Clinic Manager

Manager of Patient Access Operations

Position Code: MgrPAOM-8110

Department: Patient Access

Safety Sensitive: Yes

Reports to: Director of Patient Access Services

Exempt Status: Yes

Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHIs vision to be among the kindest, highest quality health systems in the country.

Key Responsibilities

Quality Improvement

• Possesses knowledge of various types of insurance plans (PPO, POS, HMO, Medicare, and Medicaid.) and other payors.
• Possesses basic understanding of medical terminology.
• Plans, organizes, coordinates, implements, and controls the systems by which patients are registered for services and demographic, clinical, and billing information is developed and maintained.
• Ensures patient interactions are done courteously and efficiently so that patients may arrive at their point of service as quickly as possible.
• Ensures the design of these systems always provides for timely, courteous, and accurate behavior of staff at all times.
• Monitors and evaluates the quality of the department and other de-centralized departments and takes appropriate action based on the findings.
• Engages with leadership and Human Resources (HR) on all employee management and human relations issues.
• Provides excellent customer service and adheres to Behavioral Expectations Agreement.
• Develops and revises position descriptions for all department positions.
• Responsible for interviewing, selecting, and hiring new or replacement staff to fill approved positions.
• Deals effectively, courteously, and professionally with reporting staff, peers, and superiors, as well as with patients and visitors.
• Maintains compliance with EMTALA, DNV, HIPAA, CMS and all other hospital and government regulations applicable to admissions operations.
• Effectively utilizes positive reinforcement to motivate staff and instill confidence.
• Effectively utilizes employee improvement and corrective action methods, when necessary.
• Schedules work hours and assignments for employees to meet the needs of the departments customers.
• Administers hospital and department policies and procedures.
• Provides input to HR concerning pay scales, pay structures, to enable appropriate recruitment and retention of departmental staff.
• Responsible for coaching, delivering corrective action, and addressing employee complaints and grievances.
• Completes employee performance evaluation and personnel action requests in a timely manner.
• Provides opportunities for self and staff development through orientation, in-service, education, and needed training.
• Maintains professional qualifications and remains abreast of current developments and trends in Admissions and Scheduling.
• Holds regular staff meetings to provide communication, direction, and education.

Leadership

• Effectively delegates duties, responsibilities, and special assignments.
• Plans to meet the needs of the departments customers.
• Communicates effectively with other hospital departments and services.
• Participates in the hospitals committees and meetings as requested or needed.
• Assesses current volumes, and projects/plans for future service needs.
• Establishes operational goals and objectives and evaluates achievements at least annually.
• Must be available to work hours and days as needed based on departmental/system demands.
• Must be on-call as needed.

Financial Performance

• Ensures admission, transfer, discharge, and registration functions are performed effectively and efficiently throughout the facility.
• Ensures patient information is gathered correctly and completely to ensure timely and accurate billing.
• Randomly audits registrations and cash receipts and deposits using sampling techniques to ensure accuracy.
• Coaches employees for improvement, where necessary, based on predetermined parameters.
• Ensures that insurance authorizations are obtained as required and that financial counseling is effective during the admissions process allowing representatives to collect co-pays, set payment arrangements and/or offer financial assistance as needed.

Operations

• Develops and implements policies and procedures for the department and other de-centralized registration areas.
• Helps plan and control the departments financial budget.
• Prepares policies and procedures for approval.
• Evaluates departmental performance according to current industry principles to maintain and improve the level of care and results of the patient.
• Oversees and supervises all aspects of patient billing.
• Establishes, maintains, and reviews quality control.
• Responsible for adding necessary and appropriate new services for overall good billing practices.
• Manages departmental safety and sanitation standards.
• Ensures safe and sanitary conditions.
• Provides supervision of the departments preventative maintenance program and works with the appropriate hospital personnel to ensure that equipment is safe, operable and meets regulatory standards.
• Maintains knowledge of and compliance with regulating/accrediting agency requirements.
• Works front line duties when necessary.
• Maintains departmental records for all area of responsibility.
• Performs other duties as assigned by the Director of Patient Access Services or higher supervision.
• Documents system issues while assisting in the development of systems improvements.
• Plans, coordinates, and prepares reports as they relate to Revenue Cycle Management
• Anticipate scheduling needs while maintaining adequate staffing for efficient operations.

Qualifications

Education: Associates degree in Business and/or Health related field, or 2 years equivalent relevant work experience training.

Certification: BLS certification through the American Heart Association or American Red Cross

Licensure: Valid Arizona Drivers License

Experience: Minimum of five (5) years patient access registration and insurance verification experience in a health care setting

Experience in healthcare customer service

Minimum of (3) years supervisory experience in health care setting, however, demonstrated indirect leadership experience may be considered in lieu of this requirement provided it is a direct fit to the role, lead role, project management, or other leadership experiences

Practical experience with electronic health information systems including configuration, implementation, support, and optimization in an ambulatory and acute hospital setting

Demonstrated experience in strategic planning, organization design and development

Skills and Knowledge: Knowledge of healthcare revenue cycle

Familiar with information systems, knowledge of third-party payment methodologies, ICD, and CPT coding.

Ability to demonstrate knowledge of medical terminology and financial counseling

Position requires fluency in English, both written and oral communication skills

Working knowledge with MS Office (MS Word, Excel, PowerPoint, and Outlook)

Preferences

Education: Bachelors degree in healthcare administration or related field

Special Position Requirements

Exposure Category: Category III: Expected duties do not have potential for exposure to blood, body fluids, or tissues.

Other Potential Hazard(s): Possible exposure to chemical substances

Work Requirements: Ability to sit for six to seven hours daily at a computer terminal

Must be able to deal calmly and effectively with frustrated and/or angry clients

Date Staff Position Description Created / Revised: 12/19/2022