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Director, Pre-Access Services

Chesapeake Regional Medical Center

Chesapeake, VA

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JOB DETAILS
SKILLS
Billing, Budgeting, Call Centers, Cross-Functional, Customer Support/Service, Disciplinary Action, Electronic Medical Records, Epic Systems, Financial Services, Financial Trend Analysis, Healthcare, Human Resources Processes, Insurance, Leadership, Medical Billing, Medical Office, Operational Support, Operations, Patient Care, Payroll Administration, Picture Archiving and Communication System (PACS), Problem Solving Skills, Purchasing/Procurement, Quality Control, Quality Metrics, Resource Utilization, Strategic Planning, Team Player, Time Management
LOCATION
Chesapeake, VA
POSTED
Today

Summary:

Responsible for oversight of Pre-Access operational areas (scheduling, insurance verification, authorization/referrals, and financial clearance) as well as strategic planning and execution to meet organizational goals.

Essential Duties and Responsibilities

These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.

  • Provides direct operational oversight and support for Pre-Access Services (scheduling, insurance verification, authorization/referrals, financial clearance and/or financial assistance) including hiring, evaluations, disciplinary action, orientation, and training.
  • Ensure full financial clearance process is completed for every patient.
  • Oversee and monitor department metrics and quality control standards are met on a consistent basis.
  • Remain knowledgeable of diagnostic tests and procedures performed, and serve as a resource for patients, staff, clinical areas, and physician office staff by answering questions and resolving problems
  • Act as a SME for insurance-related issues including contracts, coverages, authorization requirements, etc.
  • Promote collaborative medical staff and ancillary department relationships through availability, timely follow up on all issues, and personal one-on-one meetings.
  • Work with clinical counterparts to ensure schedules remain filled to optimize resource utilization and improve revenue.
  • Partner with Patient Accounting to stay abreast of trends and changes in various insurance requirements, ensuring proper authorization protocols are in place.
  • Responsible and accountable for the overall daily operations of one or more areas.
  • Coordinates quality and customer service initiatives.
  • Assists with development and monitoring of the department budget.
  • Coordinates purchasing and payroll processes.
  • Must always project a professional image, to include body language, facial expressions, attire and grooming standards, and communication (both written and oral)


Supervisory Responsibilities

Reports to: Sr Director, Revenue Cycle

Supervises: Manager, Pre-Access Services

Responsibilities: Directly responsible for the daily operations, quality, and service of the Pre-Access Services department, including but not limited to Central Scheduling, Pre-Registration, Insurance Verification, Authorization/Referral Management, and Financial Clearance. This role includes oversight of the high-volume Patient Access Contact Center that services patients seeking care with various entities using multiple scheduling/registration/billing platforms and will require critical thinking skills and the ability to leverage technology to assist end-users in providing a seamless patient experience. This role is critical to the financial health of the organization as oversight also includes all aspects of financial clearance (estimates, insurance verification, auth/referral, pre-service payments, financial assistance, etc.). The Director role requires significant strategic planning and proven ability to execute upon goals to allow for growth as an organization directly impacting our financial standing and current and future success of the organization. Provides leadership and administers human resource policies and practices in a multi-skilled, multi-functional environment.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and Experience

Minimum Required Education:

Minimum Required Education: Master's degree; Six (6) years of management experience will be considered in lieu of degree.

Experience:

Ten (10) years of experience within revenue cycle, scheduling, financial clearance, or healthcare setting required. Three years experience with Epic EMR is required.

Certificates, Licenses, Registrations:

Professional certification required within one (1) year of hire; Certified Healthcare Access Manager (CHAM), Certified Revenue Cycle Representative (CRCR), or Prior Authorization Certified Specialist (PACS) certification preferred.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

About the Company

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Chesapeake Regional Medical Center