Patient Registration Manager - Patient Registration

Navajo Preference Employment Act

In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.

Overview

POSITION SUMMARY

The purpose of the position is to plan, organize, manage, and continuously improve the operations, staff, training, and performance of Patient Registration and Patient Access functional areas across TCRHCC. The incumbent is responsible for leading centralized registration operations while also supporting organization-wide Patient Access Services (PAS) education, workflow standardization, competency validation, and revenue cycle readiness across hospital, ambulatory, emergency, specialty, pharmacy, and satellite clinic settings. This position provides management oversight, technical direction, process improvement leadership, and staff development to support accurate registration, timely eligibility verification, payer coordination, compliant documentation, patient experience, and reimbursement goals. The incumbent understands the unique operating environment of an IHS/Tribal 638 facility and works with Revenue Cycle, Clinical Operations, Pharmacy, Finance, Information Systems, and departmental leaders to reduce preventable denials, support third-party collections, strengthen front-end controls, and maintain consistent Patient Access standards throughout the organization. Responsibilities also include delegation and assistance to the Director of Revenue Cycle, including special projects, training initiatives, performance monitoring, and cross-departmental Patient Access remediation efforts.

Qualifications

NECESSARY QUALIFICATIONS

Education:

Associate's Degree in Business Administration or related business field (Finance, Accounting, Health Care Administration, Revenue Cycle, Public Health Administration, or related discipline) or an equivalent to 18 months of experience.

Experience:

• Minimum three-years of successful supervisory or management experience in Patient Access within a hospital facility setting.
• Minimum five-years of experience in patient access, patient registration, medical billing, accounts receivable, revenue cycle, or patient accounting within a tribal, non-profit, hospital, ambulatory, or integrated healthcare setting, or combination of.
• Demonstrated knowledge of ICD-10, CPT/HCPCS, CDT, UB-04, CMS-1500, payer billing requirements, and third-party payer rules sufficient to identify registration, eligibility, and payer setup errors that may affect claim submission, reimbursement, denials, and compliance.
• Demonstrated experience leading staff training, workflow education, competency validation, audit follow-up, coaching, corrective action, or revenue cycle improvement initiatives across multiple departments or service locations.

Certifications:

• Must obtain certification(s) through the National Association of Healthcare Access Management (NAHAM) and/or the Healthcare Financial Management Association (HFMA) within 18 months of hire.

Other Skills and Abilities:

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas:

• Positive working relationships with others.
• Possession of high ethical standards and no history of substantiated complaints related to confidentiality, integrity, patient rights, or professional conduct.
• Reliable and dependable; reports to work as scheduled without excessive absences and no reported attendance issues.
• Ability to plan, lead, and evaluate effective team meetings, huddles, staff education, department-based training, and one-on-one coaching sessions.
• Possess expertise in professional communication, interpersonal relationships, organizational leadership, change management, and team building skills.
• Possess excellent customer service skills for internal and external customers, including patients, families, providers, department leaders, clinical teams, payers, and vendors.
• Ability to work under pressure, prioritize competing operational needs, and make quality and effective decisions in a fast-paced healthcare environment.
• Ability to positively motivate individuals and teams to meet or exceed department expectations, training requirements, productivity standards, and revenue cycle performance goals.
• Computer skills; ability to access and use multiple data systems, including electronic health record systems, eligibility tools, payer portals, reporting platforms, Microsoft Excel, Microsoft Word, and related business applications.
• Ability to interpret eligibility responses, coordination of benefits information, payer portal results, registration quality reports, denial trends, and operational key performance indicators.
• Ability to support culturally respectful communication and service delivery within a Navajo Nation, IHS, Tribal, and 638 healthcare environments.
• Knowledge of hospital and physician access management processes, including centralized and decentralized registration workflows, pre-encounter functions, emergency registration, outpatient registration, admitting, scheduling support, eligibility verification, authorization awareness, point-of-service collections, and registration quality controls.
• Completion of and 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:

The work is primarily sedentary with the following physical requirements; Ability to lift up to 25 pounds, walk/stand for short periods of time as interaction between all disciplines within the facility is required, ability to stoop and pick up objects from the floor without restrictions, and have full use of hands and arms, i.e., to operate office equipment such as computer, calculator, printer, fax, etc. The position may require movement between departments, service areas, and training locations at the main campus and satellite sites as operational needs require.

