Provides leadership, organization, planning, direction, and administration to the operational aspects of the Patient Relations Department and its services. Collaborates with key members of the Hospital, Physician Practice, Service Excellence, Risk Management, and Quality/Safety Departments to investigate and assist in... [+] More

Provides leadership, organization, planning, direction, and administration to the operational aspects of the Patient Relations Department and its services. Collaborates with key members of the Hospital, Physician Practice, Service Excellence, Risk Management, and Quality/Safety Departments to investigate and assist in resolving patient complaints. Oversees staff who receive complaints and establishes processes for investigation and response.

Facilitates communication between departments and providers to ensure timely resolution of complaints. Collects data and information about patient care concerns and makes recommendations as appropriate. Resolves conflicts and acts as intermediary between patients, families, and staff. Recommends establishment of policies and operating procedures to ensure positive patient-Hospital relations. Prepares reports and analyses on progress, adverse trends, and appropriate recommendations or conclusions. Develops and tracks annual department budget. [-] Less

Provides executive leadership for a broad range of patient care operations to include nursing and several other professional services departments such as rehabilitation, respiratory care, pharmacy, diagnostic imaging, and laboratory services.

This position typically reports to the CEO or COO of... [+] More

Provides executive leadership for a broad range of patient care operations to include nursing and several other professional services departments such as rehabilitation, respiratory care, pharmacy, diagnostic imaging, and laboratory services.

This position typically reports to the CEO or COO of the organization. Plans, organizes, implements and evaluates outcomes of the patient care strategic plans. Develops strategic patient care initiatives and transforms initiatives into action plans. Performs regular data analysis of hospital census, quality data and operations cost reports to identify variances and their causes so that areas of focus may be identified and resources may be appropriately deployed. Works closely with the Medical Director to ensure that patient care services are provided in an efficient and effective manner. Provides oversight and direction in establishing and maintaining a system for developing, reviewing, approving and disseminating standards of clinical practice. Assists in reviewing and making recommendations on policy issues regarding clinical practice with appropriate discipline within the organization. Prepares and manages the departmental budget. Hires, develops and motivates a qualified patient care management staff. An advanced degree in a field of health or nursing is typically required for this position. The position typically requires strong clinical and quality improvement knowledge. [-] Less

Plans and directs business office operations of the medical facility to ensure that revenue management functions meet customer and organizational requirements. Plans and directs business office operations to include such functions as admitting, patient registration, billing, collections, and insurance claims.... [+] More

Plans and directs business office operations of the medical facility to ensure that revenue management functions meet customer and organizational requirements. Plans and directs business office operations to include such functions as admitting, patient registration, billing, collections, and insurance claims. Typically requires a college degree in business and related managerial experience.

Assists in coordinating and maintaining patient financial services programs to ensure compliance with current payments, rules, and regulations that impact the medical center and/or physician's billing and collections process. Monitors and ensures compliance with Medicare and Medicaid documentation guidelines. Monitors and evaluates current reimbursement/payment rules and ensures that legislative and regulatory changes impacting medical billing are anticipated and communicated to the clinical faculty, staff, and departmental billing personnel. Develops techniques for effective analyses of billing and collections efforts. Oversees resolution of third party denials and assists with reimbursement appeals and problems. Prepares financial reports and analyses to show progress or adverse trends and makes appropriate recommendations or conclusions. Assists in identification of new technologies that will improve departmental operations. Develops departmental strategies to meet cash projection formulas, reduce days in Accounts Receivable, and reduce denials. Ensures compliance with State and Federal law, compliance plans, HIPAA, and JCAHO guidelines. Prepares and manages the departmental budget. Hires, develops, and motivates a qualified Patient Financial Services staff. May provide assistance to physicians in determining appropriate use of codes for maximizing reimbursement of physician services. [-] Less

Manages and directs the activities of employees responsible for patient billing... [+] More

Manages and directs the activities of employees responsible for patient billing services and patient payments. This position typically requires a Bachelor’s degree with five years of patient billing management experience.

Manages and directs the activities of employees responsible for patient billing services and patient payments. Establishes billing department policies, practices and procedures to ensure timely and proper billing for services provided by the organization. Provides planning, organizing and budgeting for the department. Develops, administers and reports quality indicators for the department. Recommends and implements innovative strategies for billing and the collection of payments owed. Hires, trains, coaches, counsels and evaluates performance of direct reports. Prepares and presents management reports that billing activity, payment aging as well as collections progress, problems and resolution. This position typically requires a Bachelor’s degree with five years of patient billing management experience. [-] Less

Supervises the... [+] More

Supervises the billing and collection functions of the Business Office on private pay and insurance claims to include private insurance, Medicare or Medicaid. This position typically requires a minimum of five years of experience in patient billing or accounting.

