Manager, Business / Patient Accounts, Clinical Trials / Specialty Billing
Plans, implements, and evaluates activities pertaining to the collection of patient accounts, including legal compliance reporting. Assists in establishing departmental goals and objectives and provides direction to staff in achieving defined objectives. Performs other related duties as required.
Monitors billing, cash posting and collections reports to identify trends and help staff set collections priorities. Responsible for proper handling of bad debt accounts and monitors the performance of collection agencies. Monitors the charge control of patient accounts prior to billing and identifies required adjustments. Management/Supervision: Participates in developing departmental goals and objectives. Meets with other staff members to discuss progress and to develop future courses of action. Keeps abreast of all regulations and standards that apply to billing and collections; monitors compliance with regulatory agencies and third party payers; determines impact of changes. Interprets policies. Oversees the establishment, review and revision of policies and procedures related to billing, follow up, and collecting current and past due accounts.
Communicates policy and procedure changes to staff. Supervises staff and manages employee performance. Provides on-going performance feedback, addresses problems, determines staffing needs, interviews and hires staff, orients and trains employees, verifies competency and identifies and suggests ways to develop skills. Establishes departmental standards of customer service to ensure activities related to the collection of patient accounts are handled in a courteous and professional manner. Seeks input and recommendations from staff on ways to improve operations. Professional Development: Works with manager to formulate plan for professional development. Attends educational in-services as appropriate. Participates in professional activities and organizations to maintain knowledge of current trends, practices, and developments. Maintains a working knowledge of third party contractual arrangements, including coding requirements. Maintains a working knowledge of UB-82 requirements. Reporting/Data Management: Collects, organizes, and analyzes data to generate and provide accurate and complete reports for management and/or regulatory agencies. Assigns responsibility and reviews completed reports. Interprets applicable regulations and establishes documentation and auditing procedures. Oversees the resolution of billing system problems to avoid billing delays or errors. Identifies appropriate course of action and follows up to ensure problems are resolved. Oversees the testing of results and monitors changes made to the billing system. Staff Resource: Assesses needs and develops and implements staff development and training and in-service programs as appropriate. May serve on, hold office in, or chair committees. May assist in establishing and implementing policies or programs based on committee recommendations.
A bachelor's degree in business or healthcare administration or a related field preferred. Five years of experience in a hospital business office, healthcare finance, or health insurance related field, of which three years must be in a supervisory capacity. Education and experience may be considered in lieu of degree. PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
Preferred Qualifications Experience with revenue cycle, AR, billing
Addendum to Job Description The Manager (Clinical Trials/Specialty Billing) will be responsible for ensuring that all insurance companies and governmental entities are billed accurately and timely using the correct forms, modifiers, policies and procedures, monitoring claims through electronic claims processing system, and identifying and correcting claims that require follow up. Must function independently, have flexibility, personal integrity and the ability to work effectively with all members of team. Must have a proven ability to perform strategic planning and priority setting in a healthcare setting and a proven track record for improving process efficiencies and solving problems. Strong leadership skills with and ability to motivate direct reports are required, as well as a detail oriented individual with at least 2 of healthcare AR and billing experience preferred. Position requires excellent communication skills, analytical and problem solving skills and the ability to manage multiple projects concurrently. Experience with Specialty Billing, Clinical Trials and/or Healthcare Compliance preferred.