Mental:

Exercise a high degree of judgment and leadership in planning, organizing, staffing, directing, evaluating, training, monitoring, and improving Patient Registration and business office activities. Work is reviewed for conformance to policies, procedures, and practices relating to business office and Patient Access operations. The employee must have the ability to organize, set priorities, develop, implement, and sustain solutions, motivate employees, lead change, communicate across departments, interpret payer and system information, manage conflict, and operate the department according to the constraints of The Joint Commission, budget, regulatory agencies, TCRHCC policies, and applicable IHS/Tribal 638 requirements.

Responsibilities

ESSENTIAL FUNCTIONS:

• Manages and leads the patient access operations of the Patient Registration Department for Ambulatory and Hospital departments at TCRHCC main campus and satellite clinics, including LeChee, Sacred Peaks Health Center, Cameron, mobile units, and other assigned service areas.
• Supervises 10 or more employees and provides leadership, coaching, scheduling, performance management, and operational support to assigned Patient Registration staff.
• Provides organization-wide Patient Access training support, workflow education, competency validation, and retraining in coordination with Revenue Cycle leadership, department supervisors, Clinical Operations, Pharmacy, and other service line leaders where registration, eligibility, or front-end revenue cycle functions are performed.
• Leads or supports enterprise PAS training initiatives, including department-based staff scheduling, one-on-one training sessions, superuser coordination, audit follow-up, reinforcement training, and documentation of staff completion and competency outcomes.
• Supports standardized Patient Access practices across centralized and decentralized registration environments to reduce workflow variation, improve accountability, and align front-end operations with TCRHCC revenue cycle, compliance, and patient service goals.
• Conducts a mature and clear approach to problem-solving for various types of operational, staffing, patient access, payer, system, training, and revenue cycle issues.
• Maintains knowledge of hospital and physician access management processes, including pre-registration, registration, admitting, bed control, emergency registration, outpatient registration, specialty service registration, recurring service workflows, and satellite clinic operations.
• Maintains thorough knowledge of third-party payer rules and regulations, including Medicare, Medicaid/AHCCCS, Managed Care, Commercial Insurance, Workers' Compensation, Motor Vehicle Insurance, and other applicable payer requirements.
• Understands IHS, Tribal 638, payer-of-last-resort, and third-party collection principles and reinforces accurate eligibility verification, payer order, and coordination of benefits workflows to support compliant billing and organizational financial integrity.
• Experienced with charge master, EDI claims, medical billing, E.H.R., CCI edits, claims scrubbing, eligibility verification of benefits systems, payer portals, and front-end workflows that affect clean claim submission and denial prevention.
• Develops, implements, maintains, and recommends updates to Patient Access policies, procedures, workflows, training materials, job aids, registration quality standards, and documentation requirements.
• Maintains knowledge of medical terminology and applies this knowledge to support accurate registration workflows, patient communication, service area coordination, and revenue cycle accuracy.
• Knowledge to successfully manage each functional area of Patient Registration to include pre-encounter functions; emergency registration; outpatient surgery and special procedures; inpatient, observation, and extended recovery room processing; up-front collections; hospital and professional cashiering; and related point-of-service revenue cycle activities.
• Provides direct management to Inpatient Admitting, Outpatient Registration, Bed Control, and Pre-Encounter processes, and supports operational alignment with department-based PAS functions outside of direct Patient Registration reporting lines.
• Manages departmental staffing patterns and assigns activities and functions to maintain coverage, productivity, training participation, and continuity of operations.
• Maintains communications with Patient Access staff through monthly meetings, huddles, written updates, training sessions, performance reviews, and other communication methods needed to maintain alignment and accountability.
• Performs duties in a manner that facilitates the accomplishment of corporate objectives. Achieves budgeted objectives for revenue and expenses, minimizing bad debt losses, denials, rework, and billing delays due to insufficient registration, eligibility, payer, or demographic information.
