Patient Access Manager

Patient Access Manager

The Patient Access Manager is responsible for managing and overseeing the efficient functioning of patient access services in a healthcare facility or hospital. The Patient Access Manager works in collaboration with other healthcare professionals to ensure patients receive timely, efficient, and effective services.

Responsibilities

Oversees all registration, pre-registration, scheduling, pre-authorization/pre-certifications, referrals/orders, switchboard, financial counseling, and insurance/benefits eligibility team.

Develop policies, standards, and procedures for patient access services to ensure compliance with regulatory requirements and best practices.

Monitor and analyze departmental performance metrics to identify areas for improvement and implement changes to optimize efficiency and quality of services.

Supervise and train the patient access staff, ensuring they understand policies and procedures and have access to necessary resources for optimal job performance.

Respond to and resolve patient complaints and inquiries related to patient access services.

Collaborate with other healthcare professionals to ensure resources are utilized effectively to meet patient needs.

Completes charge reconciliation, late charge additions, and unfinalized review of billing.

Completes billing for clients and follows up on these accounts.

Review denials that are specific to authorizations, eligibility, registration, needing more information, etc. that are assigned by the Central Billing Office and Meditech.

Complete and track all appeals that are related to front office functions.

Verify that all scheduled services have authorizations, as needed.

Establish point-of-service collection goals for the registration staff.

Resolve assigned tasks. Resolved assigned account checks. Assist hospital departments with removing and adding charges. Work the return to client file as assigned by the Meduit for resolution.

Check and work mail. Quality Assurance checks of consent forms, cards, and insurances are verified. Assist other departments as needed with claim resolution. Work the assigned PAD functions, as needed.

Qualifications

EDUCATION

High School Diploma Required Bachelor's Degree Business, Finance, or Related Field Preferred

EXPERIENCE

4-6 years experience. Minimum of 5 years of experience in patient access or related field, with at least 2 years of supervisory or management experience required.

KNOWLEDGE, SKILLS, & ABILITIES

Knowledge of healthcare regulations, insurance requirements, privacy standards, and facility policies. Experience with electronic health record (EHR) systems, practice management software, and patient data management tools. Excellent organizational, leadership, communication, problem-solving, and interpersonal skills. Ability to work collaboratively with other healthcare professionals, patients, families, and caregivers. Strong attention to detail, accuracy, and quality control.