Los Angeles, California
Bethlehem, Pennsylvania
Bangor, Maine
Morristown, New Jersey
Union, New Jersey
Pennsylvania
Portland, Oregon
Phoenix, Arizona
Wilkes-Barre, Pennsylvania
Posted: 19-Mar-25
Location: Dallas, Texas
Internal Number: 25003628
JOB SUMMARY
Dir Centralized Access Services is responsible for planning, organizing, and coordinating the patient access function for Baylor Scott White Health (BSWH), which includes in-patient/out-patient admissions, insurance verification, and completion of preliminary records for entering patients. Develops and implements strategies, policies, and procedures for all access services activities for assigned area of responsibility within BSWH hospitals, clinics, and ambulatory care facilities. Plans and directs processes that ensure accuracy and completion of admitting information, insurance verification, and arrangements for financial payment. Designs and implements programs and solutions that improve quality, efficiency, and patient experience through standardization of work, process improvement, and effective use of technology. Directs and manages the confirmation that all insurance benefits coverage meets standards of admission as required by hospital policy. Minimizes financial risk to BSWH through, adherence to policies and procedures, delivery of continuous staff training, and monitoring of outcomes. Ensures compliance with legal and regulatory requirements and responsiveness to changes in requirements. Coordinates with medical, clinical, or financial departments to ensure patient access procedures are organized in accordance with the activities of other BSWH departments.
A division Director translates and implements strategic plans and objectives for area of responsibility. Makes final decisions on operational matters and ensures achievement of objectives. Recommends policies and organizational changes for area. Plans and executes projects and initiatives that meet annual objectives. Erroneous decisions at this level tend to have negative impact on the success of the area, business unit, and possibly the overall organization's operations. Plans and directs the operations of a department or area, with responsibility for staffing, processes, budgets, and costs of the unit. Leads and advises subordinate(s) to meet schedules, resolve technical problems, and monitor performance. Has a larger, more complex organization or functional area than a manager. Often has one or more managers or supervisors reporting to the role.
ESSENTIAL FUNCTIONS OF THE ROLE
1. Directs access services for assigned area of responsibility for BSWH.
2. Recommends and implements strategic and operational plans and priorities for access services aligned to BSWH overall business objectives.
3. Provides the manager team with tools, leadership, and guidance to ensure success metrics are being met and front-line staff are meeting quality and productivity expectations.
4. Leads and monitors vendor activities confirming access eligibility to minimize potential financial losses to BSWH.
5. Develops and implements access services policies, procedures, processes, and guidelines for assigned areas.
6. Monitors web-based or portal insurance verification processes to ensure all workflows are efficient and transactions are processed timely and accurately for assigned areas.
7. Leads the application and compliance of rules and regulations of third-party payers, Medicare, Medicaid, and governmental programs and implements new or revised regulatory requirements.
8. Collaborates with physicians, physician office personnel, associates, case managers, third party payer review personnel, and others to expedite the authorization process to avoid negative financial impact on the facility.
9. Leads continuous improvement activities focused on standardization of processes, attainment of performance targets, and review of financials, including up-front collections, denial management, and bad debt reduction.
10. Directs the implementation of access services system applications, process workflows, and associated training, and process improvement initiatives.
KEY SUCCESS FACTORS
1. Bachelor?s degree in finance, business, or related field preferred.
2. 5+ years of experience in access services, revenue cycle, or related area. Insurance verification/authorization experience preferred.
3. 1+ years of experience in a leadership role.
4. Ability to develop access services and revenue cycle processes and controls in hospital and clinic environments.
5. Knowledge of regulatory requirements for insurance verification/authorization in hospital and clinic environments.
6. Excellent customer and problem-solving skills.
7. Working knowledge of medical terminology and hospital and clinic operations.
8. Strong written, verbal, and presentation skills.
- EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification
- EXPERIENCE - 5 Years of Experience