GENERAL SUMMARY:
Responsible for daily operations of the Patient Service Center which includes pre-registration, insurance verification, pre-authorization, and patient scheduling and service assistants. Works with patients, physicians, physician office staff, third-party payers, patient financial services, hospital outpatient department and case management staff to secure hospital reimbursement, pre-payments, avoid denials and private non-payment.
PRINCIPAL JOB FUNCTIONS:
- Commits to the mission, vision, beliefs and consistently demonstrates our core values.
- Directs and advises departmental personnel in patient service center procedures; facilitates the scheduling of patient service staff to ensure coverage for all required areas; supervises and evaluates the work of assigned staff members.
- Supports team members in problem solving to attain first call resolution and addresses escalated customer service concerns in a responsive, timely, and accurate manner.
- Selects and hires qualified candidates for patient service center workgroup.
- Facilitates and provides on-the-job training pertaining to scheduling, pre-authorization and pre-registration activities for departmental new hires.
- Performs quarterly reporting on staff accuracy and efficiency as assigned.
- Performs direct observations of staff engaged in scheduling, pre-authorization and pre-registration functions; completes annual performance evaluations on time.
- Maintains documentation of initial and annual training of staff; ensures mandatory training is completed as scheduled.
- Meets or exceeds Patient Service Center goals for all established key performance indicators.
- Collaborates with other leaders to ensure accounts transition smoothly from the point of scheduling to authorization.
- Collaborates with Bryan Physician Network office managers and leadership to secure professional and hospital reimbursement, avoid denials and private non-payment.
- Provides information and enrolls physician offices in High Dollar Radiology and Medication Access Team (MAT) authorization services. (N/A for Assistant Manager for PSSA’s)
- Maintains awareness of insurance requirement changes, and shares knowledge with hospital staff as needed.
- Supports and facilitates a respectful and collaborative relationship between medical staff, hospital staff, and patient access staff.
- Participates in annual review of policy and procedures; enforces established performance standards and procedural protocols, ensuring proficiency and competency; implements, monitors and enforces safety policies and procedures.
- Routinely assists the manager in concurrent and retrospective resolution of patient, family, and/or physician concerns or complaints.
- Routinely assists the manager in completion and/or resolution of incidents and/or feedback B-Safe files. Responsible for monthly rounding and stoplight reports.
- Timely, objectively, and constructively coaches staff as needed when practice and/or HIPAA issues are observed or reported, and documents as appropriate.
- Routinely assists manager in safety/orientation training of staff, assessing competency, and maintaining a safe work environment through safety rounds.
- Routinely assists manager in coaching and training staff as directed to achieve an excellent patient experience.
- Routinely assists the manager in training staff in HIPAA compliance, COBRA/EMTALA understanding, and other regulatory requirements by assessing competency, and maintaining documentation.
- Practices personal and professional improvement through continuing education and development opportunities.
- Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.
- Participates in meetings, committees and department projects as assigned.
- Performs other related projects and duties as assigned. (Essential Job functions are marked with an asterisk “*.” Refer to the Job Description Guide for the definition of essential and non-essential job functions.)
In addition to the principal job functions contained in the primary job descriptions, the following duties are also required in the department noted above.
- Supervises Patient Scheduling and Service Assistants staff across multiple locations both on and off-campus in Lincoln and Norfolk.
- Ensure resources are aligned with department volumes which may include floating staff to different locations, coordination and assignment of PRN schedule, and personally working in the departments as needed.
- Completes System Registration Reviews and continued education and corrective action as needed based on performance.
- Sustains collaborative relationships with other departments.
- Schedules and maintains interdepartmental rounding with leaders and regularly attend clinic staff meetings.
- Supports the financial goals of Bryan Medical Center by ensuring timely collection of patient payments and deposits at the Bank.
- Orders supplies and forms; contacts vendors as needed to ensure proper equipment functioning/maintenance.
EDUCATION AND EXPERIENCE:
Associate's degree (AA) or two (2) years progress toward a Bachelor’s degree in finance or management or related field of study required. Bachelor’s degree is preferred. Demonstrated success in a leadership role preferred. Minimum of one (1) year of relevant Revenue Cycle experience.