Under limited supervision oversee the pre-registration process for all scheduled and unscheduled inpatient admissions, outpatient procedures and ambulatory services by verifying eligibility, benefits, coverage limitations, deductibles and co-payments.
Responsible for overseeing the Medical Assistance Eligibility, Self Pay receivable, Charity Care process and Financial Clearance for UMMS, Kernan, and Specialty Hospital.
Serve as resource to resolve issues related to admissions.
Principal Responsibilities and Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
The duties below apply to all areas of responsibility, Pre-Registration, Medical Assistance Eligibility, Self Pay receivable and Charity Care process.
Assists in the management and direction of the hospitals Pre-Registration department to include assisting with planning, organizational development, staffing, registration, and staffing related activities. Applies Medical System policies and procedures, federal, state and local statutes governing the delivery of health care services.
Ensure the successful management of daily team operations; hold self and others accountable for performance.
a. Provides direct supervision of employees engaged in the department. Delegates authority as appropriate. Maintains employee work schedules ensuring adequate staffing levels to preserve optimal provision of services.
b. Hire, orient, train, conduct performance evaluations, handle disciplinary issues, and provide an open and goal oriented work environment with establish clear and concise work procedures and productivity standards.
c. Establishes and communicates staff performance standards for each individuals job function, monitors productivity and quality indicators to meet departmental standards. Approves merit adjustments, leave time and maintains leave records.
Spearheads internal projects through scoping, planning, testing, implementing, and monitoring activities assigned by the Senior Manager of Pre-Registration.
Attends internal meetings and collaborate with other Managers, Department Administrators and outside third parties/vendors as needed. Serve on committees.
Generates daily reports for admissions, gather and sort documentation for authorization and/or referral information verification by staff. Print, review, and maintain processing of daily reports
(i.e. Midas Newborn and Medicare In-house reports, etc.) requiring additional insurance verification. Audits and monitors inpatient admissions and outpatient registrations daily
a. Assists in developing and monitoring departmental operating and patient-flow tracking and reporting mechanisms and information systems regarding hospital census and bed availability, and Admission, Discharge and Transfer (ADT) information
b. Assists in monitoring the efficiency and effectiveness of registration activities, assuring that information taken from prospective patients is accurate and complete, ultimately contributing to the successful reimbursement to the hospital for patient services
Assists the Sr. Manager, Pre-Registration in the development, implementation, review and update of department administrative policies and procedures by applying relevant legal, ethical, The Joint Commission and Medical System guidelines to assure consistent and efficient departmental operations. Communicates, interprets and assists in ensuring compliance with it to staff.
Keeps abreast of current regulatory (federal, state and the joint commission) information / guidelines and new, related hospital policies; communicates relevant changes and/or protocol and procedural revisions to staff. Implements appropriate department operational changes to ensure compliance. Attends and participates in various training and educational programs to remain up-to-date on admitting, quality assurance and various relevant health care issues and for professional growth and development.
Conduct regular team and departmental (in conjunction with the Senior Manager, Pre-Registration) meetings for purposes of education, goal monitoring, and feedback inquiries. Submits timely minutes of meeting to the Senior Manager; attend regular meetings with the Senior Director of Patient Financial Services and other Managers. Perform the functions of subordinate staff as needed due to staff absenteeism or other performance related issue to remain current.
Maintain a thorough working knowledge of payer source information requirements as defined or reported by the Senior Director of Patient Financial Services. Review difficult or unusual cases to ensure accurate assessment of financial circumstances and eligibility determinations.
Utilizes patient access intelligence to evaluate a self pay patient's ability for payment. The evaluation will consist of patient payment estimation, charity care screening, Medicaid Eligibility review, address validation and risk assessment. Collects co-payments and deductibles during the pre-registration process.
The University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women's and children's health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you'll enjoy as a member of our team.
Education and Experience
Associate's degree in business or finance related field or equivalent combination of education and experience is required.
Four years of experience in hospital/health care setting performing collection and billing is required.
Supervisory or lead role experience preferred.
Knowledge, Skills and Abilities
Knowledge of management practices and principles in order to effectively plan and direct pre-admission activities and basic statistics, and to prepare variety of pre-admission reports and analysis.
Knowledge of hospital billing systems required.
Strong knowledge and understanding of Microsoft Office product suite.
Demonstrated expertise in management operations including but not limited to managing, supervising, directing, and monitoring the daily work activities of subordinate personnel.
Demonstrated ability to perform responsibilities in a fast paced, work environment, requiring excellent organizational skills and critical decision making. Self starter with strong team player and leadership abilities to motivate staff and increase productivity.
Demonstrated technical expertise with computer hardware, software and database management functions and duties.
Knowledge of Health Care Management administrative and operational principles and practices, including budgeting and The Joint Commission regulations.
Excellent written and verbal communication skills are necessary to successfully perform all managerial responsibilities
The University of Maryland Medical System (UMMS) was created in 1984 when the state-owned University Hospital became a private, nonprofit organization. It has evolved into a multi-hospital system with academic, community and specialty service missions reaching every part of the state and beyond. UMMS is a national and regional referral center for trauma, cancer care, neurocare, cardiac care, women's and children's health and physical rehabilitation. It also has one of the world's largest kidney transplant programs, as well as scores of other programs that improve the physical and mental health of thousands of people daily. The hospitals and health systems that comprise UMMS are: University of Maryland Medical Center, University of Maryland Medical Center Midtown Campus, UM Rehabilitation and Orthopaedic Institute, UM Baltimore Washington Medical Center, UM Capital Region Health, UM Charles Regional Medical Center, UM St. Joseph Medical Center, UM Upper Chesapeake Health, UM Shore Regional Health, Mt. Washington Pediatric Hospital and UM Community Medical Group.