Patient Access Services Manager

San Joaquin County-posted 4 days ago
Full-time • Manager
Stockton, CA
5,001-10,000 employees
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This examination is being given to fill one vacancy with San Joaquin Health Centers and to establish an eligible list to fill future vacancies. Resumes will not be accepted in lieu of an application. A completed application must be postmarked or received online by the final filing deadline. Offers of employment are contingent upon passing a background check. NOTE: All correspondences relating to this recruitment will be delivered via e-mail. The e-mail account used will be the one provided on your employment application during time of submittal. Please be sure to check your e-mail often for updates. If you do not have an e-mail account on file, Human Resources will send you correspondences via US Mail.

  • Plans, organizes and directs the Patient Access Services for SJCC operations that includes financial screening, patient registration, review of payment plans, ensure compliance with federal sliding fee scale guidelines, maintenance of patient data, verification of insurance benefits and the establishment of third-party coverage.
  • Develops and maintains policies and procedures to ensure compliance with regulatory requirement standards.
  • Provides operational guidance and education to SJCC providers and senior management to maximize Federally Qualified Health Center (FQHC) revenue and minimizing payer denials.
  • Manages the activities and daily operations of patient access services and revenue cycle functions that include: intake, insurance billing, charge description master, clinic registration and scheduling, cashiering, revenue cycle/collection, provider relations, patient eligibility, and patient financial counseling.
  • Facilitates and/or participates in administrative meetings, special projects, and program development; both within and outside the organization as needed and provides operational status reports to SJCC leadership and board of directors to meet Health Resources and Services Administration (HRSA) requirements per the HRSA Compliance Manual and HRSA Site Visit Protocol.
  • Manages the Patient Access Services budget to ensure compliance with FQHC guidelines and SJCC organizational goals.
  • Conducts ongoing assessment of unit operations to ensure revenue cycle performance objectives are achieved through efficient patient financial services guidelines and procedures; and recommends modification of data processing and utilizations for continuous improvement to maximize overall performance of SJCC clinic services.
  • Manages the hiring, selection, and training of patient registration personnel, and maintains training documents and training curriculum for FQHC staff and providers pertaining to payer contracts, Medi-Cal and Medicare regulations, and other FQHC reimbursements.
  • Advise SJCC providers and staff regarding service payments and reimbursement eligibility requirements to maximize and protect reimbursement; oversee third party denials to assure timely appeals and responses to maximize revenue for clinical services rendered.
  • Interprets federal, state and local regulations, contracts and agreements as related to utilization review, outpatient reimbursement, and makes recommendations to SJCC administration for compliance; and recommends solutions to resolve the more complex problems/accounts that occur in any of the areas of responsibility.
  • Prepares and reviews reports and correspondence regarding SJCC patient access services statistics as needed or required; and recommends modification of data processing and utilizations for continuous improvement to maximize overall performance of SJCC clinic services.
  • Education : Bachelor’s degree from an accredited four-year college or university with a major in public or business administration, health care management, social sciences or a closely related field.
  • Experience : Three years of healthcare revenue cycle, medical credit and insurance, welfare eligibility, FQHC registration or hospital admitting or directly comparable experience, including one year of supervisory experience over patient access or revenue cycle activities in a hospital, clinic or health care organization.
  • Substitution : Additional qualifying experience may be substituted for the required education on a year for year basis.
  • FQHC payer and revenue cycle expertise; project and change management training; principles and techniques of personnel supervision and training; basic data processing concepts and functions; principles and techniques of gathering and organizing data and statistical analysis; principles and practices of utilization review; basic principles and practices of public and business administration; principles and practices involved in patient access or revenue cycle activities, including knowledge of applicable health information systems; laws, rules, regulations, and policies affecting revenue cycle or patient access functions. Private and third party (Medicare/Medi-Cal) insurance authorization and claiming procedures, rules and regulations.
  • Create, interpret, and implement policies and procedures; establish and implement best practices; schedule and assign work, train staff; establish and evaluate priorities; read, interpret, explain and apply regulations, laws, rules and procedures related to patient access or revenue cycle operations; develop and implement work procedures and systems to meet required standards; prepare clear and concise oral and written reports; communicate effectively; analyze situations accurately and take effective action; establish and maintain effective working relationships with patients, physicians, staff, outside agencies, community partners and the public; negotiate admitting and payment arrangements; ability to quickly and accurately access and resolve complex admission, billing and treatment authorization issues.
