Practice Administrator III

Overview

The Practice Administrator III is a member of our leadership team and works directly with the Methodist Le Bonheur Healthcare (MLBH) Vice President of Operations and will collaborate with the rest of the Practice Administration Team and be responsible for supporting the Resource Anesthesiology of Tennessee Facilities (Memphis University Hospital, Germantown Hospital, Methodist North Hospital, Methodist South Hospital, and Methodist Olive Branch Hospital). The Practice Administrator III will work with Somnia’s executive management team as well as local hospital leadership. Strong interpersonal, organizational and time management skills are a must.

Responsibilities

• RCM/Billing
  • Follow standard chart batching and scanning process according to Somnia’s billing partner’s policies and procedures.
    • Work with hospital, Somnia and billing company to scan directly to pertinent imaging system.
    • Submit 100% of charts within 3 business days.
  • Complete or appropriately train support staff to thoroughly scrub charts for all the pertinent pieces of information including but not limited to:
    • DOS.
    • Provider(s) names / signatures.
    • Start / End times.
    • Accurate and complete procedure / specificity.
    • Diagnosis / specificity / ICD-10 compliant.
    • SCIP measures (temp, beta blocker, sterile technique, etc. even if just for internal audit).
    • Documentation of who completed any ancillary services (i.e., blocks, lines, etc.).
    • Service Location (Hospital, ASC).
      • Sub-Location (i.e.: OR1, OB, Endo, etc.).
      • Ensure VP of Patient Revenue has complete lists of service locations and sub-locations.
    • Legibility.
  • Lead discussions to establish interfaces between the hospital and billing partner to include:
    • Clinical documentation – only applicable to electronic anesthesia documentation sites.
    • Billing interface.
    • Demographic interface – should be available at all locations.
  • Maintain 100% accurate case logs.
    • Information entered in the Admin Database (SIMs) within 3 business days of DOS and updated daily.
      • Reconciliation within 1 week of email notice when discrepancies with billing case log when identified.
  • Assist in ensuring enrollment of new clinicians with payers prior to start date including but not limited to:
    • Follow up to ensure paperwork is sent to new clinician.
    • Fully completed paperwork is returned and received.
    • Send out Start Date Notificati0on email no later than 45 days prior to start. If a quicker start is needed, please notify Payer Enrollment and Clinician affairs as soon as possible.
      • Send updated notification if start date changes.
    • DO NOT schedule new clinicians until payer enrollment documents are received by payers.
  • Review billing IR log daily. Keep IR list to less than 7% of monthly case volume.
    • Address pending items within 48 business hours.
  • Insurance Conversions: Work with billing partner and VP of Patient Revenue to determine a site-specific process for following up on self-pay accounts.
  • Billing coding /compliance: Establish and maintain quarterly audit review meeting with billing partner and VP of Patient Revenue and Corporate Compliance Office.
• Operations
  • Complete HIPAA Compliance Officer training.
    • Implement new role after education received from Corporate Compliance Officer.
    • Distribute annual and/or updated compliance and HIPAA materials to providers.
      • Obtain and track acknowledgement forms.
      • Send completed forms to point of contact at Somnia.
    • 100% adherence to the compliance program is expected. Rates monitored and calculated by compliance and will be shared with sites monthly.
  • Maintain up to date, complete and accurate monthly reporting - Hospital Account Review Report.
  • Maintain all required information on the Intranet.
    • FTE model – weekly.
    • Clinician Contact list – reviewed monthly for accuracy.
    • Upload presentations, education pieces, staff meeting minutes.
    • Other materials as they are developed.
  • Maintain all work on network drive.
    • Migrate any locally saved work to intranet or network folder (Somnia Intranet)
  • Sign into Teams and SIMS daily.
  • Ensure education, utilization, and audit of Somnia standard forms (work with EMR development where applicable).
    • If standard forms cannot be implemented or incorporated into EMR system responsible for alerting VP of Operations and VP of Patient Revenue.
      • • Will follow formal process to review hospital mandated forms including.
          • Review of forms by Somnia leadership / Billing Partner.
          • Feedback on potential deficiencies / compliance risks.
          • Formal letter to hospital leadership and forms committee regarding findings.
  • Clinician Support Tasks
    • Implement TLO for time keeping system (ADP).
      • Submit payroll data on Friday of payroll week ensuring 100% accuracy.
      • Capture and report actual hours worked.
        • Include locum hours when reporting total work hours for account review.
    • Fully integrate QGenda scheduling system.
      • Ensure all clinicians utilize it to full functionality.
      • Ensure QGenda data is updated if changes are made after publishing schedule (i.e.: swapping shifts, vacation time, unpaid days off, sick calls, etc.).
    • Create and follow standard process for when a clinician leaves your group.
      • Collect keys, badges, etc.
      • Send e-mail to the last day notification group indicating the last day the clinician provided services.
      • Follow MSO guidelines for termination of privileges.
  • Credentialing and Enrollment Support
    • Be point person for collecting and distributing provider information for initial and re-credentialing process.
      • Review lists of expiring or expired credentialing items, obtain outstanding information and send to Somnia credentialing and hospital medical staff office (when appropriate).