• Respects the rights and dignity of all patients. Provides and maintains patient privacy at all times. Is compliant with HIPAA guidelines and privacy practices, patient confidentiality, patient rights, and all applicable organizational compliance expectations.
• Adheres to training all employees with strong customer service skills and reinforces professional, culturally respectful, and patient-centered communication across all registration and Patient Access touchpoints.
• Proficient with MS Excel and Word software applications and uses available reporting tools to analyze productivity, quality, eligibility, denial, audit, and training performance trends.
• Develop statistical reports and control methods that identify staff productivity standards, registration quality outcomes, eligibility verification performance, audit results, and training completion. Identifies limitations and provides information for staff performance improvement.
• Coordinates and oversees work of staff; has the responsibility of distributing workloads as necessary and adjusting assignments to support operational coverage, training schedules, and service area needs.
• Responsible for maintaining time and attendance in the timekeeping system for assigned staff.
• Monitors the productivity of staff to ensure it meets production standards. Assured staff are provided with a work environment conducive to productivity, good health, quality service, and continuous learning.
• Trains employees and holds periodic in-house training sessions. Assists in interpreting regulations, requirements, payer rules, eligibility responses, coordination of benefits requirements, documentation standards, and procedures; provides technical assistance to resolve patient access system and workflow issues.
• Leads or supports training on eligibility fundamentals, payer mapping, Clearance/Suitcase or equivalent eligibility tools, independent payer portal use, coordination of benefits, Medicare-first rules, AHCCCS coverage review, pharmacy eligibility handoffs, documentation standards, and escalation requirements.
• Reviews staff work for conformance to policies, procedures, and practices relating to Alternate Resources regulations, IHS/638 considerations, patient demographic accuracy, eligibility documentation, appropriate payer selection, E&M awareness, correct CPT/HCPCS awareness, AMA requirements, ADA/CDT requirements, and HCFA/CMS guidelines.
• Prepares and conducts employee job performance evaluations and forwards to the Director of Revenue Cycle for concurrence.
• Responsible for the orientation and education of staff to ensure compliance with new and existing regulations of third-party payers, including covered services, limitations, payer-specific rules, system updates, and front-end documentation requirements.
• Assists with testing of new software, implementation of new payer requirements and guidelines, CMS regulatory guidelines, eligibility tools, payer portal processes, system workflows, new process flows, and EHR upgrade readiness affecting Patient Access and Revenue Cycle operations.
• Evaluates and addresses issues and concerns related to daily operations of assigned areas, and provides recommendations to improve overall operations, cost containment, staffing efficiency, training effectiveness, registration accuracy, denial prevention, and revenue cycle performance to the Director of Revenue Cycle.
• Responsible for initiating, carrying out, and enforcing disciplinary action policy and procedures with staff when needed, including accountability for repeated registration, eligibility, documentation, productivity, customer service, or training non-compliance issues.
• Verifies accuracy of services and billed amounts as appropriate to the scope of Patient Access review, and ensures front-end information supports services allowed by appropriate regulations, directives, payer requirements, and organizational policies.
• Identify errors, omissions, duplications, missing information, payer mismatches, eligibility discrepancies, COB concerns, and documentation gaps, and contacts the appropriate individuals or departments to resolve problems timely.
• Responsible for providing monthly reports, organizing schedules, and maintaining regular, overtime, training, coverage, audit, and operational monitoring schedules as assigned.
• Attends and participates in management meetings, revenue cycle meetings, training meetings, system readiness meetings, and interdepartmental operational meetings as requested.
• Accepts delegation in the absence of the immediate supervisor and provides leadership continuity for Patient Registration and assigned Patient Access functions.
• Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
• Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates)
• 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.
• Performs other duties and special projects as assigned or required.