Patient Access Supervisor

DRISCOLL HEALTH PLAN•Corpus Christi, TX

About The Position

The patient access Supervisor is responsible for the daily operations of all scheduling, registration or admission, registration, and financial counseling functions at all access points in support of revenue and reporting cycle. The manager will interact with departments at all levels to ensure accuracy of information and quality of processes. Assesses and improves department performance and ensures orientation and continuing education of departmental staff. This leader serves as a key promoter to service excellence which, along with the team, strives to meet and exceed the needs of their customers. As a leader in this department, this person may recommend resources/space needed by the department and may participate in the selection of outside services.

Requirements

Associate's degree (A. A.) or equivalent from two-year College or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience.

Responsibilities

Maintains utmost level of confidentiality at all times.
Adheres to hospital policies and procedures.
Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
Adheres and complies with customer service standards and dress code as set forth by the hospital and the department.
Answers the department telephone immediately or within three rings utilizing courtesy and patience.
Greet patients and their families with courtesy and concern for their needs using the Driscoll Way to Service Excellence
Listens to customer needs and takes appropriate action as indicated.
Gather patient demographic and financial information in a kind and courteous manner.
Reschedule patients upon patient request and notifies the patient’s physician.
Mark patient cancelations in the appropriate scheduling system and notify the patient’s physician.
Document telephone encounters in patient account notes; brief but important details only
Manage an appointment waiting list and canceled list as indicated to ensure services are provided promptly.
Call patients to confirm appointment times and offer any other pertinent information such as out of pocket expense, education, directions, parking information, etc.
Schedule patients for necessary procedures as indicated, using the appropriate scheduling system and obtain authorization for all planned services as indicted by insurance carrier.
Accurately create patient encounter in patient accounting systems utilizing the appropriate patient search criteria and interview method
Verify patient’s insurance benefit and document findings, this process should be completed in the appropriate timeframe for the service being provided; refer to Emergency Medical Treatment and Labor Act -EMTALA guidelines for ED arrivals/services.
Refer cases for financial screening as indicated.
Obtain Authorization or Referral for services as indicated for all elective services; following EMTALA rules for ED visits.
Add a clear copy of picture identification and insurance cards, front and back to the patients Electronic Medical Record - EMR
Explain all business forms and obtain signatures.
Issue Patient Rights and Responsibilities and the hospitals Notice of Privacy Practice as indicated.
Issue patient identification card or wristband identification as appropriate.
Ensure the patient/family is escort to the appropriate service area.
Contact the Patient Intake Nurse for all direct admissions as indicated.
Review work queues to identify potential duplicate medical record numbers.
Identify patients with multiple same day visits to match demographic and insurance data for each pre-registration.
Review patient demographic and financial data to ensure accuracy.
Validate verification and documentation of insurance eligibility and coverage for anticipated procedures.
Validate insurance authorizations was obtained from referring physicians when necessary/appropriate.
Validate insurance authorizations was obtained from payors when necessary/appropriate.
Validate documentation of patient insurance benefit, co-payment, deductible and co-insurance agreements in preparation for collection at the time of service or prior to discharge.
Reviews pre-registration list for no shows and cancellations to reschedule or cancel account as indicated.
Reconcile Census with Census Reports and Registration forms as indicated.
Review documented notes for payment requirements; explains insurance benefits as quoted to us by their insurance carrier and collects patient’s out of pocket expenses.
Prepare hospital receipt for payment received.
Validates address and phone number at every opportunity.
Ensures all paperwork is complete and all insurance cards and identification cards are copied for business record.
Document all actions taken at discharge in patient accounting system.
The department Standard Operating Procedure for cash handling will be followed.
Securely maintain system wide safety box.
Effectively administers performance management system including: Developmental feedback scorecard per employee, goal setting per employee / unit, assesses competency, progressive discipline.
Strong knowledge of and effective in administering hospital policies and procedures
Responsible for sound management of human resources
Makes and implements decisions compatible with organizational goals.
Maintains composure, effectiveness, and flexibility under pressure.
Communicates and works effectively with clinical managers and staff.
Actively participates in process improvement to standardize Patient Access processes among the department.
Actively participates in regular departmental meetings to develop, implement, and report processes that ensure staff compliance with job functions.
Assists in interviewing potential candidates for the Patient Access Representative or Financial Counseling positions.
Monitors time and attendance report for chronic tardiness and O/T
Monitors that staff are up to date on annual mandated Corner Stone courses.
Monitors work queues to ensure accounts are being completed promptly.
Prepares unit schedules.
Completes competence reviews in a timely manner.
Complete annual performance review in a timely manner