Director, Patient Access & RHM Financial ServicesMercyOne, Dubuque, IA
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Mercy Medical Center is a not for profit Catholic hospital serving the tri-state area of Iowa, Illinois and Wisconsin since 1879. Mercy – Dubuque has 263 beds while Mercy – Dyersville is a critical access hospital with 25 beds and a 40-bed nursing home.
Mercy offers a full range of acute care services, including invasive cardiology and open-heart surgery, Level II trauma center, Level II regional neonatal intensive care unit, general and orthopaedic surgery, psychiatric services and inpatient physical rehabilitation. Mercy also operates two hospital-based skilled nursing units, extensive outpatient rehabilitation services, home health care, retail pharmacy and a wide range of outpatient, community and business services. Mercy’s 1,300 full- and part-time employees and medical staff of 230 care for more than 56,000 inpatients and outpatients each year.
The hospital is accredited by The Joint Commission and achieved Magnet designation, the gold standard of patient care, in 2004 and was redesignated a Magnet hospital in 2009.
Mercy Medical Center is a member of Mercy Health Network in Iowa and is a Ministry Organization of Trinity Health based in Novi, Michigan.
Mercy is an organization that values and encourages diversity. To learn more about Mercy and its opportunities for employment, please see the postings listed on this site or visit our website at www.mercydubuque.com.
Responsible for leading and directing the work of the assigned Ministry Organization (MO) Patient Access and Revenue Management functions including: patient scheduling (as assigned), reception/check-in, bed management, registration, financial counseling, clinic back office departments, (transcription, charge entry, coding, training, and revenue management support in both hospital and clinic systems). Motivates staff to achieve the highest levels of customer satisfaction and to meet the organization goals for customer service and financial performance. Optimizes staff performance through process redesign, policy/procedure implementation, communications, and outcome feedback. Interacts with other departments within the Shared Services Center (SSC) as well as within the Ministry Organizations (MO), as required and serves as a representative of the department. Attends managerial meetings as required and supports the core values of Trinity Health, which is an integral part of this position.
Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions. Educates physicians, physician office staff, and organizational leadership and associates regarding scheduling (as assigned), registration, bed management, medical necessity review, Point-of-Service collections, financial counseling, eligibility assistance, customer service, transcription, charge entry, coding, and cashiering functions. Functions as a consultant to Ministry Organization Directors and leadership, physicians, case managers and others regarding Medicare, Medicaid, and commercial insurance guidelines for Patient Access Services and clinic revenue cycle operations.
Serves as a primary liaison to members of the medical staff, clinic administration, and other Ministry Organization associates regarding onsite Patient Access functions and clinic revenue operations; and meets with individual or groups of physicians, family members, 3rd party payers, and vendors as necessary in order to facilitate the patient access process and clinic revenue operations. Provides leadership for departmental services through collaboration with customers, associates, physicians, clinics, other internal departments and services, vendors, etc.
Directly responsible for managing the intake functions of the assigned MO Patient Access department. Manages/supports multiple supervisors with clerical staff working 24/7 to perform a variety of functions. MO Patient Access: Patient Scheduling (if responsible), Reception/Check-In, Registration (IP Admission, Outpatient, Series, Emergency Department, etc.), Medical Necessity Review/Patient Admission Designation (if responsible), Medical Necessity (ABN Delivery), Point-of-Service Collections, Financial Counseling, Eligibility Assistance, Customer Service, and Cashiering; and Revenue Management Support in both hospital and clinic operations: Quality Assurance and Training in patient access and clinic revenue operations, DNFB/Hold Maintenance, Pre-Bill Charge Audits, Pre-Bill Edits, Late Charge Monitoring, Charge Description Master (CDM) Maintenance, Technical Denial Follow-Up, TIS Support and other related activities.
Provides operational guidance and direction to assigned staff to ensure service integration, effective coordination of departmental work activities, and quality job performance. Participates in the redesign of registration and intake processes to improve service, data integrity, and staff productivity/quality to achieve departmental goals and process outcomes in both hospital and clinic operations;
Provides input and content expertise in the design and enhancement of the Patient Access Services/Registration and clinic computer systems and support processes. Represents the department in all matters directly relating to registration functions and in the absence of the Regional Manager or other management team members. Serves as primary liaison regarding registration and database issues; 3rd party reimbursement issues related to registration practices; charge entry, financial counseling; and assigned reception activities. Elicits feedback from interdisciplinary team, including the medical staff and involves them in decision-making, where applicable.
