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Patient Access Manager

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Published 10 days ago

Status: Full-Time /Exempt

Department: Medical Services

Reports To: VP of Operations

Approved: May 2021

JOB SUMMARY

Manages Patient Access Center, Insurance Verification, Collection Management, Scheduling, and Front-End Activities to support accurate billing processes. Provides daily hands-on support for all patient access functions. Works with outsourced back-end billing firm to ensure decreases in insurance denials and bad debts.

ESSENTIAL FUNCTIONS

1. Hire, train, supervise and conduct periodic performance reviews of all patient access center staff.

2. Provide oversight for completion of all patient access functions including but not limited to: handling and/or directing all incoming telephone calls, facilitate timely patient appointment scheduling, collection of all patient information necessary for appropriate scheduling and insurance verification processes, processing patient payments received via telephone or electronically.

3. Facilitate communication among billing, finance and medical services staff to streamline revenue cycle and to optimize productivity and achieve revenue goals.

4. Monitor and respond to changes in billing requirements, and ensure timely communication of changes to patient access staff, health center staff and leadership

5. Ensure PPDE compliance with regulations, requirements and standards for patient eligibility and billing.

6. Ensure patient access center staff are performing patient insurance verification and financial responsibility assessment processes efficiently and accurately.

7. With VP of Operations; monitor key performance indicators, analyze performance trends and implement process improvements to address deficiencies.

8. In conjunction with the VP of Operations, evaluate and implement technological tools to improve efficiency and productivity in the insurance verification and billing process.

9. Complete and distribute daily performance reports for Health Centers as assigned by VP of Operations.

10. Work closely with the VP of Education and Training and health center managers to train staff, as well as define and implement procedures on front-end processes such as data collection, point of service patient collections, and insurance verification.

11. Take initiative to collaborate with other Planned Parenthood affiliates in projects that have the potential to generate revenue, improve services, or reduce costs.

12. Respond to patient questions and complaints as assigned by VP of Clinical Services and/or the VP of Operations.

13. Complete and process all provider credentialing and enrollment applications. Track and monitor license and certificate expirations; work with providers to ensure all necessary documentation is available in a timely manner.

14. Others duties as assigned.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION AND/OR EXPERIENCE

1. Bachelor’s degree preferred in health, social science, or a related field preferred, along with one (1) to two (2) years of practice management experience OR three (3) to four (4) years health center/patient access management experience.

2. Minimum of three years’ supervision experience including hiring, training and evaluation preferred.

3. Demonstrated experience with electronic practice management systems, NextGen and/or Epic experience is preferred

4. Thorough understanding of insurance verification requirements and processes.

5. Familiarity with medical billing and coding, including ICD-10 is preferred.

6. Thorough understanding of third-party payer contracts, Medicaid reimbursement, provider enrollment and compliance. Familiar with various provider portals related to billing and enrollment.

7. Experience with abortion services, business growth and health center management is highly desirable.

8. Technology skills must include proficiency in Excel, Word, and other Microsoft Office programs.

PROFESSIONAL QUALITIES

Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables. Accurate and detail-oriented. Must demonstrate a commitment to the operating goals of Planned Parenthood.

REQUIRED COMPETANCIES

CUSTOMER SERVICE: Demonstrate concern for meeting internal and external customer needs in a manner that provides satisfaction. Anticipate additional needs of the customer beyond their current use of Planned Parenthood services. Understand and find solutions within the limits of what is available. Can solve problems with minimal disruption. Communicate openly and directly. Able to change communication style according to the needs of the audience and the situation. Able to effectively resolve conflict.

TEAMWORK: Able to gain cooperation from others and work collaboratively toward solutions which generally benefit all involved parties. Proactively identifies opportunities to assist others and ensures that information is communicated accurately and timely to all necessary parties. Behave honestly and ethically. Communicate openly and directly. Able to change communication style according to the needs of the audience and the situation.

PLANNING AND ORGANIZING: Establish a systematic course of action to accomplish specific objectives. Determines priorities and uses time effectively. Completes the workload required of the position. Able to change priorities according to the work load and asks for assistance as appropriate. Demonstrates excellent time management skills and ability to multi-task.

ACHIEVEMENT ORIENTATION: Self-starting. Independently demonstrate a desire to set and meet objectives, to find a better or more efficient way to do things and to compete against a self-defined standard of excellence.

SELF CONFIDENCE: Demonstrate a strongly positive image of self and own abilities, and a willingness to exercise and trust one’s independent judgment.

EXPERTISE (Technical or Procedural): Possess specialized knowledge or skills to accomplish results. Picks up on technical things quickly; is good at learning new skills. Often referred to as a quick learner.

ATTENTION TO DETAIL: Thorough in accomplishing a task. Accurately completes all areas involved no matter how small.

DEVELOPING/DIRECTING OTHERS: Strives to improve the skills of subordinates or others by providing clear, behaviorally specific performance feedback, effective coaching and mentoring, and development experiences and opportunities. Uses interpersonal style and the power of one’s position to set expectations for others, enforce standards, and tell others what they must do towards the accomplishment of identified goals and objectives. Meet requirements of Human Resources documentation, including regular evaluations and appropriate disciplinary actions. Ensure that ethics and honesty are valued and exhibited in work products and daily behavior of self and others.

PHYSICAL DEMANDS: The physical demand characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Will usually be working with general office equipment, including computers, phones, and printers. While performing the duties of this job, the employee is regularly required to stand, walk, talk, read, see and hear. The employee is frequently required to use hands and fingers to type, handle, or feel and reach. The employee is regularly required to sit. The employee must occasionally lift and/or move up to 25 pounds.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

· Work in a diverse environment, build productive relationships, and effectively work independently and collaboratively as part of a team.

· Work in an environment where protestors may be present at work and related sites.

· Work when needed on an irregular schedule, which will include some weekends, early mornings and evenings.

· Work in a cost-effective and flexible manner, multi-task and work effectively under pressure due to conflicting demands.

· Work in an environment where the noise level is occasionally low but usually moderate.

· Be willing and able to travel to local, statewide, regional, and national destinations. A valid driver’s license and insurance coverage for bodily injury and property damage as required by the State of licensing or other ability to provide own reliable transportation is required for local, regional, and statewide travel.

This description is not intended to be an exhaustive list of all duties, responsibilities, and requirements associated with this job. While this is intended to be an accurate reflection of the current job, PPDE reserves the right to revise the job or to require that other or different duties, responsibilities, and/or requirements be made part of the job. Paragraph headings are for convenience only and not intended to have substantive meaning. Nothing in this description is intended to confer any legal rights or powers on the President and CEO or to benefit any party other than PPDE.

Status: Full-Time /Exempt

Department: Medical Services

Reports To: VP of Operations

Approved: May 2021

JOB SUMMARY

Manages Patient Access Center, Insurance Verification, Collection Management, Scheduling, and Front-End Activities to…

Details at a Glance

  • Time Commitment
    Full Time Schedule
  • Start Date
    June 21, 2021
  • Professional Level
    Managerial

Benefits

Full benefits package, eligible on first day of employment

Full benefits package, eligible on first day of employment

Location

On-site
625 N Shipley St, Wilmington, DE 19801, USA

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