Summary: Under the direction of the BSWH Vice President of Access Services, the System Director, Centralized Access Services provides strategic leadership direction and oversight for insurance verification, pre-registration, financial counseling, and diagnostic scheduling functions for all BSWH wholly owned and managed joint venture hospitals and clinics.
Monitor and report on key metrics, including but not limited to: secure rates, days out, authorization initiate to complete, FPR complete, call center metrics, pre-service collections, billing WIP, productivity, and administrative write-offs. Proactively perform root cause analyses and develop action plans when metrics do not meet internal goals or industry best practices. Complete monthly trending analyses and present findings at monthly operational review meetings to senior revenue cycle leadership.
Prepare executive level presentations to inform senior revenue cycle and facility leadership about trends and issues impacting performance. Summarize detailed data in a clear and concise manner so that information is actionable and in an easy-to-understand format.
Maintain deep understanding of key processes within the department and constantly evaluate opportunities for improvement. Ensure standardization of processes across all locations, regardless of ADT system. Monitor and report overall status of key projects and initiatives at revenue cycle strategy meetings.
Develop and monitor adherence to specific goals, performance standards, and policies & procedures for each area of responsibility. Define, implement, and manage clear quality and productivity standards across all areas of responsibility.
Provide guidance for centralized access services management to resolve internal and external issues. Routinely conduct payer trend analysis focused on administrative write offs and payer service level agreements. Coordinate with the Office of Managed Care and the legal and compliance departments to address payer issues that impact centralized access services.
Stay abreast of third-party payer and government guidelines as well as company policies and procedures to ensure compliance related to all areas of responsibility. Proactively implement operational changes and provide timely staff education to maintain adherence. Collaborate with legal and compliance departments on matters that impact centralized access services.
Maintain detailed understanding of multiple ADT systems, including system functionality, workflows, and reporting. Proactively identify areas for improvement and engage with Information Services and vendors to make necessary changes. Develop innovative approaches for solving problems with system automation and functionality. Lead and/or participate in internal subcommittee to vet new enhancement and project requests through the Information Services governance process.
Collaborate with physician and clinic leadership to streamline processes that impact physician and patient satisfaction. Regularly round and seek feedback from stakeholders impacted by centralized access services processes.
Assume a lead role for innovation, knowledge sharing and leading practice identification within centralized access services. Identify and assess new technology and process improvements that reduce the overall department budget. Perform ROI analysis and provide recommendations to senior revenue cycle leadership.
Monitor the local and national emerging best practices associated with centralized access services functions. Constantly review and evaluate the effectiveness and efficiency of operations and develop and lead operational modifications as conditions change.
Develop detailed actions plans for integrating new service lines and/or new facilities. Capitalize on opportunities for improvement quickly, ensuring performance standards are met or exceeded within established timeframes.
Investigate and resolve complex problems and coordinate efforts to provide innovative strategies and solutions.
Maintain departmental budget and perform all human resource functions. Develop and implement strategies to improve employee engagement. Actively participate in succession planning and developing career advancement opportunities for employees within department.
Demonstrate ability to adapt to and lead change and to coach others in the acceptance and support of change.
Foster a collaborative working environment with centralized access services management and facility leadership focused on solving problems to improve the patient and provider experience.
Obtain buy-in from senior revenue cycle leadership on strategic direction of the centralized access services department. Communicate BSWH’s ambition and strategies, translating them into actionable projects and initiatives for management and staff.
Perform other position appropriate duties as required in a competent, professional, and courteous manner.
Strong written and verbal communication skills
Ability to manage demanding workload and to demonstrate resiliency during stressful or high-stake situations
Ability to build strong interpersonal skills with all levels of employees – including executives, physicians, and front line staff
Strong understanding of revenue cycle processes and technology
Strong organizational and analytical skills
Ability to be flexible and adapt to changing priorities and initiatives
Strong attention to detail, but ability to summarize information in a clear, concise manner
Strong Microsoft Excel and PowerPoint skills
In depth knowledge of insurance verification workflow and metric methodology and third party payer requirements and guidelines
Ability to research and interpret regulatory guidance
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!