Shift: Monday through Friday 8:00 AM to 5:00 PM
Work Arrangement: On-Site
Department: Hospital Patient Accounts - Billing Follow Ups and Denials
Facility: Quarterdeck Building 2401 Lemone Industrial Blvd, Columbia, MO 65201
Compensation:
• Base Pay Range: $73,382 - $119,808 Annually, based on experience
DETAILED JOB DESCRIPTION
• Leverage knowledge of revenue cycle functions to identify trends in claims payments and denials adversely impacting overall financial performance. Pursue reimbursement from payor via various avenues. Escalate accounts to appropriate individuals at the payor and to MU Health Care management as needed, including accounts with a lack of timely payor response. Provide Management to teams responsible for resolution of unpaid claims from various payor products including HMO, PPO, Medicaid, Medicare, and Workers' Compensation and gains commitment for payment. Escalate the payor's lack of response and/or lack of payment within the payor organization as appropriate. Serve as a subject matter expert in insurance billing and follow-up, self-pay billing and collections, accounts receivable management, and cash posting activities. Identify trends in unpaid claims, denials, accounts receivable reduction opportunities, and revenue leakage.
• Work towards resolution and improvement of the revenue cycle process. Maintain knowledge of industry trends, payor policies and protocols, and revenue cycle operations to establish compliant patient accounting processes and procedures. Prepare routine reports and ad-hoc analyses as directed, and accurately reflect payor performance trends. Establish and maintain a best-in-class workflow for the timely follow-up, escalation, and resolution of unpaid claims-related issues. Develop and maintain a dispute resolution notification and escalation process to engage the appropriate MU Health Care leaders, including Payor Contracting and Legal. This includes oversight of the functional area within hospital patient accounting, including management of workflows.
• Establish and maintain meaningful partnerships with insurance companies, medical groups, and other third-party payors to aid in the timely recovery of reimbursement for hospital-based services per executed third-party payor contracts and/or other applicable governing regulations or contracts. Manage department staffing, fiscal, and operating resources by developing and monitoring the department budget. Manage daily operational activities of the designated functional area within Hospital Patient Accounting. Establish processes and base information technology infrastructure to streamline operations and perform as a strategic business partner to influence change and recommend new processes up/downstream of the Revenue Cycle process to reduce waste in line with Lean Six Sigma/root cause methodology and increased revenue.
• Partner with other Revenue Cycle leadership to lead the development and implementation of policies, procedures, and workflows which impact net revenue cash flow or performance efficiency across the Revenue Cycle function that align with the strategic direction and standardization. Develop and ensure that the activities of the patient accounting department are performed per state and federal regulations, mandated collection practices, and all regulatory agencies including DNV, and are HIPAA compliant. Manage the development, coordination, and maintenance of daily staffing schedules to ensure the appropriate level of coverage and continuity of care. Monitor and oversee time and attendance in alignment with MU Health Care policies and practices, ensuring accuracy of records and timely approval for payroll purposes. May complete unit/department specific duties and expectations as outlined in department documents.
REQUIRED QUALIFICATIONS
• Bachelor's degree in accounting, finance, public policy, computer science with a concentration in accounting or related studies, or a related degree with strong accounting and computer science components.
• Two (2) years of experience in a responsible accounting-related position may be substituted for the college requirement.
• Five (5) years of related work experience.
• One (1) year of supervisory experience.
PREFERRED QUALIFICATIONS
• Additional license/certification requirements as determined by the hiring department.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met with or without reasonable accommodation. The performance of these physical demands is an essential function of the job. The employee may be required ambulate, remain in a stationary position and position self to reach and/or move objects above the shoulders and below the knees. The employee may be required to move objects up to 10 lbs.
