Supervises the daily operations and provides technical and administrative leadership of the front-end revenue cycle functions.  Reviews work schedules and assigns duties to ensure optimal patient flow and production goals. Oversees and evaluates accuracy and quality of technical functions.  Ensures compliance with protocols and procedures. Plans and prioritizes work assignments. Supervises various personnel functions including recruitment, scheduling, coaching and discipline. 

Education:

• High School diploma or equivalent required, and college course work in business or a health care curriculum highly preferred.
• Associate’s Degree is preferred for MPS and REQUIRED for ExpressCare. Three (3) years’ experience as a patient access/registration, medical billing, or insurance liaison and High School Diploma or GED may be considered in lieu of an Associate’s Degree.

Experience:

• One (1) year minimum in a lead or supervisor position is preferred.

Other Knowledge/Skills/Abilities:

• Demonstrates superior patient relations and interpersonal skills; demonstrates an appropriate level of mental and emotional tolerance and even temperament when interacting with staff, patients and general public, using tact, sensitivity and sound judgment; promotes a positive work environment and contributes to the overall team efforts of the department and organization.
• Knowledge of medical terminology, medical procedural (CPT) and diagnosis (ICD-9 CM) coding, and hospital billing claims, preferred.
• Working knowledge of computers, required. Ability to enter and retrieve data, and electronically notate registration software, and other required applications/systems.
• Must demonstrate ability to work successfully with internal and external customers.
• Must demonstrate detail orientation, critical thinking, and problem solving ability.
• Must demonstrate excellent oral and written communication and customer services skills, with ability to maintain a calm and professional demeanor in high stress situations.
• Must demonstrate ability to remain flexible, and consistently exercise sound judgment and initiative in very stressful situations. Ability to effectively manage competing priorities and work independently in a rapidly changing environment.
• Must demonstrate ability to educate, persuade, and negotiate effectively with patients and families.
• Demonstrated technical knowledge and proficiency to work in any area of unit responsibility (as assigned), required.

1. Recruiting, candidate selection, retention initiatives, performance appraisals, and coaching, and/or disciplinary actions. Perform applicant interviews and provide hiring recommendation. Ownership of staff onboarding and ongoing training and education. Orients and cross-trains others within assigned area of responsibility.

2. Assists Director, Regional Clinics/ExpressCare, in ensuring that financial performance and revenue cycle initiatives and objectives are achieved.

3. Executes the operational and management functions of PAS as directed by the Director, Regional Clinics/ExpressCare.

4. Assists in the development and implementation of PAS policies, procedures, and guidelines. Collaborates with MPS Department leadership in developing staff goals. Ensure compliance with department policies and procedures. Participates in and/or selects staff for unit, system, and IT testing events.

5. Assists in monitoring and trending Key Performance Indicators for PAS, and reports findings to Director, Regional Clinics/ExpressCare, with recommendations for improvement as needed.

6. Distributes work assignments and accommodates work requirements in an efficient and effective manner. Provides department coverage as appropriate during times of vacancy.

7. Assists with all aspects of scheduling, including employee call in notifications, and management and provision of coverage as necessary.

8. Assists with employee account audits, various report monitoring, and addresses related situations. Assists with resolution of issues.

9. Completes all steps of pre-registration/registration; verifies patient identity and demographic information through appropriate tools. Identifies/captures appropriate health insurance benefit eligibility, based on contract/regulatory differentiation. Facilitates appropriate billing of claims. Obtains and validates proper consent for patient treatment.

10. Educates patients/others regarding the resolution of billing, private pay options, collection efforts, coordination of benefits, third party and governmental payment criteria, insurance coverage, payments, and denials.

11. Coordinates with MMC/MPS Patient Financial Services, Utilization Management, physicians, and medical offices to ensure consistent financial documentation across the enterprise, and an interdisciplinary approach to patient and organizational needs.

12. Adheres to all CMS conditions of participation regulations regarding delivery, explanation, and acquisition of patient/designated representative signatures on (IM), CMS-R-193, per Medicare Patients’ Rights Condition of Participation (CoP) at 42 CFR 482.13(b)(2, and Section 1866(a)(1)(M) and Section 1154(e) of the Social Security Act.

13. Verifies medical necessity, and obtains appropriate signature on Advance Beneficiary Notice of Non-coverage (ABN) per CMS regulations at points of patient access.

14. Negotiates with patients and families to collect and post patient co-pays and/or deposits at point of service. Supports Patient Access Services (POS) Point of Service collection goals as defined by Revenue Cycle leadership and best practice benchmarks.

15. Ensures compliance with all applicable HIPAA, Joint Commission, CDC, MMC, and state and federal statutes, providing required associated literature to patients at all PAS access points. Educates patients regarding Advance Directives, Medicare D prescription coverage, MMC, Joint Commission, and Illinois Department of Public Health grievance process as appropriate.

16. Maintains current knowledge and complies with the Illinois Fair Patient Billing Act and Illinois Uninsured Patient Discount Act at all times. Provides relevant patient/family educations.

17. Develops and maintains a comprehensive knowledge of the health system organization and its functions. Completes all assigned annual organizational education

18. Participates in, and/or leads special projects as assigned by management.

19. Resolves assigned unbillable/rejected claims edits toward streamlining facility claims processing workflows, reducing reimbursement errors and improving payment integrity. Investigates problematic accounts.

20. Performs other related work as required or requested.