Responsible for key performance Indicators as they relate to the division (waiting/service times, staff productivity, accuracy, customer feedback, incident reporting, turnaround, and quality indicators for clinic revenue operations, etc.). Manages assigned staff in order to ensure steady workflow balance and high quality outcomes. Retains, interviews, recruits and is accountable for the on-going development and evaluation of individuals within the area of responsibility;
Develops associate work schedules to ensure cost effective staffing that meets customer requirements. Establishes, implements and evaluates on-going performance improvement programs, utilizing an interdisciplinary approach. Responsible for the financial and personnel management of assigned areas; and effectively directs and facilitates a multidisciplinary team to achieve its desired outcomes.
Identifies action plans to improve the quality of services in a cost efficient manner and facilitates plan implementation. Prepares required reports using statistically sound information, displaying content in easily understandable format. Maintains professional development and growth through journals, professional affiliations, seminars, and workshops to keep abreast of trends in revenue cycle operations and healthcare in general. Participates as appropriate in continuing educational programs and activities that pertain to healthcare and revenue cycle management, as well as specific functional areas. Develops and implements an annual plan of personal and professional development; and Participates in local, regional and national health care revenue activities and professionally represents Trinity Health at these functions. Serves in a leadership role and promotes positive Human Resource Management skills.
Fosters teamwork atmosphere between business and clinical stakeholders, retains, recruits and manages staff to achieve strategic objectives; and provides staff training and mentoring. Other duties as needed and assigned by the Regional Director or other URO Leadership, including but not limited to leading and conducting special projects. Develops project work plans, facilitates resource allocation, executes project tasks and obtains assistance from other intra and inter-regional resources, as required. Maintains a working knowledge of applicable federal, state, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
Must possess a demonstrated knowledge of Patient Access, Pre-Service and Revenue Management functions for hospital and clinic, as normally obtained through a Bachelor's degree in Healthcare or Business Administration, Nursing, or a related field, or an equivalent combination of years of education and experience. Three (3) or more years of experience managing functional areas of Registration, Pre-Service/Financial Clearance, Financial Counseling, Case Management/Utilization Review, or other management functions related to revenue cycle activities in a complex, multi-site environment. Working knowledge of computer operations and electronic interfaces is required. Formal software course training is preferred. Certified Healthcare Access Manager (CHAM) as awarded by the National Association of Healthcare Access Management (NAHAM) or eligible candidate preferred.
Ability to lead and manage diverse staff in a learning environment with frequent changes in departmental priorities. Ability to recognize necessary changes in priority of tasks and allocation of resources, and act upon them as required to meet workload balance.
Demonstrated ability to interpret 3rd party payer contract requirements and recommend, design and implement procedures for compliance with regulations and standards. Ability to negotiate with insurance vendors, medical directors, and 3rd party payers when appropriate in order to facilitate the delivery of care in the most appropriate setting. Knowledge of Medical Necessity review guidelines (LMRP/LCD and SI/IS criteria) for commercial, Medicare, and Medicaid insurance products. Uses knowledge of insurance criteria and regulations in order to expedite appropriate use of resources and compliance with 3rd party payer contracts.
Ability to communicate and work with patients/guarantors, physicians, physician office personnel, associates, case managers, 3rd party payer review personnel, and others in order to expedite the patient access process to avoid negative financial and/or customer service impact on the facility. Dynamic communication skills (verbal and written) in dealing with trainees, associates, and internal/external customers. Serves as a change agent, coach, mentor, team builder and facilitator. Must possess strong organizational and analytical skills in order to detect and resolve problems. Ability to address complex problems with multi-level impacts and with solutions not readily apparent. Uses sound judgment, in-depth analysis and expertise to resolve issues.
Ability to prioritize and deliver on key initiatives; demonstrated success in achievement of key performance metrics targets within time and budget constraints. Exhibits superior management skills that emphasize team‑building and strong leadership with the ability to provide clear direction to the department, while also functioning as an individual contributor. Ability to attract, develop, deploy and retain a world‑class revenue cycle team, capable of performing as a team and of evolving with the organization’s vision and with cutting‑edge technologies.
Displays a demonstrated understanding of project management, revenue cycle technology infrastructure and related issues. Must be comfortable operating in a collaborative, shared leadership environment. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.
Please reach out to Tiffany.Anderson003@trinity-health.org with any questions.