Department: Patient Advocacy                            Postualte
Reports To: Director of Patient Advocacy
FLSA Status: Exempt
Revision Date: March 2016

Position Summary

The Patient Advocate Manager ensures that operations are running smoothly and that patients are
satisfied with the service received. Also, if the patients experience any problems with their care and file a complaint regarding any billing concerns, the Patient Advocate Manager contacts involved parties and works to develop an appropriate solution. The Patient Advocate Manager provides staff supervision, training and consultation, serves as a liaison between the team, other departments. The Manager is also responsible for keeping and maintaining communication with the Director of Patient Advocacy regarding daily operations and issues. The Manager will provide reports and updates regarding the department assignments. The Manager will be responsible for maintaining and keeping payroll for the patient advocate team biweekly. Provides team members with the appropriate training, tools, direction and motivation to enable their success. Responsible for the processes and systems related to the servicing patients and support of department. Directs the delivery of administrative and operational assistance designed to promote revenue growth, productivity, and exceptional levels of patient satisfaction.

Essential Duties & Responsibilities

• Handle and resolve escalated patient calls to ensure service recovery and positive outcome.
• Coordinate the daily activities of assigned team members.
• Oversee all incoming and outgoing patient calls to ensure maximum patient satisfaction.
• Maintain and approve payroll for employees.
• Review and approve adjustments to patient accounts.
• Identify, prioritize and implement improved processes to increase efficiency and effectiveness of the department.
• Drive a culture of success through continuous role modeling and mentoring.
• Measure and document employee performance on a daily basis and reviews overall performance monthly using the Quality Audit Program Tool.
• Responsible for fielding complaints about facility / clinical care, standards as well as HIPAA, red flag rules, and other problems that patients may have. Must record complaints and forward to appropriate manager.
• Follow up with patients as necessary to ensure that appropriate changes were made to resolve patients’ problems.
• Coordinate and facilitate monthly department meetings.
• Keep records of patient interactions by recording details of inquiries, complaints, and comments as well as actions taken.
• Obtain and examine all relevant information in order to assess validity of complaints and to determine possible causes, such as incorrect billing information.
• Assist with interviewing, hiring, orienting, and training new staff.
• Promote patient loyalty and retention through quality Customer Service and quick resolutions.
• Ensure delivery of excellent customer service through communication, and coordinating with other departments to resolve issues.
• Complies with all applicable policies and procedures to meet JCAHO and company standards.
• Perform other duties as assigned

Safety/Infection Control

• Demonstrate knowledge of and adhere to regulations and Emergency Center policies and procedures pertaining to safety, emergency preparedness, infection control, OSHA, fire safety and hazardous materials
Performance Improvement
• Participate in performance improvement activities as necessary
• Maintain confidentiality of patient related issues and adhering to all HIPAA rules and regulations.
• Demonstrate effective interpersonal skills
• Treat all patients, visitors, and staff members fairly and with respect
• Utilize effective communication methods and skills
• Explain all procedures, treatments, and care while remaining aware of language barriers
• Able to perform care in non-judgmental manner and recognize discrepancies between patient and personal beliefs

 

Emergency Center Policy

• Ensure personal appearance is business casual and professional at all times
• Responsible for wearing Emergency Center identification badge at all times which must be visible and above the waistline
• Attend all required meetings and in-service education
• Remain flexible in staffing patterns and resolution of staffing conflicts; participates in temporary assignments
• Compliance with attendance standards
• Demonstrate flexibility when changes in assignments are necessary

Qualifications

EDUCATION & EXPERIENCE
• Bachelor’s degree in Healthcare or related field required
• Minimum 2 yearsyears’ customer service experience required
• Minimum 2 years experienceyears’ experience in managing teams
• Experience in managing a call center
• 5 plus years of experience in medical billing to include extensive knowledge in understanding EOB’s, understanding insurance claims and reimbursements
• Ability to communicate complex reimbursement scenarios to patients
LANGUAGE/MATH/REASONING ABILITY
• Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization
• Ability to add and subtract two digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of American money and weight measurement, volume, and distance
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations
COMPUTER SKILLS
• Intermediate computer skills
• None
CERTIFICATE/LICENSES
• CPCS (if not certified at the time of hire, will obtain within two (2) years)

Competencies

• Professional Maturity: The ability to separate emotional feelings from the real issues at hand
• Responsibility: The ability to accept choices you have made and the results they have led to
• Communication: The ability to write and speak effectively; actively listens to others, and give feedback
• Flexibility: Demonstrate responsiveness and adaptability following change initiatives
• Intelligence: Understand information and apply new knowledge
• Energetic: Exhibits high levels of energy and enthusiasm
• Organized: Efficient in structuring tasks to be accomplished
• Computer Savvy: The ability to use technology efficiently and effectively
• Customer Service: The ability to enhance customer satisfaction
• Job Knowledge/Technical Knowledge: Knowledgeable of current role and technical systems, and the impact it has on the organization
• Integrity and Respect: Demonstrates upmost level of integrity
• Interpersonal Communication: Writes and speaks effectively based on the psychological, relational, situation, environmental and cultural dynamics within the situation
• Collaboration and Partnership: Encourages participation from team members
• Manages Change: Demonstrates flexibility with changing environments
• Problem Solving: Resolve issues in a timely manner
• Attention to Detail: Follows procedures to ensure entry of data
• Organization: Uses time efficiently by prioritizing and planning work activities
• Judgment: Ability to make independent decisions
• Teamwork: Works with others to accomplish objectives and shows support for decisions
• Quality: Sets high standards to ensure quality in work performed
• Accountability: Takes responsibility for adhering to all company policies, procures, and performance expectations

 

Physical Demands

• The physical demands for this position include: adequate vision, hearing, and repetitive motion
• Light physical activity performing non-strenuous daily activities of an administrative nature
• Ascending or descending stairs, ramps and the like, using feet and legs and/or hands and arms
• Substantial movements (motion) of the wrist, hands, and/or fingers in a repetitive manner
• Bending legs downward and forward by bending leg and spine

Work Environment

• Well-lighted, heated and/or air-conditioned indoor office setting with adequate ventilation

Postulate

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