Overview

The Corporate Business Office Director is responsible for providing leadership and direction for the Business Office in a manner that will contribute to the achievement of hospital financial and clinical goals and which promotes the development of teamwork and effective operations throughout the hospital. It is the BOM's responsibility to develop the Business Office department in a manner that enables the hospitals to achieve its cash collection and accounts receivable goals through management of the business office staff and related functions, including billing, and collection/follow-up.

Strong revenue cycle technical skills required. Good communication and organization and interpersonal skills. Ability to type; knowledge of billing forms (i.e., UB-82, 1500); billing procedures and regulations for Medicare, Medicaid, Managed Care, etc.; detail oriented; good writing skills. Resolve and reconcile traditional Medicare claims through the DDE system. Must possess extensive knowledge of Healthcare systems and operations.

Responsibilities

• Directs inpatient collection efforts to meet organization and business office goals and objectives.
• Ensures appropriate in-house amounts due from clients are collected prior to discharge.
• Establishes and monitors collector goals and timetables.
• Provides client financial counseling as appropriate to resolve account problems including disputed amounts and credit balances.
• Maintains an effective exchange of account information between business office staff, other hospital departments and external agencies.
• Recommend benchmarks against which to measure the performance of the business office operations.
• Comply with local, state, and federal government reporting requirements.
• Maintains a system of controls over billing/collection transactions
• Maintains a documented system of billing/collection policies and procedures
• Manages cash collection; maintains journal and receipts accurately
• Ensure maximum reimbursement through measures including writing appeals on payment and billing issues and initiating retro reviews.
• Assures all adjustments are posted accurately and timely; maintains administrative adjustment logs and documentation.
• Assists HR Department with hiring and selection processes through screening, interviewing and making recommendation for hire.
• Provides feedback to staff on performance, reinforcing desired behaviors and team building efforts and intervening promptly in deficiencies to reduce turnover rate and formal performance measures.
• Performs personnel management activities including direct staff supervision, orientation/training/development, performance management and employee relations functions; adheres to HR policies/procedures, and applicable employment laws, standards and regulations
• Completes performance evaluations for staff in a timely manner, including initial and 90-day competencies, and annual performance evaluations
• Screening insurance information to identify patients requiring pre-admission approval from third-party payor’s; verifying that approval has been obtained
• Develops relationships with insurance companies.
• Serves as the lead point of contact for all patient account management issues.
• Investigates requests/appeals from inside and outside the company for complex cases and special patients.
• Maintains knowledge of medical claims payment policies and procedures relative to medical claims payments and adjustments, including Medicare, Medicaid and Commercial plans.
• Communicate/collaborate with patient accounts, utilization review, intake, and any/all other needed departments/agencies/payers, to ensure the appropriate and timely handling of patient claims.
• Responds to requests from insurance carriers and medical personnel in a timely manner.
• Maintains confidentiality of information as legally required or otherwise directed.
• Maintains appropriate communication on all issues and concerns to the CFO.
• Complies with federal and hospital requirements in the areas of protected health information and patient privacy.
• Understands and adheres to NPH’s compliance standards as they appear in NPH’s Corporate Compliance Policy, Code of Conduct and Conflict of Interest Policy.
• Keeps abreast of all pertinent federal, state and hospital regulations, laws and policies as they presently exist and as they change or are modified.

Qualifications

• Bachelor's degree in Finance, Business Administration, or Management field required. Master's degree preferred.
• A combination of significant relevant experience (7+ years) in business office leadership may be considered in lieu of a degree.
• Minimum of 5 years of experience in hospital business office operations, including billing, collections, and revenue cycle management.
• 3+ years of supervisory experience required.
• Experience working across multiple facilities highly preferred.
• Strong revenue cycle technical skills required.
• Knowledge of billing forms (i.e., UB-82, 1500), billing procedures and regulations for Medicare, Medicaid, Managed Care, etc.
• Resolve and reconcile traditional Medicare claims through the DDE system.
• Must possess extensive knowledge of Healthcare systems and operations.