DIRECTOR OF PATIENT ACCESS-SRMC

Department: Patient Financial Services - SRMC

FTE: 1.00

Full Time

Shift: Days

Position Summary:

Plan, direct, and manage assigned programs and activities related to the following areas: Health information Management (medical records), Coding/CDI, PBX operations, Call center, centralized prior authorization/referral services and charge entry. Responsible for frontline education of staff/management and revenue cycle processes for front end operations. Oversees SRMC Care program. Manage department Managers and/or Supervisors/Leads to ensure that UNM: Sandoval Regional Medical Center meet established standards. Train and support direct staff and management in their duties. Verify through direct observation and systematic reporting that all information necessary to create a complete and accurate patient account is consistently obtained and entered. Ensure that appropriate and necessary notifications are made to insurance carriers or agencies. Advise, inform and assist patients before, during and after their date of service. Ensure policies and procedures are developed, administered and monitored for efficient, effective management of all programs. Responsible for coordinating the planning, implementation and evaluation of patient registration, health information management, coding and admitting functions at SRMC. Responsible for the ongoing development of admission, preadmission, and patient assistant strategies, monitoring and evaluation of project outcomes, and effectively communicating and integrating the mission, values, and strategic initiatives of the hospital. Ensure compliance with the Joint Commission requirements and other governmental requirement as applicable for the department. Ensure adherence to Hospitals and departmental policies and procedures. No patient care assignment.

Detailed Responsibilities:

• POLICIES AND PROCEDURES - Maintain established departmental policies and procedures, objectives, and quality assurance programs
• PROFESSIONAL DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops; stays current and proactive in new regulations to ensure highest level of compliance in the department
• COMMUNICATION - Strong client relationship and communication skills
• DATA ANALYSIS - Identify data required to support performance improvements and analyze for trending and building of improvement measures. Support CFO in the development, implementation, and tracking of financial activities identified in revenue cycle strategic plans and annual plans
• DEVELOPMENT - Project management; Oversee the development and implementation of Revenue Cycle initiatives, including the management, revision, and on-going monitoring of utilization management practices including prior authorizations, registration and patient admission activities, claims and data entry
• PERFORMANCE - Ability to identify performance gaps and effectively lead change to address
• LEADERSHIP - Mentors and manages staff to affect superior performance. Provide leadership through identification of problems, opportunities for improvement, action planning, and implementation; make personnel decisions to include interviewing, hiring, supervising, training, evaluating, disciplining and terminating department personnel
• POLICIES AND PROCEDURES - Effectuates performance evaluations, personnel policies, hiring, promotion and discipline
• EDUCATION - Provide in-service, continuing education to the staff, ensuring that they are made aware of changes in policies and procedures pertaining to their area
• REVENUE CYCLE - Knowledge of full revenue cycle
• PERFORMANCE - Oversee the work of department personnel by training, allocating and monitoring work; evaluate performance and make recommendations for personnel action; oversees staff hours to best suit departmental and organizational needs; develop plans and make recommendations relative to organizational and departmental operations such as organizational structure, space and layout, equipment use, work flow, and staffing
• PROJECTS - Assist with special projects and assignments
• DEVELOPMENT - Oversee the development and implementation of Revenue Cycle initiatives, including the management, revision, and on-going monitoring of utilization management practices including prior authorizations, registration and patient admission activities, claims and data entry
• RECORDS - Serve as Custodian of Records for UNM: SRMC
• PATIENT ACCESS - Monitor KPI for HIM and Patient Access functions
• COMMITTEES - Actively participate in various hospital committees
• RELATED DUTIES - Perform miscellaneous job-related duties as assigned
  
  

Qualifications

Education:

Essential:

• Bachelor's Degree
  
  

Nonessential:

• Master's Degree
  
  

Essential:

Education specialization:

• Related Discipline
  
  

Nonessential:

• Related Discipline
  
  

Experience:

Essential:

4 years directly related experience

Nonessential:

8 years directly related experience Bilingual English/Spanish

Credentials:

Essential:

• Not Applicable/Not Required
  
  

Physical Conditions:

Light Work: Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. May require walking or standing to a significant degree or requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or may require working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of materials is negligible.

Essential:

Working conditions:

• Minor Hazard - physical risks, dirt, dust, fumes, noise