Director – Patient Access @ UofL Health

Operations & Logistics (3)
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Operations & Logistics (3)

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Primary Location:

250 E Liberty St

Address:

250 East Liberty St. Louisville, KY 40202

Shift:

Varied (United States of America)

Job Description Summary:

About UofL Health:
UofL Health is a not-for-profit 501(c)(3) fully integrated regional academic health system with six hospitals, three medical centers, Brown Cancer Center, Eye Institute, more than 250 physician practice locations, and more than 1,200 providers in Louisville and the surrounding counties, including southern Indiana.
With more than 14,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care.

Job Description:

Position Summary and Purpose
The Director of Patient Access provides leadership, direction, and administrative guidance to Pre-Access and all Registration areas within the inpatient units, scheduling, written orders, insurance verification, medical necessity, authorizations, and all points of registration entry. Individual must promote a culture to provide very good service to patients, physicians, department staff, and ancillary areas with the expectation to achieve improved patient and team member satisfaction. Participates in establishing policies, procedures, and accountability to meet best in class metrics and operates within the CMS guidelines, and accreditation standards of quality performance standards. Designs a revenue producing mindset and aligns department goals to create a positive patient financial experience.
Essential Functions:
•   Oversees and achieves success in departmental operations based on staffing, census, regulatory changes, budgetary and administrative controls, and market/industry changes,
•   Maintains responsibility for the overall development, implementation, and monitoring of consistent operational processes in each area of the Patient Access Department,
•   Provides leadership to management team and employees of the Patient Access Department including the growth/mentoring of leaders and ensures staff engagement are committed to strategy, mission, and goals of the department,
•   Utilizes benchmarking data to improve departmental outcomes; develops goals and objectives, which support organizational goals and objectives; communicates expectations and progression towards the departmental goals,
•   Develops and motivates Patient Access team members by evaluating, updating, and effectively communicating staff competencies for each department position,
•   Investigates denials to determine “root causes” and patterns to avoid denials and assure claims are processed without errors,
•   Identifies areas hindering performance, including technology and/or processes; develops and implements action plans, as identified,
•   Implements process improvement initiatives continuously focused on meeting metrics and proactively identifying areas of opportunity by working collaboratively, professionally and fostering positive relationships with both internal and external peers,
•   Oversees the hiring, orientation, training, coaching, counseling, and terminations as deemed necessary for the department,
•   Prepares and conducts evaluations for Patient Access leadership,
•   Reviews and accurately approves employee payroll on a bi-weekly basis,
•   Oversees and closely monitors compliance of CMS guidelines, i.e. Admit Source, Medicare Secondary Payor Questionnaire (MSP), Medicare Outpatient Observation Notice (MOON), and Important Message from Medicare notice, and Surprise billing,
•   Oversees and closely monitors that authorizations are obtained, and medical necessity is checked on scheduled procedures prior to service (minimum 24-48 hours).
•   Oversees the screening of self-pay patients for Medicaid eligibility and understands the importance of enhanced payments and uncompensated care to the organization,
•   Creates and maintains a patient collection (Point of Service Collections) strategy (what patients can expect to pay),
•   Ensures guidelines of the healthcare assistance (charity) policy is consistently followed and administered,
•   Ensures quality assurance audits are executed and written analysis is provided to leadership,
•   Guides the process of the correct insurance plan assignment at time of registration, creation of job aids, identification of new plans that should be created to align with electronic and correct “clean” claim submission,
•   Operates the department in a cost-effective manner by: (a) developing budgetary objectives for operational costs (b) Maintaining departmental operations within established budgetary guidelines (operating costs, minimizing overtime, etc. (c) Correlating departmental volumes with expenses when monitoring budget (d) Identifying opportunities to lower departmental costs,
•   Reviews, provides updates/revisions, and implementation of Patient Access policies and procedures at a minimum of once every two years or as needed,

Scheduling Requirements: Must have flexibility with work schedule to meet with and round on staff working all shifts.

