Saginaw, Michigan
Manager - Admitting and Registration Job Opening in Saginaw, Michigan - Summary:
The Admitting and Registration Manager is responsible for the overall operations of patient registration, central scheduling and precertification processes. Responsibilities include overseeing staff who obtain patient identification, demographic information, insurance verification, price estimation and collection of patient liabilities. Oversees clinical staff that review medical necessity and obtain prior authorization. Promotes data integrity, productivity, goal accomplishment of the staff to enhance the delivery of safe, quality patient care. Develops and implements departmental policies. Ensures department functions in a manner that complies with administrative policies and procedures as well as government regulations. Builds effective working relationships and fosters a spirit of teamwork with every department in Covenant as well as physician offices.
Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to Extraordinary Care for Every Generation.
Responsibilities:
* Contributes to organization success targets for net operating margin.
* Effectively and efficiently prepares/manages annual budgets, monitoring expenditures during the year.
* Responsible for overseeing patient liability identification and collection processes that have been integrated into the workflows.
* Establish point of service collection goals. Daily monitoring/tracking of staff and department achievements.
* Monitors daily cash posting and deposit functions.
* Monitors account quality for clean claims submission.
* Responsible for excellent customer service and department specific Press Ganey scores.
* Communicates with physicians and physician offices resolving issues and concerns.
* Accountable for all departmental functions 24/7.
* Demonstrates age specific competency in the selected age groups: newborn, infant, pediatric, child, adolescent, adult, geriatric.
* Has social contact with patients, primarily adult, able to appropriately assess, care for and treat them according to the guidelines as defined by Covenant HealthCare.
* Assists RN staff in their decision making processes in obtaining prior authorization:
o Criteria for Medical Necessity
o Payer guidelines
o Provision of clinical information
o Service appropriate with physician order
o Monitor staff clinical expertise
* Provides updates and education to staff on the many changes to insurance and managed care requirements, referral and authorization guidelines.
* Intervenes in decision-making, regarding cancellation or rescheduling of procedures until proper authorization is obtained.
* Keeps abreast of account appeal processes to ensure financial integrity.
* Assists staff regarding denials, appropriateness, pending referrals and authorizations.
* Continually assess current workflows and revise as necessary to improve work efficiencies.
* Performs, assists, and initiates special projects to improve workflows between departments and Admitting; Scheduling; Precertification.
* Keeps abreast and provides staff with education regarding issues that impact their job duties including HIPAA, EMTALA, Red Flags/Identity Theft and Corporate Compliance.
* Participates and conducts performance appraisals of staff. Institutes employee development plans and corrective action if necessary.
* Maintains confidentiality.
* Assures compliance with HFAP and other regulatory agencies.
* Continually monitors quality and integrity of registrations, scheduled appointments and authorizations and referrals. Intervenes as necessary.
* Develops and updates policies and procedures related to registration, scheduling and precertification processes.
* Actively involved in integrated clinical and revenue cycle work groups to support the continual improvement of multidisciplinary processes that effect patient care.
* Works collaboratively with ECC physicians, management and staff for desired quality, fiscal and service outcomes.
* Provides strategic leadership for Central Scheduling to assure all department criteria are aligned during appointment scheduling.
* Productivity monitoring, quality review, process improvement and other duties as assigned.
Other information:
EDUCATION/ EXPERIENCE REQUIREMENTS
* Registered Nurse with current licensure.
* Bachelor?s Degree in healthcare related field.
* Responsible for acquiring continuing education credits in pertinent areas and maintaining RN licensure at state level.
* Minimum of 3-5 years of experience in supervision.
* Management skills and techniques with supervisory experience encompassing multiple areas, including but not limited to: patient registration, billing operations, budgeting, financial analysis, reporting, etc.
* Computer competency, including Microsoft Office and Lotus Notes.
* Knowledge of standard office equipment.
* Has a solid understanding about health care insurance and maintains current knowledge about third party reimbursement benefits, authorization, reimbursement, and billing requirements.
* Extensive knowledge of each component of the Revenue Cycle.
* Demonstrated organizational skills.
* Ability to communicate effectively, verbally and in writing, with all levels of hospital personnel on a one-on-one and group basis.
* Ability to work independently and prioritize work.
* Ability to protect the confidential nature of the information.
WORKING CONDITIONS/PHYSICAL DEMANDS
* Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.
* Frequent standing, walking, sitting, twisting, reaching, handling, fingering, feeling, talking and hearing.
* Frequent depth perception, near, midrange and far vision.
* Frequent color and field of vision.
* Occasional lifting 0-25 lbs.
* Occasional carrying, pushing, pulling, balancing, stooping, kneeling, crouching and squatting.
NOTICE REGARDING LATEX SENSITIVITY IN APPLICANTS FOR EMPLOYMENT.
It has been determined that Covenant HealthCare cannot provide a latex safe or latex free work environment at any of its facilities. Unfortunately, that means that any individual, including an applicant or an employee, is likely to be exposed to latex while on Covenant?s premises. Therefore, latex tolerance is considered to be an essential function for any position with Covenant.
Job Type: Full-time
Required education:
Bachelor's
Required experience:
supervision: 3 years
Required license or certification:
Registered Nurse (RN)
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