St. Joseph’s Healthcare System is recognized for the expertise and compassion of its highly skilled and responsive staff. The combined efforts of the organization’s outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation’s “100 Best Places to Work in Health Care”.
Responsible for the management and coordination of departmental activities. Main workflow and operations which ensures prompt and accurate collection of patient demographic and Insurance information. Ensures excellent customer service, efficient patient flow, effective communication with patients, physicians and other hospital departments. The primary goals are Patient, Customer, Physician satisfaction and accurate billing practices.
Performs Quality reviews weekly/monthly basis, error identified QA log by employee to include reporting findings to the Director, this initiative is utilized for re-training, and communicating Quality Issues to the employee for performance improvement. Provides for effective verification and pre-certification of benefits prior to services being rendered. Coordinates alternatives resources for financial and clinical patient needs when pre-authorization is denied or patient requires financial counseling. Uses and understands "systems" related to Registration. (i.e.: ADT, Soarian, Invision, INFINITT, Insurance Verification, Medical necessity, Paynav, etc.). Ensure statistical data is maintained, monitored, and reported. Changes to be made based on data when needed. Provides for effective fiscal management of pre-certification and verification of benefits for Patients prior to services being rendered. Coordinates alternative resources for financial and clinical patient needs when pre authorization is denied or patient requires financial counseling. Works collaboratively with Director, Billing Analyst and PFS to review Denials. After analyzing report, summarizes findings and develops an action plan with Director and Billing Analyst. Responsible for implementing work plan. Meets all required competencies for department, unit and/or hospital. Responsible for performing all other duties as assigned. Special Projects
Work requires the knowledge of theories, principles, and concepts normally acquired through completion of a Bachelor's degree in Health Care Management or closely related field and three to five years of previous work related experience, plus three to six months of on-the-job training. National Association of Healthcare Access Management certification preferred. Work requires analytical ability to collect information from diverse sources and apply professional principles in performing various analyses, and summarize the information and data in order to solve problems.