Director of Access Services at Memorial Health Care Center – Owosso, Michigan

JOB SUMMARY

The Director of Access Services works closely with the Director of PFS, Director of HIM and MMA Practice Managers to improve revenue capture and reduce denials related to eligibility, patient intake, and collections. This role focuses on frontend processes, ensuring accurate registrations, insurance verifications, prior authorizations and pre-collections. Responsibilities include tracking issues, creating training programs, leading quality improvement initiatives for the front-line staff. This position demands strong communication skills and a deep understanding of how front-end workflows impact the entire revenue cycle. Strives for superior performance by consistently providing a product or service to leadership and staff that is recognized as ultimately contributing to the patient and family experience. Recognizes and demonstrates understanding of patient and family centered care.

PRIMARY JOB RESPONSIBILITIES

1. Monitors and analyze denials and revenue leakage tied to eligibility, registration and patient collections.
2. Plans and directs the activities of Patient Access, Guest Services, Prior Authorization, Referral and Scheduling teams.
3. Collaborate with back-end leadership to resolve cross-functional revenue cycle challenges.
4. Creates and implements policies and procedures to promote effective processes to ensure customer satisfaction and front-end operational effectiveness.
5. Responsible for oversight of all registration, scheduling, referral and prior authorization processes for the organization.
6. Provides direction and oversight for the implementation of key internal controls and procedures supporting the integrity of the front-end operations.
7. Evaluates and ensures appropriate and compliant collection policies and procedures.
8. Manages the front-end vendors to optimize the financial impact of the facility.
9. Responsible for determination of personnel requirements for the front-end departments.
10. Assesses, identifies and defines areas of opportunity for reengineering processes to improve the management of the front-end collection processes.
11. Responsible for assessing and implementing appropriate training programs to meet organizational and customer expectations.
12. Develops and provides in conjunction with IT, adequate reporting tools for monitoring and validating RQA, Pre-Collections and analyses opportunity for improvement.
13. Maintains a close working relationship with the Finance department of the hospital, PFS department including both facility and professional and professional health information management departments.
14. Develops and maintains strong interpersonal relationships with members of the leadership team.
15. Works independently and manages multiple projects simultaneously.
16. Demonstrates knowledge of and supports hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality statements, corporate compliance plan, customer service standards, and the code of ethical behavior.

DEPARTMENTAL AND ADDITIONAL JOB RESPONSIBILITIES

1. Revenue Cycle Team and BCA team member
2. Ensures compliance with insurance verification, prior authorization, and payment protocols.
3. Prepares and reports on monthly stats, wins, issues and improvement opportunities.
4. Other duties as assigned

JOB SPECIFICATIONS

EDUCATION (List required, and preferred if applicable)

1. Associate’s Degree in Accounting, Finance, Business Administration or Healthcare Administration is required
2. 5 years of experience or greater in a management position within the Revenue Cycle or Front-end of Revenue Cycle required.

EXPERIENCE (List required, and preferred if applicable)

1. Minimum of (5) years’ experience working within hospital registration and or Registration, scheduling, and/or Prior authorization highly preferred.
2. Experience in processing referrals for physician practices.
3. Knowledge of physician registration processes.
4. Knowledge of CMS and third-party payor regulations and policies related to front-end of the revenue cycle.
5. Experience with Microsoft Excel and Word required.
6. Demonstrated experience in leadership with exercising judgment in problem solving.

ESSENTIAL PHYSICAL ABILITIES/MOTOR SKILLS

1. Able to travel independently throughout all Memorial Healthcare facilities.
2. Small motor skills required for operating modern computer, office, and telephone equipment as utilized by Memorial Healthcare (MHC).
3. Able to stand, and sit for long periods of time.

ESSENTIAL TECHNICAL ABILITIES

1. Proficiency using modern office, computer and telephone equipment as used by Memorial Healthcare.

ESSENTIAL MENTAL ABILITIES

1. Ability to adapt and maintain focus in fast paced, quickly changing or stressful situations.
2. Ability to read and interpret a variety of documents including, but not limited to policies, operating instructions, white papers, regulations, rules and laws.

ESSENTIAL SENSORY REQUIREMENTS

1. Able to see for the purpose of reading information received in formats including but not limited to paper, computer, reports, bulletins, updates, manuals.
2. Able to hear for work-related purposes.

INTERPERSONAL SKILLS

1. Ability to interact with co-workers, hospital staff, administration, patients, physicians, the public and all internal and external customers in a professional and effective, courteous and tactful manner, at all times, physically, verbally and in all written and electronic communication.
2. Required to remain calm when adversity is encountered.
3. Open, honest, and tactful communication skills.
4. Ability to work as a team member in all activities.
5. Positive, cooperative and motivated attitude.