- Other Appropriate affiliation with national organizations which provide or enhance expertise and ongoing knowledge.
- 3 Years experience in large hospital setting, medical group, or A/R consulting company in inpatient accounting. Preferred Qualifications
- EPIC system experience. Other Qualification Requirements
- Bachelors Degree in Business Administration or equivalent knowledge and experience, preferably in accounting or finance. - Required Essential Functions
- Under the direction of the System Director Revenue Cycle-Access Services, the Manager of Patient Access Services/GH prepares budgets and financial reports for the functional areas, develops operational plans (short-term and long-term) and ensures that all claims submitted comply with rules and regulations governing Medicare and Medi-Cal billing. The Manager determines appropriate staffing ratios, evaluates performance, recommends changes which may reduce staffing, enhance efficiencies, improve billing production, maximize reimbursement, and ensures satisfactory service to physicians, patients, and other customers. The Manager also advises the System Director on appropriate integration strategies which affect billing and affiliated services. The Manager serves as a professional role model in overall conduct, communication, and approaches to practice. The Manager assures employees possess the training and knowledge to competently deliver services with expected outcomes. The Manager provides leadership to assure that staff practice safe work habits, and that the working environment is consistently within regulatory standards.
- QUALITY
Patients are received and processed accurately, timely and completely in compliance with appropriate system priorities, goals, and objectives.
MEASUREMENT: Customers dependent on Business Services are satisfied with information received as demonstrated by few complaints.
Data is collected in a manner that facilitates a clean hospital claim. Overall outcome is prompt payment on account and patient satisfaction with billing product.
MEASUREMENT: 95% of claims accepted on first claim voucher to payor.
Systems are implemented to assure patient satisfaction with admission process and billing information received. Necessary documents are developed and implemented that will improve patients' understanding of billing expectations, payment options, and personal balances.
MEASUREMENT: Patient Satisfaction Survey results meet acceptable standards. Where improvement is needed, action plans are developed and implemented. - SYSTEM DEVELOPMENT
Seeks opportunities to improve Department performance through computerization/automation and/or process enhancement.
MEASUREMENT: Implements 2-3 system improvements per year.
Establishes a working rapport with peers that facilitates procedural standards and optimal use of resources across Sharp HealthCare.
MEASUREMENT: Defines and implements 3-5 policy/procedure system standards per year.
Assures that systems are established and implemented to maintain accuracy and functionality of Centricity database.
MEASUREMENT: Centricity subgroups (ADT, HPA) are current, accurate, and user-friendly. - FINANCIAL PERFORMANCE
Manages hospital unbilled accounts to assure an average DNFB days of 5.
MEASUREMENT: DNFB days achieved 9 of 12 month of review year.
Develops Department budget and ensures that Department operates within confines of established budget.
MEASUREMENT: Year-end and monthly trend reports at or below budget (variable or fixed).
Develops and enforces production standards for each position description. Communicates individual and team production performance on a regular basis. Acknowledges and addresses individual exceptional performance, exceeding the standard or failing to meet standard, when appropriate.
MEASUREMENT: Goals are reported monthly to include individual and Department goals. Rewards and recognition are presented timely as evidenced in monthly report to System Director.
Monitors compliance with administrative allowance, charity, and other PFS policies to ensure appropriateness and consistency among Sharp HealthCare. Reviews financial statements and shares assessments with System Director. Facilitates prompt identification of payment source for all patients and assists staff in identifying and facilitating alternate payment sources, when needed.
MEASUREMENT: Frequency of unidentified payor source is within acceptable range. Charity and Bad Debt are within National Standards for the hospitals. Achieves on-site cash collection goal. Registration and Financial Counselors document daily efforts to secure payor source on unfunded patients. - LEADERSHIP
Ensure staff receive proper training and education regarding the rules and regulations governing Medicare and Medi-Cal patient registration and billing. Participates in the administration of the department Billing Compliance Plan.
MEASUREMENT: Claims are compliant with Medicare and Medi-Cal rules and regulations. Staff attend a minimum of 3 workshops per year. All staff sign "Declaration of Understanding" as published in department Billing Compliance Plan. Facility stays off Focus Medical Review for Medicare.
Enforces all policies in a consistent and fair manner. Manages and resolves all payroll, compensation, evaluation, training, hiring, termination, grievance, disciplinary, and development issues for assigned staff.
MEASUREMENT: All human resource issues are resolved in a satisfactory and timely manner with no more than 1 exception annually. 95% of performance reviews are completed on or before due date.
Creates an environment that fosters appropriate development and utilization of human resources. Effectively communicates external changes which impact the Department as well as organizational changes, issues, plans, and directives on a routine basis. Serves as a professional role model in overall conduct and communication.
MEASUREMENT: Maintains an availability to staff in informal and formal settings. Conducts at least 12 staff meetings per year at which System, Hospital, and Department issues are discussed. Meeting business is documented with minutes. Topics to include several of the following:
* Compliance
* Quality Improvement
* Financial Reports
* Customer Relations
* Insurance Updates
* Safety
* Employee Recognition
* Employee Motivation/Morale Enhancement
Assures that all staff training, training material, and training checklists are developed, current, and available to employees.
MEASUREMENT: Evidenced by producing material upon request of PFS System Director and maintaining employee checklists and inservice records in employee files. Knowledge, Skills, and Abilities - Exposure to and knowledge of the continuous quality improvement concept.
- Strong professional level of written and oral communication skills.
- Ability to defuse volatile situations, use good judgement and tact in dealing with the public.
- Working knowledge of hospital and ambulatory care charging policies, contractual payment schemes, and collection agency policies.
- Working knowledge of medical terminology, ICD10 coding, RVS coding, and CPT coding.
- Ability to discuss personal and financial matters with patients or their representatives.
- Ability to withstand pressure, meet deadlines, and positively react to stress associated with job duties.
- Ability to use resources in an organized manner.
- Bilingual preferred.
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Patient Access Services Manager-Patient Access Services-Emergency-Sharp Grossmont Hospital-Full Time-Variable Shift - La Mesa, United States - Sharp HealthCare
Description
Hours :
Shift Start Time:
VariableShift End Time:
VariableAWS Hours Requirement:
8/40 - 8 Hour ShiftAdditional Shift Information:
Weekend Requirements:
As NeededOn-Call Required:
NoHourly Pay Range (Minimum - Midpoint - Maximum):
$ $ $82.731The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.
What You Will DoThe Manager of Patient Access Services/GH is responsible for the 24-hour per day, 7-day per week operation of all patient access and account activities from admission notification through creation of final billing product. The Manager is accountable for assuring consistency with standards promulgated by appropriate professional organizations, accrediting bodies, and regulatory agencies. Additionally, the Manager assures compliance with established hospital and system objectives, balancing quality, cost, clinical outcomes, and organizational mission, values and philosophy.
Required Qualifications
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class