Other Functions:
•   Stays abreast and communicates payor changes to management/department staff,
•   Participates and motivates the leadership to ensure processes are in place so all patient registrations are complete prior to the discharge of a patient,
•   Communicates proactively and positively with Patient Access leadership to ensure personal growth in knowledge and skill set,
•   Assists with complex registration discrepancies; collaborates with other revenue cycle leaders, clinical leaders, and Patient Experience leaders to improve customer service, efficiency, and effectiveness of the department,
•   Maintains compliance with all company policies, procedures, and standards of conduct,
•   Complies with HIPAA privacy and security requirements to always maintain confidentiality,
•   Performs other duties as assigned

Additional Job Description:

Job Requirements
(Education, Experience, Licensure and Certification)
Education:
•   Bachelor’s degree in business, Education or other related degree (required)
•   Master’s degree in business administration, healthcare administration (preferred)
Experience:
•   Minimum five (5) years of experience in leadership within a healthcare setting (required)
•   Experience designing and implementing new programs and services relative to Patient Access (preferred)
Licensure:
•   N/A
Certification:
•   Certified Healthcare Access Manager (CHAM) (preferred)
Job Competency:

Knowledge, Skills, and Abilities critical to this role:
•   Knowledge of budget preparation and control, financial statement analysis, staffing models, scheduling, and telecom systems
•   Maintains knowledge of Advance Beneficiary Notification (ABN), Medicare as a Secondary Payer (MSP), Advanced Directives, Patient Bill of Rights, medical necessity, use of observation status, and other regulatory guidelines
•   Strong knowledge of CPT and ICD-9 and ICD-10 coding protocols, federal, state and HIPAA privacy regulations, FQHC’s regulatory requirements, health care delivery standards, policies, and procedures
•   Knowledge of health care trends; ambulatory care, managed care systems and clinical systems, and pertinent information technology systems; understands and can speak to all aspects of Patient Access, from technology, processes, and regulations,
•   Strong mentoring and relationship building skills with ability to effectively manage group and interpersonal conflict situations.
•   Working knowledge of telephone information technology systems, medical office procedures, methods, and equipment, including computerized EPM and EHR systems
•   Exemplifies service excellence – responsive, informs constituents of process, pleasant to work with, educates and provides timely, accurate information.
•   Displays strong organizational skills – manages time effectively, keeps tasks appropriately prioritized and delegates appropriately; works proactively- anticipates and plans for problems before they arise; can perform work in a neat, efficient, well-coordinated, well communicated manner with a high degree of accuracy and professionalism.
•   Role models strong work ethic – motivated, diligent, industrious, and persistent in the workplace, stays on tasks to completion, works at a fast pace to ensure optimal efficiency; remains flexible – ability to change directions, as needed, to ensure optimal outcomes.
•   Displays strong interpersonal skills– can build effective, strong working relationships with employees, colleagues, management and vendors through trust, communication, and credibility; displays self-awareness and emotional intelligence, exercises sound judgement; ability to quickly establish rapport, motivate and gain respect.
•   Displays strong leadership skills – ability to work collaboratively with others, serve others, help others, lead others, mentor others, and take directions from others in the interest of moving process and programs forward to the desired outcome,
Language Ability:
•   Must be able to communicate effectively in both verbal and written formats,
•   Basic research methods and report writing technique,

Reasoning Ability:
• Ability to break down problems or tasks; scanning one’s own knowledge and experience to identify causes and consequences of events,

Computer Skills:
•   Proficient in Microsoft Office Suite (Word, Excel, Outlook)
•   Knowledge of complex computer systems relating to all hospital operations and clinical systems requirements
•   Must possess working knowledge of data requirements for a complete and compliant registration,

Additional Responsibilities:
•   Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor always,
•   Maintains confidentiality and always protects PHI and sensitive data,
•   Adheres to organizational and department specific safety standards and guidelines,
•   Works collaboratively and supports efforts of team members,
•   Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community,

UofL Health Core Expectation:
At UofL Health, we expect all our employees to live the values of honesty, integrity and compassion and demonstrate these values in their interactions with others and as they deliver excellent patient care by:
•   Honoring and caring for the dignity of all persons in mind, body, and spirit,
•   Ensuring the highest quality of care for those we serve,
•   Working together as a team to achieve our goals,
•   Improving continuously by listening, and asking for and responding to feedback,
•   Seeking new and better ways to meet the needs of those we serve,
•   Using our resources wisely,
•   Understanding how each of our roles contributes to the success of UofL Health system,

Director – Patient Access

UofL Health

Primary Location:

Address:

Shift:

Job Description Summary:

Job Description:

Additional Job Description:

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