      • Support Joint Commission process and standards for all PD staff.
    • On Boarding – lead on boarding process for assigned clinicians.
      • Utilize, reference, and refer people to on boarding spreadsheet for accurate and up to date clinician information.
      • Send Start Date Notification email as described above.
    • Recruitment
      • Actively participate in all facility related recruitment calls including weekly recruitment calls.
      • Ensure completion of CEs within 72 business hours.
      • Help with local recruitment efforts and follow up with local candidates when/if necessary.
      • Engage with facility marketing and recruitment team to expand recruitment efforts locally.
  • Policies & Procedures
    • Create non-clinical policies where required/requested.
    • Ensure annual review and update of said policies and procedures.
• Quality
  • Hospital QA Department relationship: Provide support to ensure a positive and supportive working relationship with the hospital quality department to include periodic visits and emails to ensure that we are meeting the goals and expectations of the hospital.
    • Communicate any issues to Somnia’s Quality Department.
  • Clinical Audits: Facilitate and support improvements in conducting periodic clinical practice audits and maintaining accurate records/reporting.
    • Clinically focused audits (10 per month).
    • Store audit results on Somnia SharePoint.
    • Facilitate evaluation and use of audit methods, i.e.: paper, smartphone, etc.
  • Ensure completion of at least 1 cost savings project annually.
  • Formally Document on-going PI (process improvement) projects (not just on HAR spreadsheet).
  • Ensure TIMELY completion of F/OPPEs.
    • Load on shared drive folder and provide copy to hospital MSO.
  • Review hospital SCIP (surgical care improvement project) data with chief and staff, if applicable.
    • Report HOSPITAL calculated results monthly on HAR.
      • Enter all results in numerator/denominator fashion so sample size is easily identifiable.
    • If hospital is not tracking and reporting SCIP data complete annual audit of SCIP measures and include in HAR.
  • Ensure OB epidural tracking times are reported and either captured locally or sent to billing partner.
  • Patient Satisfaction: Facilitate and support improvements, especially with OB patient satisfaction, i.e.: patient education, tablet e-survey roll-out, etc.
    • Ensure competency with accessing and using the MTC web portal to access data, update practice info, produce reports, etc.
    • Support rollout and utilization of OB tablet surveys
      • Ensure safe storage and maintenance of tablet.
  • Conduct annual surgeon satisfaction survey to obtain feedback from > 30% of surgeons (or more frequently if required by contract).
  • Support annual nursing satisfaction survey, if applicable.
  • Develop, implement, and audit action items based on patient, surgeon, and nursing satisfaction survey results.
    • Ensure there is an action plan to improve scores and report on this monthly on HAR spreadsheet.
  • Respond timely to requests for information / data collection for creation of quarterly, annual, and ad-hoc client reports.
  • Implement, maintain, and make available an up-to-date policy and procedure manual with:
    • At least annual review and sign off by chief.
    • Sign off sheet for all credentialed anesthesia clinicians for your facility acknowledging review and understanding of contents.
  • Incident Reporting: Facilitate and support improvements in reporting rates.
    • Help identify reporting trends and address suspected under reporting.
    • Facilitate timely chief reviews and processing within guidelines.
  • QM database: Maintain complete, accurate, and timely database entries.
    • Frequent database maintenance
    • Competent at pulling data and reports as needed for practice and Somnia.
    • Be able to discuss trends in the types of incidents reported.
    • Facilitate entry of timely chief reviews in the database
  • Peri-op/OR data: If the site does not already have readily available and accurate Peri-op/OR data on the traditional KPI metrics, facilitate and support a process to either implement a new electronic tracking process or one by hardcopy form.
  • Somnia University:
    • Complete modules as assigned.
    • Participate in the development of content when requested.
    • Monitor and follow up with clinicians to ensure they complete their assigned training.
    • Support and facilitate compliance with the use of Somnia University (minimum monthly staff access and review) to include electronic and posted reminders for the staff and discussion at staff meetings.
    • Support and facilitate the use of the data for F/OPPEs and Chief reviews.
  • Staff Awareness/Education:
    • Support and facilitate the regular presentation and discussion of compliance and quality related data and issues during staff meetings, etc.
    • Post compliance/quality related data and materials at appropriate locations to for staff reminders and awareness of goals and performance.
• Other duties as assigned. 

Qualifications

• Bachelor’s and/or Master’s Degree, preferably in Business or Healthcare-related field, or similar advanced knowledge of healthcare industry, with fluency in various processes/cycle management activities (Revenue, Recruiting, Credentialing, enrollment, etc.)
• Must be able to commute to all applicable facility locations (driver’s license is preferred).
• Must have a minimum of 2-5 years of prior healthcare management experience.
• Prior experience with clinical & clinical management.
• Prior project management experience.

Skills & Knowledge:

• Strong organizational skills with a problem-solving attitude.
• Strong interpersonal & communication skills (both written and verbal).
• Proficiency: Microsoft Office: Word, Excel PowerPoint
• Availability: Standard work schedule with night and/or weekend as needed.