  • Preferred experience includes revenue cycle and patient registration management at a Federally Qualified Health Center (FQHC).
  • Health Insurance : San Joaquin County provides a comprehensive benefits package to employees of this bargaining unit. The benefits include the option of three medical plans: a Kaiser Plan, a Select Plan, and a Premier Plan. Employees pay a portion of the cost of the premium. Dependent coverage is also available.
  • Dental Insurance : The County provides employees with a choice of two dental plans: Delta Dental and United Health Care-Select Managed Care Direct Compensation Plan. There is no cost for employee only coverage in either plan; dependent coverage is available at the employee’s expense.
  • Vision Insurance : The County provides vision coverage through Vision Service Plan (VSP). There is no cost for employee only coverage; dependent coverage is available at the employee’s expense.
  • Life Insurance : The County provides eligible employees with life insurance coverage as follows: 1 but less than 3 years of continuous service: $1,000 3 but less than 5 years of continuous service: $3,000 5 but less than 10 years of continuous service: $5,000 10 years of continuous service or more: $10,000 Employees may purchase additional term life insurance up to a maximum of $200,000 at the group rate. Regular employees in this unit shall be provided with a supplemental life insurance policy with a face value up to $75,000.
  • 125 Flexible Benefits Plan : This is a voluntary program that allows employees to use pre-tax dollars to pay for health-related expenses that are not paid by a medical, dental or vision plan (Health Flexible Spending Account $2550 annual limit with a $500 carry over); and dependent care costs (Dependent Care Assistance Plan $5000 annual limit).
  • Retirement Plan : Employees of the County are covered by the County Retirement Act of 1937. Please visit the San Joaquin County Employees’ Retirement Association (SJCERA) at www.sjcera.org for more information. NOTE: If you are receiving a retirement allowance from another California county covered by the County Employees’ Retirement Act of 1937 or from any governmental agency covered by the California Public Employees’ Retirement System (PERS), you are advised to contact the Retirement Officer of the Retirement Plan from which you retired to determine what effect employment in San Joaquin County would have on your retirement allowance.
  • Deferred Compensation : The County maintains a deferred compensation plan under Section 457 of the IRS code. You may annually contribute $22,500 or 100% of your includible compensation, whichever is less. Individuals age 50 or older may contribute to their plan, up to $30,000. The Roth IRA (after tax) is also now available.
  • Vacation : Maximum earned vacation is 10 days each year up to 3 years; 15 days after 3 years; 20 days after 10 years; and 23 days after 20 years.
  • Holiday : Depending on date of hire into the unit, employees earn either 10 or 14 holidays per year.
  • Administrative Leave : Each fiscal year, department heads grant 10 days of administrative leave to eligible salaried employees. Administrative leave may not be carried beyond to the next fiscal year.
  • Sick Leave : 12 working days of sick leave annually with unlimited accumulation.
  • Sick leave incentive : An employee is eligible to receive eight hours administrative leave if the leave balance equals at least one-half of the cumulative amount that the employee is eligible to accrue. The employee must also be on payroll during the entire calendar year.
  • Bereavement Leave : 3 days of paid leave for the death of an immediate family member, 2 additional days of accrued leave for death of employee’s spouse, domestic partner, parent or child.
  • Merit Salary Increase : New employees will receive the starting salary, which is the first step of the salary range. After employees serve 52 weeks (2080 hours) on each step of the range, they are eligible for a merit increase to the next step.
  • Educational Reimbursement Program : Eligible employees may be reimbursed for career-related course work up to a maximum of $850 per fiscal year. Eligible employees enrolled in an approved four (4) year College or University academic program may be reimbursed up to $800 per semester for a maximum of $1600 per fiscal year.
  • Parking Supplemental Downtown Stockton : The County contributes up to $20 per pay period for employees who pay for parking and are assigned to work in the Downtown Core Area.
  • School Activities : Employees may take up to 40 hours per year, but not more than eight (8) hours per month, to participate in their children’s school activities.
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