PATIENT ACCESS SUPERVISOR

Compensation Disclaimer Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations. Department: UNMHS Appointment Center

FTE: 1.00

Full Time Shift: Days Position Summary Supervise Patient Services Representatives, Patient Care Coordinators, and other prior authorization referral scheduling staff. Ensure referrals and prior authorizations are obtained for all services of an elective or non-urgent nature. Ensure that appropriate and necessary notifications are made to insurance providers. Develop, implement, and direct the provision of appointments, referrals and authorizations. Ensure adherence to Hospitals and departmental policies and procedures. No patient care assignment. Detailed responsibilities APPOINTMENTS - Assist staff with scheduling and coordinating ancillary service and clinic appointments ASSIGNMENT - Oversee and assign case loads and staff hours to best suit Hospitals needs CONTINUITY OF CARE - Collaborate with the health care team to ensure continuity of patient care throughout all health care settings; promote effective communication among health care team members including the patient, family, and significant others COVERAGE - Organize case coverage during absence of staff CUSTOMER SERVICE - Conduct appropriate customer relations activities DOCUMENTATION - Provide routine verbal and written documentation for the initial assessment and progress of the patient to other members of the health care team in a timely manner EDUCATION - Develop educational mechanisms required to review basic staff skills and integrate new practices LIAISON - Act as liaison between staff, UNMH Business/Billing Department, Managed Care Office, Admitting and outside agencies OPERATIONS - Ensure departmental programs run smoothly and efficiently; oversee operations, schedule staff, and expedite problem resolution POLICY & PROCEDURE - Develop and maintain policies and procedures for referral, prior authorization management and centralized scheduling PROBLEM SOLVING - Troubleshoot and resolve referral and prior authorization problems with third party agencies PROCESS IMPROVEMENT - Monitor staff functions, identify opportunities for improvement, and take necessary steps to achieve the identified opportunity QUALITY - Monitor 96/72/48 hour 10-5day process and number of cancelled patients due to prior authorization or referral REIMBURSEMENT - Ensure optimal reimbursement from governmental third party payers, obtaining proper authorization REPORTS - Create monthly reports on UPA/UH denial activity by department DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops RELATED WORK - Perform related duties and responsibilities as required ADMINISTRATION - Perform various administrative functions such as monitoring expenditures and preparing reports and correspondence; may participate in a variety of research projects to develop service plans; may propose changes to program policies and procedures SUPERVISION - Develop efficient organizational structure. Supervise employees and select, terminate, train, educate, correct deficiencies, perform appraisals, issue discipline, counsel, schedule work assignments; encourage staff teamwork and growth initiatives Qualifications Education Essential: High School or GED Equivalent Nonessential: Bachelor's Degree Education specialization: Nonessential: Related Discipline Experience Essential: 3 years directly related experience Nonessential: No preferred experience Credentials Essential: Not Applicable/Not Required Physical Conditions Sedentary Work: Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met. Working conditions Essential: No or min hazard, physical risk, office environment May be required to travel to various work sites May perform subordinate tasks in high census/vol May be required or is required to perform on-call duties May work rotating shifts, holidays and weekends Tuberculosis testing is completed upon hire and additionally as required #J-18808-Ljbffr UNM HOSPITALS