a clear, distinct, and audible voice. m. Run a daily registration quality report before the end of each shift to check the accuracy of registrations and make corrections as necessary. n. Controls visitor access to hospital after hours, clears any afterhours visitors with Charge Nurse, and issues visitor pass as appropriate. o. Fosters high levels of customer service and releases only appropriate patient information while ensuring HIPAA compliance is followed. Refers all other medical information releases to HIM for processing. p. Ensures all patient information is safeguarded and kept confidential according to prescribed policies and procedures. q. Analyze information and evaluate results to choose the best solutions available and solve problems as they arise. r. Develop constructive and cooperative working relationships with others; ensure flow of communication within department. Participates in a wide variety of special projects and compile a variety of special reports.