Job Purpose

The Manager, Patient Access will provide leadership to Insurance Verification/Authorization Supervisor and their teams, including supervision of staff, reviewing of processes, and providing recommendations for improvement of operations. Goal is to meet or exceed national Patient Access KPI benchmarks and client specific KPI’s. Maintain or exceed team productivity and quality standards. Work with Director to understand and communicate the impact of insurance verification and authorization related errors causing denials and provide data and implement effective processes to correct actions.

Duties and Responsibilities

Operational Management

• Plan, organize and direct overall operations of the Insurance Verification and Authorization Team as it relates to patient intake and pre-visit services.
• Work in conjunction with Director, Patient Access Services to set and manage target performance levels
• Ensure that team stays current with payer specific registration requirements and industry requirements and/or trends
• Maintain an overall objective of maximization of cash collections, reduction of eligibility, benefit and authorization denials and the minimization of write-offs/non-collectible adjustments
• Actively engage with and manage Insurance Verification and Authorization team, reviewing weekly productivity and quality scores to develop action plans for improvement accordingly.
• Establishes consistent communication processes with front-desk leadership to ensure feedback is provided timely on all appointments that require schedule changes.
• Ensures all client KPIs are met including days out, POS collection targets, completed referral and authorization volumes.
• Identifies denial trends and makes recommendations for improvements in process, executing to completion.
• Develop and communicate weekly performance to internal and client leaders on IV, POS Collections, Authorization and Referral processes.

Personnel Management and Professional Development

• Provide management and supervisory duties related to educating and training staff, evaluating staff performance and monitoring productivity
• Interview, hire, train, evaluate, and develop subordinate staff, where applicable
• Develop and maintain quality control programs, including in-depth and individual performance reviews
• Orient new hires and provide in-services and training, continuing education, and development related to those functional areas of responsibility
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Qualifications

• Bachelor’s degree or equivalent combination of education and experience
• 5+ years’ experience managing and leading front-end processes at a physician business office or physician practice at a supervisory level or higher
• Experience with Physician Practice Management Systems preferred:
• Athena
• Cerner
• EPIC
• Ability to work well individually and in a team environment
• Must be reliable, responsible, goal oriented and flexible
• Excellent interpersonal, communication and organizational skills
• High degree of integrity including ability to successfully deal with sensitive or confidential information
• Ability to exhibit poise, composure and confidence when confronting stressful or high-pressure situations

Working Conditions

• Occasional travel to client locations
• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.