Allegheny Health Network Careers

Date Posted: 12/15/16

Position Number: D-MNGPA

Location: 4 Allegheny Center

Allegheny Health Network is an integrated delivery network focused on preserving health care choice and providing affordable, high-quality care to the people in our communities.  With more than 14,000 employees including 7,400 health care professionals, nearly 200 primary care and specialty care practices, Allegheny Health Network includes seven hospitals in Pennsylvania with nearly 2,400 licensed beds.

Allegheny Health Network’s clinical expertise ranges from primary care to the most complex surgical procedures.  Services include cancer diagnosis and treatment, cardiovascular care, neurological and neurosurgical services, organ transplantation, orthopedic and rehabilitation services, and women’s health.

Department: Patient Access

Status: Full-time

Union/ Non-union: Non-union

Job Summary:

• Reporting to the Director of Financial Clearance, the primary job responsibility is to provide leadership in achieving ongoing quality, productivity and efficiency in the Pre-Service department.
• Oversees the following functions: scheduling, pre-registration, financial clearance (insurance eligibility, benefits verification, authorization/referral management, payor notification, pre-service/point of service cash collections) and financial counseling.
• Implements strategies designed to minimize the financial risk to the organization by ensuring collection of comprehensive and accurate demographic and financial data to optimize timely billing and collection of accounts receivable.
• Exhibits knowledge of regulations impacting payor financial requirements and ability to integrate activities under his or her direct control with the overall Patient Access functions are essential elements to this role.
• Effectively plans, manages and monitors assigned departments within Pre-Service.
• Manages the department's personnel, suggests modifications to policies and processes, implements new initiatives within the department, and continually seeks mechanisms to streamline and automate processes to maximize the effectiveness of the department.
• Supervises the implementation of policies and procedures, working with management to lead the development of training and orientation programs, managing initiatives to improve processes, maximizing efficiencies, serving internal and external customers and maintaining high employee morale. Creates an environment that excels in customer service.
• Helps design and implement the pre-service physician revenue cycle department, including scope, workqueue methodology, training materials and program, and hiring staff.

Job Responsibilities:

• Delivers consistent and effective leadership on various business processes and technologies in line with organizational policies and procedures for all Pre-Service functions.
• Conceptualizes, develops, and implements all policies and procedures for the various departmental functions; monitors the progress of the departments' short and long-term goals; develops and implements the strategic plan concerning the above functions for the ongoing Department reorganization.
• Implements enterprise-wide projects, as assigned, for realizing process improvement opportunities within Pre-Service.
• Provides formal feedback on project results to management.
• Oversees the development of Pre-Service strategies to maintain and manage key performance indicators: financial clearance rates, pre-service/point of service collection rates, denial rates, registration accuracy rates.
• Provides administrative direction and support to department management to ensure efficient work flow, resolution of difficult problems, adherence to budgets, monitoring of quality assurance measures, completion of timely employee performance appraisals and enforcement of consistent Pre-Service departmental and Hospital policies.
• Keeps current on new or changes in regulations and organizational policies, and works with management team and staff to determine impacts of such changes
• Directs ongoing programs for staff development, which include: hiring and training for management positions and directing the hiring and training of all management and staff in the department, completing (or directing the completion of) all necessary human resource documentation and adhering to all human resources expectations for subordinates, communicating regularly and effectively with subordinates and superiors regarding the status and condition of the business operations under control of the Pre-Service Manager, and continuously taking action to enhance employee engagement and satisfaction.
• Continuously implements strategies to improve internal and external customer experience and satisfaction.

Required Experience:

• BA/BS degree or equivalent work experience in a multi-physician medical practice or facility billing/business office specifically related to revenue cycle management is required.