Summary

Under general supervision, supervises and directly supports the day to day administration and operations of a patient care unit functioning as a component of a critical care diagnostic and treatment center. Provides support to include, but not limited to, patient scheduling, orders processing, registration, insurance verification, prior authorization, and medical records administration. Performs or directly oversees patient intake, examinations, and tests. Coordinates referrals and authorizations, and provides patient education and instruction. Provides training, direct oversight, and enforcement of staff productivity and performance expectations.

Duties and Responsibilities

1. Oversees the daily administrative operations of a Patient Services Department including establishing work priorities and overseeing the workflow.
2. Supervises personnel which typically includes recommendations for hiring, firing, performance evaluation, training, work allocation, and problem resolution. Ensures adequate staffing for the department on a daily basis, including coverage for annual and sick leave and holidays.
3. Assists in the development and administration of operating policies for the unit; reviews and interprets applicable university, local, state, and federal regulations; enforces compliance with applicable rules, regulations, and policies.
4. Maintain, monitor and evaluate all operations affecting registration, scheduling, orders processing, insurance verification, prior authorization, and medical records administration.
5. Coordinates the orientation and ongoing training of staff in the implementation of operational initiatives and standardization of key functions and practices throughout the department.
6. Evaluates the needs of the department as it relates to the clinic operations and provides the appropriate tools and resources needed to successfully complete the day-to-day responsibilities of the Patient Services Department.
7. Actively participates in the development, implementation, and evaluation of standard operating procedures, metrics to track progress, on-going evaluation and performance tools, guidelines, checklists and templates based on best practices and quality benchmarks.
8. Performs miscellaneous job-related duties as assigned.

Minimum Job Requirements

• High school diploma or GED; at least 5 years of experience directly related to the duties and responsibilities specified.
• Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis.

Knowledge, Skills and Abilities Required

• Skill in examining and re-engineering operations and procedures.
• Ability to maintain quality, safety, and/or infection control standards.
• Knowledge of cash management principles and/or procedures.
• Advanced knowledge of patient registration and scheduling procedures.
• Ability to effectively interact and communicate with people in person and over the telephone.
• Skill in organizing resources and establishing priorities.
• Ability to interact proactively and effectively with healthcare professionals, nursing staff, and departmental management.
• Ability to maintain composure within a demanding, sometimes stressful, environment.
• Advanced knowledge of medical records managment and prior authorization requirements.
• Integrated working knowledge of scheduling protocols and procedures within a complex critical care clinic environment.
• Advanced knowledge of operational protocols and administrative procedures within a complex clinical environment.
• Strong working knowledge of medical billing processes and procedures.
• Highly developed computer skills and the ability to multitask using various medical and office software programs.
• Advanced knowledge of medical insurance, claims procedures, authorization requirements and documentation.
• Ability to successfully communicate and interact with seriously ill patients and families on complex administrative matters.
• Ability to follow complex and involved instructions concerning patient care coordination and administration.
• Ability to lead, train, and functionally supervise staff and/or student employees.
• Advanced working knowledge of patient care charts and patient histories.
• Ability to analyze complex information, and to define and solve problems.
• Knowledge of the pre-certification requirements, procedures and documentation of third party medical insurance payers.
• Ability to plan work schedules and assign duties; ability to provide or arrange for training.
• Ability to supervise and train employees, to include organizing, prioritizing, and scheduling work assignments.

Conditions of Employment

• May be required to submit to annual TB and rubella screening.
• Must pass a pre-employment criminal background check.
• Successful candidate must submit to post-offer, pre-employment physical examination and medical history check.

Working Conditions and Physical Effort

• Work is performed in an interior medical/clinical environment.
• No or very limited physical effort required.
• No or very limited exposure to physical risk.

The University of New Mexico provides all training required by OSHA to ensure employee safety.

Revised Date: 03/20/2017