Supervises the billing and collection functions of the Business Office on private pay and insurance claims to include private insurance, Medicare or Medicaid. Supervises business office processes and ensures timely submission, adjudication, follow-up, and posting of insurance claims and the issuance of bills to patients/guarantors. Establishes and maintains full receivable accounting function. Facilitates teamwork among the patient account representative staff and the clinical staff. Receives and addresses patient complaints in an appropriate and timely manner. Hires, trains, and motivates a qualified staff to perform assigned functions and achieve objectives. Monitors claims preparation processes to make sure that payer specific billing requirements are met. Ensures the development of processes to monitor and audit policies and procedures. Ensures compliance and follow-up with all standards and audits. Provides financial counseling to patients and their families regarding charges for health care services. Assists financially responsible persons in arranging payment schedules. Determines necessity of third party sponsorship and processes patients accordingly. Examines insurance policies and other third party sponsor materials for sources of payment. Maintains records of patient's accounts and corrects, updates and consolidates records to include the application of proper discounts to patients. This position typically requires a minimum of five years of experience in patient billing or accounting. [-] Less

Performs registration, admission, pre-admission, reception, and discharge functions for all patients receiving services in the healthcare system. Greets, instructs, and directs patients. Receives incoming calls on multi-line phones and schedules and confirms appointments.

Pulls, prepares, and files charts. Obtains complete and... [+] More

Performs registration, admission, pre-admission, reception, and discharge functions for all patients receiving services in the healthcare system. Greets, instructs, and directs patients. Receives incoming calls on multi-line phones and schedules and confirms appointments.

Pulls, prepares, and files charts. Obtains complete and accurate patient demographic information. Determines and verifies patients' insurance coverage and eligibility for services and understands admission types. Collects co-payments and deductibles from patients and handles daily cash management. Prepares referrals while working with insurance companies. Serves as liaison between patients and staff. Adheres with all State and Federal regulations such as EMTALA and HIPPA requirements. [-] Less

Develops, coordinates, and evaluates educational programs for the orientation and development of staff. Develops, plans, and implements a program of education for all facility personnel, including orientation of new personnel to facility and operational techniques.

Provides training in safe, effective delivery... [+] More

Develops, coordinates, and evaluates educational programs for the orientation and development of staff. Develops, plans, and implements a program of education for all facility personnel, including orientation of new personnel to facility and operational techniques.

Provides training in safe, effective delivery of patient care that assures compliance with standards outlined in the facility procedure manual and State and Federal regulations. Determines the effectiveness of orientation materials and procedures through direct observation and in collaboration with the Director of Nursing Services and Medical Director. Plans, coordinates, and conducts special in-service classes for facility personnel to implement new procedures, policies, equipment, and patient care techniques. Maintains library educational materials for facility personnel. [-] Less

Collects and analyzes data on patient admissions, transfers, and bed availability in specified clinical areas to improve patient care and maximize bed utilization. Typically requires licensure as a Registered Nurse with strong administrative skills and significant clinical nursing experience.

Coordinates bed... [+] More

Collects and analyzes data on patient admissions, transfers, and bed availability in specified clinical areas to improve patient care and maximize bed utilization. Typically requires licensure as a Registered Nurse with strong administrative skills and significant clinical nursing experience.

Coordinates bed assignments and utilization by reviewing admissions, transfer, and discharge statistics within a specialty area. Develops, coordinates, and implements daily plans for patient assignment to ensure appropriate levels of patient care, distribution of nursing unit workload, and physician preferences. Communicates with physicians and nurses regarding emergency and direct admissions based on bed availability. Evaluates the admission and transfer processes. Makes continual rounds on floors to make sure that discharges occur in the appropriate time period and to ensure that environmental services turn rooms around quickly and efficiently to improve bed utilization. Initiates elective precertification and coordinates urgent or emergent admission authorizations. Coordinates out of network admissions, lack of referral from primary care provider, no insurance, and other special admissions with attending physicians and health care staff. Acts as a negotiator in resolving and clarifying the true bed needs of the patients and may discuss case specifics with the admitting physicians. Typically knows the exact number of open beds for every floor and unit as well as specific needs for all admissions at any given time. Refers long-term diagnoses and other high risk diagnoses to case management to ensure that patients remain on proper clinical pathways. [-] Less

Serves as liaison between the employer, patients, and patients' relatives in resolving patient care problems. Resolves patients' complaints and grievances.

Conveys questions, complaints, problems, and concerns of patients to proper personnel. Describes and interprets patient care procedures, and policies to patients.... [+] More

Serves as liaison between the employer, patients, and patients' relatives in resolving patient care problems. Resolves patients' complaints and grievances.

Conveys questions, complaints, problems, and concerns of patients to proper personnel. Describes and interprets patient care procedures, and policies to patients. Prepares reports regarding incidents that may result in legal action if not settled. Trains staff on humanizing patients' care. Establishes rapport with personnel. Takes part in employer's public affairs activities. [-] Less

Observes patients under the direct supervision of a Registered Nurse to maintain the safety of the patient. Monitors assigned patients within a hospital, skilled nursing, or mental health facility. Typically requires a high school diploma or GED and the ability... [+] More

Observes patients under the direct supervision of a Registered Nurse to maintain the safety of the patient. Monitors assigned patients within a hospital, skilled nursing, or mental health facility. Typically requires a high school diploma or GED and the ability to read and write fluently in English for documentation purposes. Does not require State licensure. May require completion of behavioral health orientation and crisis prevention intervention training or prior experience with geriatric, developmentally disabled, or mentally ill patients.

Contributes to the maintenance of a safe and therapeutic milieu by promptly reporting safety concerns and pertinent observations to the Registered Nurse on duty. Duties may include preparing meal trays, providing fluids, and walking with patients. Must be capable of transferring and lifting patients as well as ambulating patients to the bathroom. [-] Less