Job Purpose
The Director, Patient Access will provide leadership to RCM/AR Follow Up Managers and their teams, including supervision of staff, reviewing of processes, and providing recommendations for improvement of operations. Goal is to meet or exceed national AR KPI benchmarks and client specific KPI's. Maintain or exceed productivity and quality standards set for departments assigned. Understand and communicate the economic impact of upstream revenue cycle errors causing denials and provide data and recommended effective processes to correct actions. Rely on extensive experience and judgment to plan and accomplish goals.
Duties and Responsibilities
- Plan, organize and direct overall operations of the Insurance Verification and Authorization Team as it relates to patient intake and pre-visit services
- Serve as the visionary for Patient Access workflow and work in conjunction with Med-Metrix leadership to set target performance levels
- Ensure that Med-Metrix stays current with payer regulations and industry requirements and/or trends
- Identify opportunities/risks and establish and convey to VP, Patient Access Services and other Med-Metrix leaders, providing solutions and plans to execute
- Maintain an overall objective of maximization of patient satisfaction, reduction of eligibility, benefit and authorization denials and the minimization of write-offs/non-collectible adjustments
- Proactively monitor KPIs, process metrics and SLAs to ensure the department is achieving best practice performance
- Review weekly and monthly reporting, and utilize other work tools to review trends in RTE Errors, work queue volumes and denials and proactively address potential issues
- Provide concise reporting to Executive Leadership on performance benchmarks as they relate to national and client based KPI's
- Provide management and supervisory duties related to educating and training staff, evaluating staff performance and monitoring productivity
- Interview, hire, train, evaluate, and develop subordinate staff, where applicable
- Develop and maintain quality control programs, including in-depth and individual performance reviews
- Orient new hires and provide in-services and training, continuing education, and development related to those functional areas of responsibility
- Mentor Manager, Patient Access on strategic thinking, analysis of metrics and effective client communication.
- Perform a variety of tasks including development of front-end processes, training material, control reports and KPIs
- Serve as facilitator and lead on Med-Metrix front-end implementations. Finding the "best practice" solutions looking at the whole process
- Represent Med-Metrix on Client Projects and provide communication back to Med-Metrix executive leadership
- Provide professional and summarized quantitative analysis to Med-Metrix and client executives through presentation and reporting
- Provide summarized analysis to Operations Leadership and staff
- Attend external seminars/training as needed
- Other duties as assigned
- Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Understand and comply with Information Security and HIPAA policies and procedures at all times
- Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Qualifications
- Bachelor's Degree
- 7 yrs. min. experience directing and leading a physician business office/professional services CBO or hospital Patient Access department
- Must be experienced in and have extensive working knowledge of all systems related to the revenue cycle
- Ability to work well individually and in a team environment
- Must be reliable, responsible, goal oriented and flexible
- High degree of integrity including ability to successfully deal with sensitive or confidential information
- Proficiency in Microsoft Office Suite
- Strong interpersonal skills, ability to communicate well at all levels of the organization
- Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
- Gracious and welcoming personality for customer service interaction
Working Conditions
- Occasional travel to client sites
- Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
- Work Environment: The noise level in the work environment is usually minimal.
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
