Director of Patient Access (DHRG04) - Patient Registration

POSITION SUMMARY

The Director of Patient Access will function as an internal consultant and subject matter expert on patient access functions, utilizing their knowledge of governmental and third-party payer guidelines to facilitate accurate and timely claims submission and reimbursement. The responsibilities for this role include overseeing operational, financial, programmatic, and personnel activities related to patient access functions throughout the organization. They are tasked with developing, implementing, and maintaining processes to guarantee registration, financial clearance, and regulatory compliance is maintained within their areas of responsibility. Plus, keen to research and seek the source of truth when necessary and collaborate with stakeholder departments whenever necessary to achieve optimal financial performance and enhance patient experience: ensuring high-quality, compliant, patient-centered care delivery and addressing any issues related to patient dissatisfaction at Tuba City Regional Health Care Corporation.

NECESSARY QUALIFICATIONS

Education:

Bachelor’s in health administration, business or related field

Certification:

Completion of one (1) of the following Certification programs within 1 year of hire:

1. NAHAM CHAM (Certified Healthcare Access Manager) Certification
2. HFMA CRCR (Certified Revenue Cycle Representative) Certification

Experience:

Minimum of five (5) years demonstrated experience in the understanding and management of healthcare revenue cycle

Other Skills and Abilities:

• Ability to maintain a Culture of Accountability
• Possess analytical/critical thinking skills
• Ability to organize and successfully work on multiple complex projects simultaneously
• Demonstrated leadership and management skills
• Demonstrated ability to create and implement strategies to improve performance
• Ability to use influence and lead change while working collaboratively across TCRHCC departments and disciplines.
• Demonstrated commitment to patient and family centered care.
• Maintain variable work schedule to meet department needs. (evenings, holidays, weekends, and limited travel).
• Ability to ensure a high level of customer satisfaction including employees, patients, visitors, and other departments within TCRHCC.
• Completion of above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job.
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job.
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job.
• Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC.

MENTAL AND PHYSICAL EFFORT

The physical and mental demands described here are representative of those that must be met by an   employee to successfully perform the essential functions of this job.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Physical:

Require the ability to sit, stand, walk, maintain balance, and reach for extended periods of time, to occasionally stoop, drive, bend, climb, kneel, crouch and twist to pick up small objects. Must be able to continually lift/push/pull up to 24 pounds and occasionally over 100 pounds. Sensory requirements are far vision, near vision, color vision, depth perception, seeing fine details, hearing normal speech, hearing overhead pages and telephone use. The duties require the ability to use telecommunications and office equipment. Work also requires ability of simple grasping, firm grasping and fine manipulation with both hands and fingers.

Mental:

Exercises initiative and judgment in deviating from existing department or corporation practices to resolve billing issues/concerns. Work is reviewed for conformance to policies, procedures, and practices relating to billing practices. Must have ability of prolonged concentration and to work alone, frequent ability to cope with high levels of stress, make decisions under high pressure, handle multiple priorities in stressful situation, demonstrate high degree of patience, adapt to shift work, work in areas that are close and crowded, and occasionally cope with anger/fear/hostility of others in a calm way, manage altercations, and handle a high degree of flexibility including frequently accepting a flexible schedule to meet unit needs.

Environmental:

May occasionally be exposed to infectious disease, chemical agents, dust, fumes, gases, extremes in temperature or humidity, hazardous or moving equipment, unprotected heights, and loud noises.

ESSENTIAL FUNCTIONS

1. Promote the mission, vision, and values of the organization.
2. Oversight and strategic direction for patient access (pre-care engagement, registration, admitting), coverage identification (coverage & eligibility verification, insurance enrollment, prior authorization coordination), patient contact center (inbound and outbound calls) and financial clearance (collections, counseling) functions.
3. Oversee daily operations; ensures accurate and complete data capture of demographics and insurance data required for billing and collections.
4. Accountable for well-run, efficient patient access workflow with direct oversight of recruitment, hiring, onboarding, and individual staff performance evaluation.
5. Supports, educates & works directly with scheduling functions to ensure close integration of pre-registration and admitting.
6. Sets directions and establishes priorities; clearly defines problems, logically diagnose root causes, identity solutions, and create action plans
7. Periodically assess workforce needs of support functions to assure the appropriate recruitment of skilled personnel
8. Analyze past and present performance with data, identify trends, make, and follow through on recommendations for improvement
9. Identifies and establishes departmental goals and objectives. Ensures that the productivity and actions of the department meet/support and achieve those goals
10. Responsible for patient access subject matter and domain expertise for the organization - includes training materials, onboarding, continuing education, quality, and competencies for staff performing patient access function
11. Certifies compliance with policies, procedures, regulations, laws, and standards.
12. Manages, coaches, and supports the team’s career development, and succession planning.
13. Implement strategies to improve employee engagement
14. Maintains optimism and composure in all situations with an ability to create win/win solutions and relationships
15. Prepares and deliver presentations to senior leadership, management, and stakeholders
16. Collaborate with individuals across all TCRHCC departments/facilities
17. Drive strategies to increase enrollment of healthcare coverage and retention avoiding month-to-month lapses in health coverage.
18. Establish and maintain a patient advisory group to assess patient experience and identify value-added interactions
19. Ensure proper PPE is always worn while on duty including but not limited to face mask, gloves, gown, NIOSH-approved N95 filtering respirator or higher (if available), and eye or face shield.
20. Complete donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (See CDC website for most current updates).
21. Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction.
22. All other duties as assigned