PAS, Lead Admitter - 40 Hours Rotating Shift
Salem Hospital(NSMC)

Salem, Massachusetts


Summary:

Under the general direction of the Manager of Patient Access Services, performs duties relative to the admissions/registration process of patients to the Medical Center. Coordinates the various components of the Admissions /Registration process including: interviewing, recruiting, training and disciplining staff, management of cash collection efforts; obtaining prior approval for all elective visits, entering this information into the Medical Center data base and if/when applicable, into the P.O.S. device or HDX Eligibility to obtain verification of the insurance coverage; manages the daily operations of Admissions, maintaining the systems and controls set forth by Operations Administration and the Director of Patient Access Services. Utilizes the professional knowledge of Admissions, Registration, Scheduling, Managed Care and other related areas in order to meet requirements of the Medical Center, Federal, State and all other governmental agencies. In all areas of responsibility (E.R., outpatient, inpatient and surgical registrations) provides management and direction to the department.

Qualifications
Job Specific Responsibilities:

  • Establishes goals and objectives for departmental denial management and updates them annually, in conjunction with hospital targets.
  • Provides case follow-up until resolution has been achieved.
  • Formulates and submits timely, well prepared appeals with supporting clinical information and required data.
  • Works in conjunction with all levels of hospital personnel in establishing and maintaining programs to meet the increasing contractual demands of third party payers, and minimizing loss of revenue due to denials.
  • Initiates departmental write-off policy, when necessary.
  • Maintains clear channels of communication for effective supervision and problem-solving, as related to denials.
  • Cultivates, maintains and enhances relationships with third party payers.
  • Makes day-to-day administrative decisions consistent with the missions of the department and the hospital, utilizing general management principles.
  • Works as a team with managers of other departments to accomplish operational requirements, increase reimbursement and minimize denials.
  • Designs and implements programs to monitor denials.
  • Assists with the designing and implementing of programs to reduce denials and increase reimbursement.
  • Designs and implements programs to monitor denial database, identify patterns and develop remedial intervention.
  • Designs and implements Quality Assurance programs targeting as goals not only accuracy and efficiency, but also high levels of patient and physician satisfaction.
  • Actively participates in the design, development/acquisition, implementation and evaluation of computerized information systems to be used as operations and/or management tool for Patient Access Services, as well as other hospital departments.
  • Develops functional specifications/requirements for computer systems, new computer programs and enhancements to existing systems.
  • In conjunction with Information Systems, Care Coordination and the Finance Department, assists in design, creation and verification of the Denial Database.
  • Performs extensive testing during implementation of any new program to ensure data integrity.
  • Maintains specified database dictionaries.
  • Designs and develops screens and standard reports.
  • Troubleshoots and finds effective solutions to Denial Database issues, often coordinating the necessary technical support.
  • Assures accuracy and completeness of data collected by Patient Access Services and submitted to third party payers.
  • Actively participates on designated committees, both internal and external regarding the revenue cycle.
  • Identifies, investigates and resolves system errors to prevent loss of revenue.
  • Adhere to hospital wide standards and department specific standards for service excellence, including, but not limited to: identification of and response to customer needs, appropriate communication, protection of patient privacy and confidentiality, etc.
  • Comply with established department protocols, including but not limited to: Using the standard greeting when answering the telephone ("Admitting, ES Registration, Outpatient Registration, this is John, how may I help you?") and identifying own name to caller;Using the standard confidentiality statement for all emails, using professional language (avoid slang) and spell check for written communication; Providing thorough contact information in signature (signature, listing name, title, department, phone, fax and email address); Communicating absences to others (activate email Out of Office Assistant, provide expected return date, expected reply date, and an alternate contact)
  • Maintain a professional relationship and cooperative rapport with co-workers, other healthcare professionals, supervisors and others in positions of authority.
  • Communicate in a professional manner with particular emphasis on interacting positively and respectfully with patients, visitors and others. Respond constructively to feedback from any customer group (patients, visitors, co-workers, physicians, departments, etc.).
  • Coordinate work to achieve maximum productivity and efficiency during the assigned shift. Assist in other areas of department work, filling in clerical work, working on projects, assisting others, tracking QA and QI, etc.
  • Identify opportunities and make recommendations for operations improvements in a positive manner. Contribute to department problem solving with a "team" perspective.
  • Maintain the confidentiality of patient records and uses discretion when discussing patient matters.
  • Comply with infection control, chemical safety, and general safety policies and procedures. Follow safe work practices to ensure proper care and use of hospital equipment, vehicles, etc. Identifies and reports safety concerns/hazards to supervisor.
  • Wear identification badge according to policy.
  • Comply with attendance policies; provide proper notification and advance notice to appropriate individuals. Manage time in order to be punctual for appointments and ready to work at the start of the assigned shifts. Prioritize work to meet deadlines.

Job Qualifications:

Experience: Required;Previous experience in hospital admissions, insurance or billing required, preferably 2-3+ years

Education/Degree Requirement:

Required: High School Diploma or equivalent required

Preferred: Associate's Degree in business preferred



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