Duties and ResponsibilitiesActs and leads in a manner that will instill trust and foster team play.
Ensures that all employees know and understand all State and Federal Rules and Regulations.
Ability to make good judgment and quick decisions, strong AR acumen
Provide a working environment which allows employees to communicate ideas for improvement to department. Whenever possible request employee input on policies and procedures that may affect or impact the way their job is performed.
Maintain open communications and provide appropriate feed back to PBA staff and management.
Allow employees to attend seminars which will enhance productivity and knowledge.
Ensures employees have all the tools necessary to achieve the goals set.
Billing/Cash Posting/Collections:Experienced in driving cash and AR account resolution.
Working with all payers for resolution and escalation.
Experienced with expected reimbursement variance management.
Works with all departments to ensure accuracy of CPT4, HCPCS and Revenue Codes.
Provide departments with Medicare and other payer updates, notices and coverage changes which effect both billing and reimbursement.
Reviews process and systems to ensure the most effective methods are maintained to meet all departmental and facility goals.
Works with IT to ensure that all changes are completed to ensure accuracy of billing is maintained.
Ensures bill hold in electronic systems meets established goal.
Works with both electronic billing vendor and payers to resolve billing/cash posting issues.
Identifies and resolves problems in the patient accounts receivable process and when appropriate initiate changes to rectify payer issues, underpayments and denials.
Reviews and approves credit arrangements, refunds, write-offs and adjustments on accounts and insures departmental and medical center policy regarding signature levels are followed.
Manages all employees providing follow-up on third party and self-pay accounts post initial billing.
Prepares, distributes, and presents daily, weekly, and monthly reporting packages as required.
Monitors overall performance and productivity in department.
Ensures all reports are completed timely.
Acts as a technical resource for Medicare regulations and reimbursement.
Ensures that all components of the Medicare Bad Debt Log and supporting documentation are complete.
Oversees Completion of Bad Debt vendor reconciliation.
Informs management of all compliance issues.
Assigned special projects will be completed within the time frames given.
Appropriately documents each account worked in patient accounting system.
Ensures all established goals are met.
Develops and executes projects to reduce aged A/R and enhance collections.
Understand and manages client service level metrics and key indicators of revenue cycle performance. Develop and adhere to methods of KPI improvement.
Compliance:Communicates all compliance issues to Manager.
Educates and ensures that all employees understand Compliance and appropriate procedure for reporting compliance issues for State, Federal and HIPAA.
Attends pertinent seminars, internal and external and shares obtained information with staff and other appropriate departments.
Reviews and maintain JACHO requirements for billing, cash posting and collections.
Reporting:Responsible for the weekly Key Indictor Reports
Patient Accounting and Billing Scrubber reports to departments daily.
Maintain logs by department for claims on hold status.
Daily electronic and paper claim report.
Other reports as requested by management.
What You Will Need:Requires a bachelor’s degree and a minimum 7 years of prior relevant experience. (Relevant experience may be substituted for formal education or advanced degree.)
Relevant experience coming from healthcare, business or professional settings.
Of the seven years of relevant experience required, a minimum of two years must include people management experience.
What Would Be Nice To Have:Solid understanding of healthcare revenue cycle.
Demonstrated competency in working in teams and ability to effectively communicate with all levels.
