Director Revenue Cycle - Patient Access | Admissions

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Primary Work Location

Monument Health Rapid City Hospital

Department

RCH Admissions Services

Scheduled Weekly Hours

40

Job Summary

Maintains department standards and achieve department goals. Performs responsible and moderately complex management-level duties by overseeing the Main Admissions, Emergency Department, and Behavioral Health Patient Access teams. Serves as member of the Patient Access management team and ensures that assigned programs, functions and operations conform to organizational goals and objectives. Duties include significant responsibility for formulating and administering policies and procedures in assigned areas, as well as, providing management support and advice to superiors. Assigned operations and functions primarily emphasize the administrative and financial aspects of pre-arrival services points of care service areas. Demonstrates a caring and respectful attitude to all patients, family members, visitors, caregivers, and providers as defined in the Monument Health Standards of Performance. Demonstrates ongoing growth and development of self through active self-reflection, personal competency development strategies, and role modeling the “Grow myself, grow my team, and grow Monument Health (G3) Leadership Competencies” to promote our Monument Health vision and mission.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions (extra pay for working evening, nights or weekends)

*Flexible scheduling

Job Description

Essential Job Functions:

• Plans, organizes, directs, caregivers and controls patient access operations and activities including financial counseling and referrals, insurance verification, pre-registration, service scheduling, point-of-service collections and related activities; ensures that assigned areas conform to organizational and department goals, objectives and requirements. 

• Assists in achieving the financial objectives of the organization by following Revenue Cycle guidelines.

• Ensures the financial clearance process is completed timely and accurately prior to patient arrival and escalates directives for Executive and/or Medical Director evaluation of urgency of services to maintain high quality and safe patient care.

• Maintains a knowledge of core revenue cycle functions such as billing, claims filing, charge entry, insurance follow up, coverage record management, payment posting, customer service, billing records review, and medical collection practices to support duties related to preservice financial clearance, clean claims submission, and denial management.

• Demonstrates an understanding of claim reimbursement denial areas, such as: medical necessity, eligibility issues, coding concerns, no authorization obtained, and timely processing of claims per payer requirements.

• Provides escalated customer support services, acts as a liaison for both internal and external customers to inform financial clearance processes, patient access and scheduling of care, and resource fund finding.

• Plans, assigns, directs, and monitors the work of subordinate caregivers, including subordinate supervisors; develops and/or approves caregivers schedules; analyzes and distributes caregivers assignments and workloads; evaluates caregiver performance; recommends and performs corrective action as appropriate; responds to grievances and complaints; initiates and coordinates caregiver selection and training processes; ensures that caregiver activities comply with organizational expectations.

• Develops, recommends and implements policies and procedures for assigned programs and services to ensure their consistency with departmental standards and requirements; directs the development and maintenance of appropriate procedure manuals and related documents.

• Develops, recommends and implements quality control systems to ensure that assigned programs, services and activities are efficient, effective and in compliance with internal and external laws, policies and standards; Monitors and records activities to meet or exceed best practice baseline Key Performance Indicators for Admissions/ Patient Access caregivers. Develops systems pertaining to confidentiality, information security, safety, environmental/infection control, financial accountability and other related areas.

• Develops, recommends and implements policies and procedures designed to ensure a quick, efficient and courteous experience for patients; monitors and controls patient waiting times; ensures that appropriate test results, orders, and other critical documents are available at the time of patient scheduling.

• Assists with the development of the annual operating budget.  Controls expenditures within approved budget.

• Conducts regularly scheduled meetings and gives presentations.

• Oversees the preparation and maintenance of documents and information in order to comply with administrative policies, as well as, JCAHO and other regulations.

• Conducts special studies and projects as assigned; researches and analyzes information; prepares statistical and narrative reports and documents as needed.

• All other duties as assigned

Additional Requirements

Required:

Education - Some College (1-2) years in related field

Certification - Certified Healthcare Access Manager (CHAM) or Certified Healthcare Financial Professional (CHFP) or Certified Associate in Project Management (CAPM)

Certification - within one year of hire – Lean Yellow Belt or IHI Quality and Safety

Experience - 5+ years of progressive leadership and staff management experience and10+ years progressive work experience in Healthcare/Medical Preservice and Financial Counseling, Admissions, Patient Access, Registration, Referral/Order Management, Medical Coding, and/or Medical Billing

Preferred:

Education - Associates or Bachelors in Healthcare Administration, Healthcare Services, Business Administration, or related field

Job Category

Revenue Cycle

Job Family

Registration and Scheduling

Shift

Employee Type

Regular

10 Monument Health Rapid City Hospital, Inc.

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.