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Position Summary

:

Under the direction of the Manager/Director of

Patient Access

; plans, directs, evaluates, controls, and organizes the staff and functions of the

Patient Access

Department.

Essential Functions and Responsibilities:

1.

Coordinates the pre-registration and financial counseling activities for surgery, elective diagnostic and inpatient services. Assures that demographic and insurance data is entered utilizing the conventions required to produce correct claims and HIPAA compliant transactions, and that services are financially screened.

2. Coordinates review of emergent inpatient admissions, ensuring that precertification and concurrent review requirements set forth by third party payers are met in a manner to prevent denials and avoid the need for appeal. Coordinates financial counseling activities for inpatient services up to and including completion of medical assistance applications, in house collections, as well as courtesy discharge process when indicated.

3. Hires, trains or schedules for training, assigns duties, supervise and evaluates performance of employees who perform pre-arrival and inpatient financial clearance functions. Monitors inventories of scheduled services in order to correctly assess staffing needs and ensure timely completion of prearrival registration and financial clearance functions.

4. Maintains current knowledge of computer registration and patient care system applications in use at the hospital. Maintains current knowledge of various third party electronic eligibility tools.

5 .Functions as subject matter expert on third party benefit levels and coverage criteria, as well as pre-certification, authorization and referrals requirements, in order to ensure that appropriate data gathering and insurance verification is performed in accordance with third party regulations and in a timely manner. Functions as resource for subordinate personnel in resolving complex and/or sensitive work related matters. Accountable for adherence to deny/delay policy. Accountable for furnishing Patient Registration staff sufficient financial/self-f pay detail in order to expedite patient intake process on date of service.

6 .Prepares and monitors long-range productivity and volume related statistics for enhanced operational efficiency of the department.

Qualifications

Required:

* Bachelor’s degree required or equivalent combination of education and relevant experience may be acceptable.

* Three years of patient accounting or patient access experience.

* Experience in health care setting.

* One year leadership experience.

* Working knowledge of medical terminology and billing systems/software.

* Must demonstrate effective interpersonal, communication and analytical skills.

Preferred:

* Bachelor’s degree in business management, accounting or related field.