Director, Patient Access
Manage, direct, coordinate and oversee all patient access responsibilities, including but not limited to scheduling of new and established patients, point of service payment operations, authorizations for both new and established patients, patient insurance registrations and ongoing verification, and admission and registration.
• Oversees the proactive monitoring and resolution of health plan authorizations and claim denials and investigates root cause for patterns in denials.
• Develops and unitizes key performance metrics that relate to the operation of Patient Access and works to bring results to within organizationally established benchmarks.
• Administers established departmental policies and procedures, objectives, quality assurance programs, safety, and compliance standards.
• Ensure staffing meets the needs of the Patient Access goals and objectives and develops and oversees the execution of
emergency departments plans including staffing, emergency equipment, procedures, and internal/external communications.
• In collaboration with senior leadership, explores, recommends, and develops new opportunities/programs to optimize access.
• Works with the Directors, Managers, Supervisors to develop and implement a comprehensive annual budget in collaboration with the corporate budget department.
• Establishes and/or maintains open lines of communication with Director HIMS, clinical departments, physicians, patient accounting, utilization review, outside professional services, managed care, patient services, third party insurers and other administrative departments.
• Provides direction in complex situations and ensures timely resolutions of issues.
• Facilitates multidisciplinary meetings by establishing efficient meeting procedures, setting goals, and ensuring favorable outcomes.
• Investigates patient complaints and works with staff/advocates to determine the facts; works with the involved staff and Patient Access to develop and implement resolutions and preventative strategies as necessary; responds to patient or family complaints in a timely manner.
• Works with Patient Access Supervisors to cultivate a strong team dynamic; helps facility group meetings and activities.
• Conducts annual and ongoing reviews of staff performance; provides guidance to direct reports to ensure goals and objectives are achieved within established time frames; intercedes to resolve problems when necessary.
• Assures conformance with standards including The Joint Commission (TJC), the Food and Drug Administration (FDA), the New York State Department of Health (NYSDOH), and other regulatory agencies.
MINIMUM QUALIFICATIONS (All applicants MUST meet these):
1. Master’s Degree in Business or Healthcare Administration with 8 years of work experience in Patient Access and/or Revenue Cycle Operations; or
2. Bachelor’s Degree in Business or Healthcare Administration with 10 years of work experience in Patient Access and/or Revenue Cycle Operations; or
3. Associate’s Degree in Business or Healthcare Administration with 12 years of work experience in Patient Access and/or Revenue Cycle Operations.
Required degrees must have been granted by an accredited school, college or university or one recognized by Roswell Park Comprehensive Cancer Center as following acceptable educational practices.
• Health care experience, preferably in a clinical capacity to ensure a deep appreciation for the complexity of health care delivery.
• Business acumen and budget development and management experience.
• Hospital patient access experience.
• Experience in obtaining insurance authorizations for patient care, patient registration and other revenue cycle experience.
• Ability to manage a high-volume, high-throughput department.
• Ability to make modifications to workflows and decisions independently when and where appropriate
• Excellent interpersonal skills, strong organizational and strategic planning skills, and excellent communication skills (written and Verbal).
• Knowledge of insurance, specifically approvals/pre-certifications/referral management.
• Knowledge of database management and data analysis.
• Ability to analyze and create meaningful executive-level and detailed reports.
• Ability to work with persons and families of all ages