Job Description
Job Summary The Director of Admissions, under the administrative direction of the Sr. Director of Pre-Arrival, ensures that each applicable team within Pre-Arrival provides timely scheduling, verifies benefit coverage, performs medical necessity verification, determines and communicates estimated patient financial responsibility, and ensures that a valid order is on file for scheduled outpatient services in a timely manner. This position will support our Shared Services Center and client hospitals around the country for a wide variety of payers, service lines, and patient types by providing top-notch support to the entire revenue cycle.
Essential Functions - Supervises and provides strategic direction to the Pre-Arrival team to ensure all tasks related to scheduling, benefit verification, medical necessity, financial responsibility estimation, and order validation are completed on time and accurately.
- Collaborates with the Senior Director of Pre-Arrival to set departmental goals, establish performance standards, and evaluate team performance regularly.
- Works closely with hospital staff and clients to ensure alignment and understanding of the admissions processes for a wide variety of service lines, payers, and patient types.
- Ensures timely and accurate verification of patient benefits, including insurance coverage, medical necessity, and patient financial responsibility prior to scheduled outpatient services.
- Oversees the validation of medical orders, ensuring that all necessary documentation is in place before services are provided.
- Monitors and analyzes departmental workflows and identify opportunities for process improvements to enhance the speed and accuracy of admissions activities.
- Implements and maintains best practices and industry standards to streamline the pre-arrival process, with a focus on reducing delays, denials, and billing errors.
- Acts as a liaison between the Shared Services Center, client hospitals, and various departments (e.g., billing, insurance verification, financial counseling) to ensure seamless coordination and communication.
- Provides training, support, and guidance to staff on complex cases and payer-specific requirements to ensure consistent performance across the department.
- Ensures that all Pre-Arrival processes comply with applicable regulatory requirements, payer rules, and internal policies.
- Provides regular reports to senior leadership regarding department performance, service levels, and any challenges or issues that may impact operations or revenue cycle outcomes.
- Ensures a patient-centered approach throughout the Pre-Arrival process, emphasizing clear communication and timely resolution of any concerns or issues related to scheduling, benefit verification, and financial responsibility.
- Oversees the development of patient-facing communication materials that explain the financial and insurance verification process in a clear, understandable manner.
- Performs other duties as assigned.
- Complies with all policies and standards.
Qualifications - H.S. Diploma or GED required
- Bachelor's Degree in Healthcare Administration, Business Administration, or a related field preferred
- 5-7 years of experience in healthcare admissions, revenue cycle management, or related fields required
- 2-4 years of Management experience focused in Healthcare Revenue Cycle experience preferred
Knowledge, Skills and Abilities - Individual should have knowledge of Word Processing software, spreadsheet software and database software.
- Ability to motivate others
- Must have strong communication skills.
- Ability to work independently and as part of a team
- Ability to work with a cross functional team.
- Ability to manage multiple tasks.
- Excellent communication and interpersonal skills.
- Strong customer service skills.
Licenses and Certifications - CHAA - Certified Healthcare Access Associate preferred or
- CHAM - Certified Healthcare Access Manager preferred
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