Job Description

Job Summary:

Supervises, leads, directs, evaluates, and trains staff at the Cherokee Nation Health Clinics. The Supervisor, Patient Access will be responsible for directing and overseeing operations of registration activities for multiple patient types and multiple shifts of employees within the Patient Access department. Areas of responsibility include Patient Access Representatives and Patient Benefit Coordinators. These responsibilities include appointment scheduling, patient registration, pre-registration, verification, financial counseling, admissions and registration, data entry, Resource Patient Management System, and managing patient representative complaints or issues that arise. Assist the manager in overall direction and control of the registration functions, operations, and personnel. Responsible for ensuring standards for quality and productivity are met. Works closely with the Business Office to coordinate activities such as insurance verification and pre-certification of admission, collections at or before admission, and patient billing inquiries. Adheres to and supports the policies, procedures, and standards of Health Care. Supervises various personnel functions including recruitment, schedules, coaching, and discipline.


Job Duties:

Routine duties shall include providing health care services to individuals eligible for services in accordance with the self-governance compact and funding agreement between the Cherokee Nation and the United States executed under the authority of the Indian Self-Determination and Education Assistance Act.



Oversees Resource Patient Management System (RPMS):


Supervises data entry personnel. Serves as the Computer Site manager for the Resource Patient Management System. Generates reports as needed for the clinic. Performs quality control activities by examining random samples of records.



Oversees Patient Access Representative:


Trains and monitors staff to greet patients in a friendly manner. Assures that eligibility guidelines are met before establishing charts for new patients as per laws and Cherokee Nation policies and procedures. Performs quality control activities by examining random samples of records including review of insurance scans and billing information entry, MSPQ statuses, and will maintain past due arrival work queues. Assures that patient charts are created and maintain accurate electronic health records and that the proper consent, privacy, and authorization forms are present. Monitors department schedules to validate scheduling, canceling, and rescheduling of patients in the respective clinic/department. Manages patient complaints and other issues that arise. Continuously monitors system updates for continued training within the staff.



Oversees Patient Benefit Coordinator:


Assures that alternate resources are identified for patients at every visit. Supervises Patient Benefit Coordinators who assist by conducting eligibility screenings, assessments of patient financial requirements, and counseling patients in applying for alternative resources. Stays up to date on CMS, OHCA, and ACA Marketplace regulations. Assures proper workflow of patients to the PBCs to guarantee collections at or before the visit and patient billing inquiries. Monitors queues and task lists to maintain patient care working closely with various departments including Contract Health.



Supervises Assigned Personnel


Assures that patient needs are met in a timely, professional, friendly, caring, and culturally appropriate manner. Performs supervisory duties in accordance with Cherokee Nation Human Resources Policies and Procedures and any other applicable rules, regulations, and guidelines. Provides direction to staff in matters of departmental operations. Handles patient complaints by gathering information, analyzing situations, making determinations, and implementing results. Ensures that safety and security are maintained and the laws are upheld, including laws and policies regarding Division of Health Services management objectives. Coordinates staff activities to ensure compliance with applicable policies and procedures, laws, regulations, and guidelines set by funding agencies. Holds regular staff meetings and maintains files with agendas and minutes. Coordinates, assigns and delegates the activities and functions to the appropriate staff.

SUPERVISORY RESPONSIBILITIES

Directly supervises five (5) to thirty (30) employees in Patient Services and Managed Care. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.


Qualifications:

EDUCATIONAL REQUIREMENT

Bachelor's degree from a four (4) year college or; or six (6) years of related experience and/or training; or equivalent combination of education and experience.

EXPERIENCE REQUIREMENT

An additional two (2) years of experience in a related field is required.

COMPUTER SKILLS

An individual should know Database, Internet, Order Processing systems, Spreadsheet, and Word Processing software.

CERTIFICATES, LICENSES, REGISTRATIONS

Must possess a valid driver's license with a driving history verified through a motor vehicle report that meets requirements for Cherokee Nation underwriting rating.

OTHER QUALIFICATIONS

The employee must not be and will not be under sanction by the United States Department of Health and Human Services Office of the Inspector General (OIG) or by the General Services Administration (GSA) or listed on the OIG's Cumulative Sanction Report, or the GSA's List of Excluded Providers, or listed on the OIG's List of Excluded Individuals/Entities (LEIE).

PHYSICAL DEMANDS

While performing the duties of this job, the employee is regularly required to stand, walk, use hands to finger, handle or feel, and talk or hear. The employee is frequently required to sit and reach with hands and arms. The employee is occasionally required to climb or balance and taste or smell. The employee must frequently lift and/or move up to ten (10) pounds.

WORK ENVIRONMENT

While performing the duties of this job, the employee may occasionally be exposed to wet or humid conditions (non-weather), outdoor weather conditions, or the risk of radiation. The noise level in the work environment is usually moderate.