Patient Access Supervisor

2 weeks ago

Peoria, United States Professional Partners Group Full time
Job DescriptionJob Description

Position Summary

The primary function of the Patient Access Supervisor is to coordinate and manage patient access, including managing: Patient Scheduling Department and Eligibility & Authorization Department including but not limited to: overseeing scheduling appointments, verifying insurance coverage, eligibility authorization, and patient billing.

Reports To: Revenue Cycle Manager

Principal Duties and Responsibilities

  1. Coordinating and overseeing patient access including patient scheduling, eligibility, and authorization process of insurances for all patients.
  2. Manage teams of eligibility and authorization specialists and patient schedulers.
  3. Collaborate with other departments to ensure timely and accurate processing of eligibility and authorization requests.
  4. Provide training and support to staff on patient scheduling, eligibility, authorization, and billing processes.
  5. Monitor and analyze patient access data to identify trends and areas for improvement.
  6. Maintain accurate records and documentation of eligibility and authorization activities by monitoring staff KPIs, reports, and data.
  7. Responsible for effective and efficient scheduling appointments, and verification and authorizations of all patients’ benefits.
  8. Utilization of electronic verification/eligibility technology or contacting insurance companies to verify and/or obtain patient eligibility and benefits.
  9. Verify existing patient insurance coverage and update the information in the practice management software system.
  10. Responsible for obtaining all referrals and authorizations for procedures and services, as required.
  11. Responsible for acting as a liaison between patients, healthcare providers, and insurance carriers to ensure all proper measures are taken and information is collected.
  12. Address rejected claims related to patient eligibility, authorization, or demographics.
  13. Responsible for answering incoming calls from other providers, recipients, and carrier groups in relation to insurance coverage.
  14. Ensures all patient questions are answered and issues are resolved timely by utilizing the appropriate resources.
  15. Develops and maintains effective relationships with the patients ensuring all patient demographic and insurance information is obtained and current.
  16. Maintain up-to-date knowledge of specific clinical services, registration, and pre-registration requirements for all departments.
  17. Maintain awareness of federal and state health care legislation and regulations, OSHA, and HIPAA.
  18. Proactively identifies and leads department process improvement opportunities.
  19. Develop and implement policies and procedures to improve the eligibility and authorization process.
  20. Maintain patient and company confidentiality.
  21. Other duties as assigned by the Revenue Cycle Manager.

 

Required Skills, Knowledge, and Abilities

  • Strong knowledge of state and federal regulations related to eligibility and authorization.
  • Ability to analyze data and identify trends.
  • Ability to operate basic office equipment, answer multi-line telephones, and have a strong computer background.
  • Establish and maintain effective working relationships with patients, insurance companies, and staff.
  • Knowledge and skills in working with computerized billing systems including practice management software and EMR.
  • Must adhere to all HIPAA guidelines and regulations.
  • Knowledge of medical insurance and authorization processes
  • Knowledge of medical terminology and experience working in a healthcare or insurance environment.
  • Knowledge of organizational policies, procedures, and systems.
  • Ability to document electronically and accurately.
  • Use appropriate guidelines for releasing information.

Education

  • High School diploma or equivalent with 5+ years of experience in the related field
  • Preferred Bachelor's degree in healthcare administration or related field

Experience

  • Minimum of 1 year supervision/management experience
  • Minimum of 3 years of experience performing patient scheduling, insurance verification or working with medical insurance programs.
  • Experience with eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers, and other funding sources.

 

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