Job Summary: Responsible for providing leadership in achieving a high level of performance and efficiency for the organizations Patient Financial Services. Responsible for directing and managing the hospital billing and payment cycle.
- Consistently uses an outward mindset and puts forth exemplary effort in accomplishing his/her goals and objectives in a manner that helps others to achieve their goals and objectives.
- Responsible for patient billing and collection, third party payer relations, and preparation of insurance claims for facility and professional services.
- Manages claims to 3rd party payers, ensuring adequate systems are in place to facilitate processing and complete payment of claims
- Monitoring/managing accounts receivables while incorporating strategies for reducing the A/R aging.
- Work closely with other departments (HIM, Case Management, Information Technology, Nursing, and Ancillary departments) to streamline procedures that will help ensure correct billing to patients and payers in a timely manner, thereby expediting hospital receivables.
- Maintains a culture of compliance, ethics and integrity.
- Maintains knowledge of billing regulations to assure adherence to state and federal regulatory requirements
- Administers policies and procedures to ensure all office activities comply with hospital standards and government regulations.
- Ensures that patient financial matters are handled in an efficient manner.
- Facilitates monthly staff meetings and service huddles.
- Attends leadership meetings and participates in improvement projects as assigned
- Direct the selection, supervision and evaluation of staff. Ensure performance evaluations are conducted in a timely manner according to hospital policy and initiate disciplinary actions as warranted. Resolve grievances and other sensitive personnel matters.
- Maintains days in AR at or below levels established by the board of directors.
- Develops strategy to minimize bad debt and oversees the placement of accounts with collection agencies, ensuring appropriate and timely placement of accounts.
- Oversees the development and management of departmental budgets.
Minimum Qualifications: Bachelor’s degree in Business, Management, or Healthcare Administration. Minimum five years’ experience in related field or commensurate combination of education and experience. Prior management experience in a healthcare claims processing setting is preferred.
Knowledge, Skills & Abilities.Knowledge of policies, governmental regulations, and business practices pertinent to Hospital and Professional billing. Working knowledge of Hospital and Professional billing, and an in-depth knowledge of Medicare and managed care billing and payment practices. Knowledge of CMS and third-party payer regulations and policies related to billing operations required. Ability to manage a wide range of responsibilities and employees is necessary. Strong written and verbal communication skills, strong analytical and critical thinking skills and ability to multi-task are essential.
Working Conditions: Work is generally performed within an office environment, with standard office equipment available. Car travel to various off-site locations is required and in all types of weather.
Physical Requirements: Constantly see/visual acuity, handle/grasp/feel, talk/hear, taste/smell. Frequently stand, sit, walk. Occasionally lift/carry 1 to 25 lbs.