Mgr-Patient Access Operations, FT, Day

Inspire health. Serve with compassion. Be the difference.

Job Summary

Responsible for developing, managing and organizing an efficient registration process to ensure an optimal patient experience in support of clinical operations and Prisma Health mission and goals. Responsible for a 24/7 operation and multiple campuses across the organization. The scope of responsibility includes elements that are subject to review by CMS, The Joint Commission, DHEC and other regulatory agencies. Monitors quality and compliance for areas of responsibility, ensuring timely remediation for deficiencies. Maintains sound credit, collection, and cash control procedures.

Essential Functions

• All team members are expected to be knowledgeable and compliant with Prisma Health's values:  Inspire health.  Serve with compassion.  Be the difference.

• Develops and implements efficient registration processes to support an optimal patient experience aligning people, processes, and technology. This includes processes for collecting demographic and financial information to facilitate timely payment, discussing the patient estimate, and collecting patient balances due. Responsible for recording information in the system that supports the clinical team with health equity and social determinates of healthcare. Includes education for team members that outlines specific workflows to be followed. Conducts account reviews to ensure processes are followed and timely feedback is provided to team members.  Proficient with resolving Patient and Account work queues assigned to Patient Access. This is a patient-facing position.

• Ensures adequate processes are implemented for the provision of documents and forms as required by regulation; in some instances, patient signatures are required. Compliance regarding documents and forms is subject to review by CMS, DHEC and the Joint Commission. These forms/documents include but are not limited to Advance Directives, Lewis Blackman Patient Safety Act, Notice of Privacy Practices, Patient Rights and Responsibilities, Permission to Treat, Limited Visitation Policy, Medicare Admission Questionnaire, Medicare Important Message and Medicare Outpatient Observation Notice. Lack of compliance can create a regulatory finding or jeopardize the organization's participation with CMS.

• Collaborates with clinical departments, Patient Financial Services and other personnel as appropriate to lead and manage change initiatives designed to transform and improve Patient Access processes. Supports the use of technology as available to automate workflow and reduce errors. Integrates with Campus Leadership to foster relationships and ensure Patient Access is included as part of the campus team.   

• Collaborates as appropriate with other departments to proactively facilitate problem solving. Pivots to meet the changing needs of payor requirements to maximize cash flow for the organization.

• Manages human resources, supplies and equipment according to established Prisma Health and departmental policies and procedures. Responsible for assisting with the development of the FTE, expense and capital budget for areas of responsibility.

• Provides timely education to inform team members of relevant changes and developments in payor requirements.  

• Stays abreast of payor, regulatory and compliance requirements.

• Performs other duties assigned.

Supervisory/Management Responsibility

• Job has direct and/or indirect supervision of employees that may include final budget authority, hire/termination authority, performance appraisal responsibility and disciplinary authority. Job will be considered a member of management staff at Prisma Health and will have direct reports.

Minimum Requirements

• Education - Bachelor's degree in Healthcare Management, Business, Accounting, Finance or related field of study.

• Experience - Five (5) years of patient access, patient financial services, or healthcare finance. Two (2) years previous leadership or management experience preferred.

In Lieu Of

• In lieu of education and experience detailed above, a High school diploma and eight (8) years of banking/finance, billing/collections, healthcare admissions, insurance or credit/collections including four (4) years supervisory experience may be considered

• In lieu of education and experience detailed above, an Associate deg