Job Info
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Executes the admission, discharge and transfer process by establishing patient placement priorities to facilitate patient flow and distribution in the most efficient and equitable manner possible, in order to maximize utilization of beds, and at the same time meet the medical needs of the patients.
Responsible for ensuring that all aspects of maintaining two hospitals (BWH & DFCI) within one building are in compliance with local, state and federal regulations, guidelines and mandates; including, but not limited to admission, discharge, transfer, room assignments, billing, and medical legal cases.
Administratively responsible for all patients requiring admission to a medical service, including ICU's; performing specific tasks such as managing resident admission caps, team size and adherence to work hour regulations, that were previously the responsibility of two Senior Residents in the Department of Medicine, addressing and resolving all issues and concerns that arise during his/her shift using powers of persuasion, tact and diplomacy to achieve the desired outcome.
Interacts with sophisticated computer program developed to address the changes made to the Department of Medicine based on mandates of ACGME; entering data on each admission, the accuracy and completeness of the data is imperative to ensure that computer alerts are generated to the correct physicians.
Ensures quality of data for the housestaff admissions and provides that data for reporting purposes to ensure compliance with ACGME mandates.
Assigns housestaff as appropriate, and notifies physicians of their assignments to ensure equitable distribution of workload.
Determines that all interhospital transfers are appropriate, including level of care needed, and arranges for adequate staffing levels and the availability of monitors, ICU beds, etc.
Determines eligibility for admission in compliance with hospital policy, utilization review criteria, and state and federal regulations and/or guidelines.
Ensures that adequate information is obtained in order to identify and resolve cases that pose potential financial risk to the institution. Refers complex issues to the Director of Patient Access Services, and recommends delay or deferral of non-emergent admissions when reimbursement cannot be assured.
Maintains dynamic census for Brigham and Women's Hospital and Dana Farber Cancer Institute inpatients to ensure accurate generation of charges and statistics. Prepares and reconciles daily census, identifies and resolves census and/or system issues to prevent loss of revenue.
Administers Brigham and Women's Hospital and Dana Farber Cancer Institute policy in medical-legal cases, notifies New England Organ Bank, coordinates autopsy permits, post-mortem exams, anatomical donation, prepares death certificates and completes all departmental records (on-line and paper) in accordance with hospital policy and Commonwealth of Massachusetts Department of Public Health Statutes.
Ensures a smooth-functioning, organized system of record keeping for all aspects of Patient Access Services including registration and admission.
Notifies physicians of their admissions, discharges and transfers to ensure accuracy of information and data integrity.
Acts in conjunction with Nursing Administration as in-house administrative representative during off hours. Acts as a resource for the Administrator On-call by providing information on specific issues, with particular emphasis on deaths.
Maintains patient confidentiality and privacy by accessing patient information only to the extent necessary to fulfill assigned duties. Executes departmental policy in regards to HIPAA requirements. Ensures that all patient information is kept private, confidential and secure. Properly secures and stores all lists, reports, files and documents. Ensures that interviews and examinations are conducted in such a manner as to afford the patient reasonable audio and visual privacy.
Adheres to Customer Service Standards by demonstrating professionalism, alertness, helpfulness and receptiveness to all patients, visitors and other staff members.
Establishes and maintains effective working relationships with all levels of hospital professional, administrative and support staff, as well as patients, their families and representatives of other organizations where considerable tact and persuasiveness must be employed to maintain patient confidentiality and overall harmony.
Performs special projects as assigned.
QUALIFICATIONS: Bachelor's degree, preferably in health care related field.
Extensive experience accepted in lieu of degree.
Three or more years experience in health care, preferably access management.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED: Technical knowledge of specific legal requirement and thorough understanding of the Commonwealth of Massachusetts Department of Public Health Statutes in regard to births, deaths and reportable cases.
Ability to use common sense, decision-making and negotiating skills to achieve desired results.
Ability to function independently and prioritize work within established policies.
Thorough knowledge of hospital and interdepartmental functions.
Technical knowledge of specific legal requirements and an understanding of complex third party and medical assistance policies and procedures.
Medical Terminology.
Interpersonal relationship skills necessary to communicate effectively with patients, attending physicians and their support staff, medical staff, nursing staff administrators, other hospital personnel and external organizations and agencies.
WORKING CONDITIONS: Busy office environment, with frequent interruptions. Due to the size and complexity of the department, the pace of work can be hectic and challenging.
SUPERVISORY RESPONSIBILITY: Manages a very complex patient flow process, which becomes even more complicated during peak occupancy periods.
FISCAL RESPONSIBILITY: The key to the institution's reimbursement lies in the integrity of data collected. This position plays a crucial role in collecting, monitoring, and maintaining the information necessary to ensure timely billing and reimbursement. The position is also responsible for maximizing the utilization of available resources which contributes directly to the institution's financial viability.
Qualifications Bachelor's degree, preferably in health care related field.
Extensive experience accepted in lieu of degree.
Three or more years experience in health care, preferably access management.
EEO Statement Brigham and Women's Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, national origin, sexual orientation, protected veteran status, or on the basis of disability.
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