Summary of Position:
Reporting to the Director of Patient Access Services, the Front End Revenue Cycle Manager will have the overall responsibility and will direct and lead all processes related to Patient Access; Outpatient Clinic and Hospital pre-registration of scheduled and unscheduled services (excluding maternity services).
Essential Duties and Responsibilities:
- Responsible for working collaboratively with clinic & hospital management team members, to ensure accurate and timely patient pre-registration is completed in 95% of scheduled cases, maintain a minimum lead of >2 working days in accordance with patient access industry best practices (NAHAM);
- Ensures required services have been prior authorized to circumvent billing denials;
- Interacts with Information Technology to develop, evaluate and maintain information systems for registration, eligibility, authorization, denial management, compliance and collections to maximize reimbursement, providing peak performance and reporting;
- Overall responsibility of assuring timely and effective processing of Ancillary Service insurance authorizations. These may include but not limited to Radiology, Diagnostic Services, Chemotherapy, Surgery, Cardiopulmonary referral requests from physicians;
- Responsible for the successful process of a unit specific orientation, training and continuing education program for unit specific Patient Access staff;
- Provides oversight of the defined QA/CQI program for enhanced efficiency and net service revenue for Kern Medical;
- Assist in the development of financial planning policies and procedures collaborating with other Front End Revenue Cycle Managers;.
- Performs other related duties as assigned.
- Minimum of 5 years of acute Hospital Patient Access experience required;
- CHAM preferred;
- Experience working with Cerner preferred;
- Knowledge of Win32 and CPM scheduling applications;
- Excellent writing and analytical skills;
- Highly developed work organization and project management skills with the capacity to manage competing priorities and respond to emerging needs, work towards specified targets and deadlines and pay attention to detail;
- High level communication and interpersonal skills with the capacity to work consultatively and collaboratively with staff at all levels;
- Ability to prepare reports and presentations using clear, concise language; organize information into a logical sequence and include content appropriate for the purpose and audience;
- Ability to proficiently prepare documents and spreadsheets using MS Word, Power Point and Excel.
- Dependent upon assignment, applicants may be required to pass an extensive background investigation;
- May be required to maintain all health requirements designated by assignment.