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Plans and directs business office operations of the medical facility to ensure that revenue management functions meet customer and organizational requirements. Plans and directs business office operations to include such functions as admitting, patient registration, billing, collections, and insurance claims. Typically requires a college degree in business and related managerial experience.: Assists in coordinating and maintaining patient financial services programs to ensure compliance with current payments, rules, and regulations that impact the medical center and/or physician's billing and collections process. Monitors and ensures compliance with Medicare and Medicaid documentation guidelines. Monitors and evaluates current reimbursement/payment rules and ensures that legislative and regulatory changes impacting medical billing are anticipated and communicated to the clinical faculty, staff, and departmental billing personnel. Develops techniques for effective analyses of billing and collections efforts. Oversees resolution of third party denials and assists with reimbursement appeals and problems. Prepares financial reports and analyses to show progress or adverse trends and makes appropriate recommendations or conclusions. Assists in identification of new technologies that will improve departmental operations. Develops departmental strategies to meet cash projection formulas, reduce days in Accounts Receivable, and reduce denials. Ensures compliance with State and Federal law, compliance plans, HIPAA, and JCAHO guidelines. Prepares and manages the departmental budget. Hires, develops, and motivates a qualified Patient Financial Services staff. May provide assistance to physicians in determining appropriate use of codes for maximizing reimbursement of physician services.

Patient Relations Director

Provides leadership, organization, planning, direction, and administration to the operational aspects of the Patient Relations Department and its services. Collaborates with key members of the Hospital, Physician Practice, Service Excellence, Risk Management, and Quality/Safety Departments to investigate and assist in resolving patient complaints. Oversees staff who receive complaints and establishes processes for investigation and response.: Facilitates communication between departments and providers to ensure timely resolution of complaints. Collects data and information about patient care concerns and makes recommendations as appropriate. Resolves conflicts and acts as intermediary between patients, families, and staff. Recommends establishment of policies and operating procedures to ensure positive patient-Hospital relations. Prepares reports and analyses on progress, adverse trends, and appropriate recommendations or conclusions. Develops and tracks annual department budget.

Patient Registrar

Performs registration, admission, pre-admission, reception, and discharge functions for all patients receiving services in the healthcare system. Greets, instructs, and directs patients. Receives incoming calls on multi-line phones and schedules and confirms appointments.: Pulls, prepares, and files charts. Obtains complete and accurate patient demographic information. Determines and verifies patients' insurance coverage and eligibility for services and understands admission types. Collects co-payments and deductibles from patients and handles daily cash management. Prepares referrals while working with insurance companies. Serves as liaison between patients and staff. Adheres with all State and Federal regulations such as EMTALA and HIPPA requirements.

Referral Authorization Coordinator

Expedites administrative requirements for patient referrals for managed care plans. Typically requires and associate's degree and three years of health care insurance experience.: Deals directly with managed care plans to expedite administrative requirements for patient referrals.

Information & Referral Director

Plans, organizes, and coordinates programs with agencies and groups concerned with social problems of community: promotes and coordinates activities of agencies, groups, and individuals to meet identified needs. Studies and assesses strength and weakness of existing resources. Interprets needs, programs, and services to agencies, groups, and individuals involved and provides leadership and assistance. Prepares reports and disseminates information. Maintains contact with representatives of other organizations to exchange and update information on resources and services available. May write proposals to obtain government or private funding for projects designed to meet needs of community. May assist in budget preparation and presentation. May assist in raising funds. Works in specialized fields such as housing, urban renewal and redevelopment, and health or in public or voluntary coordinating agency, such as community welfare or health council, or combined fund raising and welfare planning council. Works with special groups such as elderly, financially disadvantaged, juvenile delinquents, or physically or mentally handicapped. Usually required to have degree from school of social work. May direct and coordinate activities of volunteers or practicum students.

Medical Patient Relations Representative

Serves as liaison between the employer, patients, and patients' relatives in resolving patient care problems. Resolves patients' complaints and grievances. : Conveys questions, complaints, problems, and concerns of patients to proper personnel. Describes and interprets patient care procedures, and policies to patients. Prepares reports regarding incidents that may result in legal action if not settled. Trains staff on humanizing patients' care. Establishes rapport with personnel. Takes part in employer's public affairs activities.

Patient Relations Representative

Temporary Help Referral Clerk

Compiles and records information about temporary job openings and refers qualified applicants from register of temporary help agency. Responds to hospital, business, or other type of organization requesting temporary workers and obtains and records job requirements. May give employment applications to applicants, schedule interviews with agency registration interviewers, or administer skill tests. Performs other clerical duties.: Reviews records to locate registered workers who match job requirements and are available for scheduled shift. Notifies selected workers of job availability and records referral information on agency records. Sorts mail, files records, and performs other clerical duties. May refer workers in specific occupations, such as nursing.

Referral & Information Aide

Receives callers and responds to complaints in person or by telephone for government agency: questions callers to ascertain nature of complaints against government agency; records complaint on standard form; and routes form to appropriate department or office for action. Contacts department or office to which complaint was referred to determine disposition. Contacts complainant to verify data and follow-up on results of referral. Compiles complaint records, by category, department office, and disposition. Notifies supervisor of patterns of poor provision of service. Maintains up-to-date reference materials and files.

Medical Top Patient Care Executive

Directs, through managers, supervisors or head nurses, activities of nursing staff. Administers nursing program in hospital or other medical institution to maintaining standards of patient care. This is the highest level position in patient care.: Plans and organizes activities in nursing services, such as obstetrics, pediatrics, or surgery, or for two or more patient-care units to ensure patient needs are met in accordance with instructions of physician and hospital administrative procedures. Coordinates activities with other patient care units. Advises medical staff, department heads, and hospital administrator in matters related to nursing services. Recommends establishment or revision of policies, and develops organizational structure and standards of performance. Interprets policies and objectives of hospital nursing services to staff and community groups. Performs personnel management functions. Plans and organizes orientation and in-service training for unit staff members, and participates in guidance and educational programs. Assists in formulating budget. Engages in studies and investigations related to improving nursing care. May direct activities of school of nursing.

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