Supervisor Patient Access Services - Specialty Nursing

Supervisor Patient Access Services - Specialty Nursing

Supervises employees engaged in scheduling, registration, insurance and procedure guidelines verification, verifying practitioners’ orders, admitting, and/or transferring outpatients, inpatients, and/or Emergency Room patients. Ensures that documentation is accurate, financial information is verified, and provides information to appropriate units in a timely manner.

• Performs supervisory functions: prepares work schedules, assigns staff, observes and reviews performance to provide input to formal evaluations, makes recommendations for personnel actions, assists in staff selection, provides orientation, training and ongoing in-services for staff, and schedules and supervises Patient Access Services functions/activities so as not to interrupt or interfere with patient care activities.
• Exhibits excellence in customer service through appropriate attitude and interaction with all patients, visitors and staff; adheres to and supports staff in exhibiting TMCH values of integrity, community, compassion, and dedication.
• Demonstrates and upholds established standards of behavior, safety, and confidentiality, as well as TMCH and department policies and standards; ensures compliance with all applicable regulatory requirements.
• Provides input for budget preparation and monitors/controls expenses within approved budget allocations.
• Compiles and distributes information regarding patient’s personal, insurance, and financial status.
• Provides appropriate forms to billing and other departments.
• Maintains department records, reports, and files as required.
• Authorizes written and/or verbal inquiries to third party payers to reconcile patient accounts.
• Interprets and explains hospital policy regarding charges and payment of bills to employees, patients, and their representatives and may collect deposits or deductibles as required.
• Maintains current knowledge of regulatory requirements and practices related to patient billing processes.
• Ensures notification of ancillary and admitting departments of affected patient’s charges, cancellations, and/or problems, which may affect patient care quality, when necessary.
• Oversees the process of notification to Manager Access Financial Services when financial counseling intervention is indicated for potential uncompensated care.
• Schedules procedures, participates in pre‑registration and financial verification of patients, when necessary to ensure the smooth workflow of the unit.
• Implements CPT and other coding systems with periodic review; maintains current coding knowledge.
• Adheres to TMCH organizational and department‑specific safety, confidentiality, values, policies and standards.
• Performs related duties as assigned.

• Education:
  
  Associates Degree (A.A.) or equivalent from an accredited two‑year college or technical school, or an equivalent combination of relevant education and experience.
• Experience:
  
  4 years related medical billing, insurance, healthcare documentation, and/or scheduling experience, preferably in a lead or supervisory role.
• Licensure or Certification: CHAM (Certified Healthcare Access Manager) preferred.

• Knowledge of hospital billing, insurance and scheduling processes and procedures.
• Knowledge of medical terminology and coding.
• Skill in the use of computer applications such as Excel, Word, Internet, e‑mail, and terminal emulator programs; maintains basic knowledge of networked computer systems.
• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
• Possesses and maintains knowledge of current regulatory and third‑party payer changes with respect to authorizations, verification requirements to support billing reimbursement.
• Ability to write reports, business correspondence, and procedure manuals.
• Ability to effectively present information and respond to inquiries or complaints from employees, patients, and/or their representatives, and the general public.
• Ability to calculate figures and compute rate, ratio, and percent and to draw and interpret bar graphs; ability to apply basic algebraic concepts.
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Ability to solve problems involving several concrete variables in standardized situations.