Shift: Mon.-Fri. 8:00am-5:00pm ET

Position Goal:

The Manager role is to plan, organize, and direct Patient Accounting functions to include the day-to-day management of the departmental operations. Serves as the liaison between the Patient Accounting and the various facility departments. This key position must be knowledgeable of and ensure compliance with all regulatory and accreditation standards. The Manager will be responsible for developing and coordinating all the activities involving patient billing and resolving all outstanding patient and/or insurance balances. The Manager will oversee denials management for the organization to include approving write-off of fatally denied accounts, appealing denials, and preventing denials through process and procedure change recommendations.

Position Responsibilities:
Manages Patient Accounting functions by planning, directing, coordinating, and controlling human and material resource needs for the delivery of patient information and other departmental activities. Establishes planned accountability to assure the department as well as individual team members meet acceptable standards of production and quality while providing constructive feedback on work performed.

• Identifies potential problems and performs root cause analysis to identify and create recommendations and/or enact solutions.

• Plans and establishes Patient Accounting departmental staffing by managing the processes of coordinating time, attendance and scheduling to ensure continuous operational throughput of all billing and payment functions.

• Maintains professional and employee competency through formal and/or informal education programs.

• Responsible for all interviews and making selection recommendations to the System Chief Revenue Cycle Officer.
• Monitors, tracks and evaluates staff productivity and performance, quality assurance, collections and provides summary KPI reporting to the System Chief Revenue Cycle Officer monthly.
• Gathers, maintains, and reports Map Key and other externally required reporting data as required.
• Ensures competency assessments are adequate for employee-related training along with individual development to include coaching and counseling of staff.
• Promotes public relations within the Hospital and Surgery Centers while fostering collaborative working relationships with all departments.
• Supports the Mission and Vision, Lean Objectives and continuous improvement efforts of the organization, the leadership team and the System Chief Revenue Cycle Officer.
• Communicates verbally and in writing with personnel, physicians, patients and families.
• Performs continuous review of departmental processes and procedures and implements updates as appropriate.
• Provides feedback to team members during one-on-one monthly performance reviews.
• Attends meetings as appropriate.
• Provide direction, support, training and continuing education to section personnel on proper claims submission, collection follow-up, credit balances, appeal processes, posting and balancing.
• Create claim edits within SIS, Waystar, and/or Medhost to optimize clean claim rate.
• Oversees denials management to include reviewing denied claims to determine potential for appeal and reversal of denials.
• Sets annual and quarterly goals for the department along with System Chief Revenue Cycle Officer and puts processes and procedures in place to meet them. Monitors progress toward goals and makes changes when needed.
• Assists with keeping the Discharge Not Final Billed (DNFB) clean.
• Approves all denial write-offs that cannot be appealed.
• Oversees the appeals process for denied claims.
• Advises Chief Revenue Cycle Officer of needed process improvements to prevent denials and assists with implementation of changes.
• Serves as a liaison between HIM, Patient Access, Patient Accounting, Case Management, Underpayments, and Hughston Clinic staff to resolve denied claims.
• All other duties as assigned to include projects, goals, issues surrounding the revenue cycle, conflicts or concerns as directed or indicated by Management.

Experience:

Required:

• 1-3 years of medical supervisory/management experience
• Must have working knowledge of tests, procedures, and terminology in addition to insurance knowledge.
• Must have exceptional customer service skills as well as verbal and non-verbal communication skills.
• Must have exceptional time management skills to perform during high periods of stress.

Preferred:

• 3-5 years Hospital and/or Surgical Center Business Office experience.

Education:

Required:

• Bachelors’ Degree in Business Administration, Health Administration or equivalent experience .
• CPAR, CRCR, CHAA, CHAM, or equivalent Certification (within 180 days of employment).

Special Qualifications:

Required:

• Valid Driver’s License, satisfactory motor vehicle report (MVR) and proof of insurance required for position on-boarding.
• Annual MVR may be required per policy and procedure; background reports may be ran as needed throughout the course of employment.
• Ability to use Microsoft Office and other software packages.
• Excellent typing skills and phone etiquette.
• Excellent Customer Service and Communication Skills.
• Ability to effectively lead and supervise people.