We are seeking a skilled Patient Access Manager to lead and oversee the operations of the Patient Access team. This individual will be responsible for ensuring efficient and effective patient access processes including scheduling registration insurance verification and pre-authorization for medical services. The Patient Access Manager will ensure that patients receive timely and accurate service while also maintaining compliance with healthcare regulations and organizational standards.
Leadership & Team Management:
Lead mentor and manage the Patient Access team including front desk staff schedulers and insurance verification specialists.
Foster a positive work environment ensuring the team is motivated well-trained and performing at a high standard.
Provide performance evaluations coaching and professional development opportunities for staff members.
Monitor staffing levels and adjust team schedules to ensure optimal coverage.
Patient Scheduling & Registration:
Oversee the scheduling process ensuring that appointments are scheduled accurately in a timely manner and in accordance with provider availability.
Ensure that patient registration processes are compliant with HIPAA and other healthcare regulations.
Confirm patient demographics insurance information and other relevant data to ensure accuracy and completeness in patient records.
Insurance Verification & Authorization:
Ensure that insurance verification is completed for all patients before scheduled appointments including confirming eligibility benefits and coverage.
Work closely with the billing and coding team to ensure pre-authorization and pre-certification requirements are met for medical procedures and services.
Resolve insurance-related issues or discrepancies promptly including working with insurance carriers when necessary.
Compliance & Quality Assurance:
Ensure compliance with healthcare regulations including HIPAA CMS guidelines and payer-specific requirements.
Implement and oversee best practices to ensure efficient patient access processes that minimize errors and delays.
Develop and monitor key performance indicators (KPIs) for the Patient Access team reporting on performance and recommending improvements as needed.
Conduct audits and quality checks to ensure accuracy in patient data insurance verification and registration.
Patient Experience:
Act as a point of contact for patients with questions or concerns regarding scheduling registration or insurance verification.
Ensure that all patient-facing interactions are professional compassionate and patient-centered.
Address and resolve patient complaints and issues in a timely and effective manner.
Work with other departments to enhance the overall patient experience ensuring seamless coordination of care and services.
Collaboration with Clinical & Administrative Teams:
Work closely with clinical staff (physicians nurses and medical technicians) to ensure timely and accurate access to patient information.
Collaborate with other administrative departments including billing finance and IT to streamline patient access and ensure accuracy in patient records and service delivery.
Participate in meetings with healthcare leadership to identify trends address issues and recommend process improvements.
Training & Development:
Develop training programs for new hires and ongoing staff development related to patient access processes systems and customer service skills.
Ensure that all team members are up-to-date with changes in healthcare regulations payer requirements and internal policies.
Keep the team informed of new technologies systems and tools that enhance patient access operations.
Technology & Process Improvement:
Oversee the implementation of new technologies or patient access systems (e.g. Electronic Health Records scheduling software) to improve operational efficiency.
Identify and implement process improvements to reduce wait times streamline workflows and improve accuracy in patient access procedures.
Manage the integration of patient access systems with other clinical and administrative systems to improve data flow and patient care coordination.
Education:
Bachelors degree in Healthcare Administration Business Administration or a related field.
Certification in Patient Access Health Information Management or related certifications (e.g. CPAM Certified Patient Access Manager) is a plus.
Experience:
At least 3-5 years of experience in a patient access front office or healthcare administration role with at least 2 years in a supervisory or managerial capacity.
Strong understanding of healthcare insurance pre-authorization processes and medical billing practices.
Experience with healthcare software systems (e.g. EHR/EMR practice management software).
Skills & Abilities:
Excellent leadership communication and interpersonal skills.
Strong organizational and problem-solving abilities with the ability to manage multiple tasks simultaneously.
In-depth knowledge of healthcare regulations HIPAA and payer requirements.
Ability to train and develop staff to ensure high levels of performance and patient satisfaction.
Proficient in Microsoft Office Suite (Word Excel PowerPoint) and healthcare-specific software platforms.
Previous experience working in a hospital outpatient clinic or medical group practice environment.
Knowledge of medical terminology billing codes (ICD-10 CPT) and insurance verification processes.
Experience with electronic health records (EHR) systems such as Epic Cerner or Allscripts.
Full-time role with the potential for occasional evening or weekend hours depending on the facilitys hours of operation.
Ability to work in a fast-paced high-volume healthcare environment.
Occasional travel may be required for training conferences or meetings with off-site locations.
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