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PATIENT FINANCIAL SRV MGR

Margaret Mary Health

$80K — $111K *

repostReposted more than 8w ago

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5 - 7 years of experience

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Job Description

This is a Business Office Manager position.

Location/Department: Business Center - Business Office

FT 80/pp

Job Summary:

The Patient Financial Services (PFS) Manager will evaluate business processes, anticipate requirements, uncover areas for improvement, & develop & implement solutions across the department. Additionally, this position will lead the design, development & implementation of best practice guidelines within systems &/or policy & procedures to achieve workflow efficiency across the department. Successful candidates will be able to access & manipulate data, possess critical thinking skills & will possess an ability to guide & train PFS staff in the completion of projects across the department.

Responsible for hospital & physician accounts receivable (AR) management to ensure timely billing & collections of insurance & patient revenue. Project manages various system implementations, provides team member training & education, responsible for providing regular project updates to management, must have strong analytical skills & will be responsible for providing analytical & technical problem resolution to issues & barriers while ensuring project risks have been mitigated. Will investigate, update, & provide necessary documentation to insurance/third party liability carriers on all open receivable accounts in a timely manner. Responds to emails & patient inquiries within 24 hours. Performs detailed review of Aged Trial Balances by payer as assigned. Investigates all denied claims & works with appropriate individuals to appeal as necessary. Provides support to Patient Account Reps to ensure efficiency, adherence to processes & workflows, to ensure quality performance levels.

Supervisory Responsibilities: Business Office staff

Duties/Responsibilities:
  • Leads the analysis implementation & maintenance of revenue cycle best practice processes & activities across the department & ensures goal setting & project tracking.
  • Develops & monitors staff work queues & productivity to ensure work volumes & staffing are aligned.
  • Audits staff work & participates in developing & delivering training programs within the department.
  • Creates system & processes audit plans. Resolves discrepancies, as required.
  • Troubleshoots issues & resolves concerns, as well as recommends necessary fixes. Advises management of results & recommends actions.
  • Prepares data analysis for departmental leadership in organized format to clearly convey trends & identify key areas for revenue optimization.
  • Creates reports to evaluate accounts receivables, operational productivity & departmental outcomes.
  • Analyzes data trends to determine the root cause & conducts deep dive sampling.
  • Provides a detailed assessment of revenue cycle processes with a focus on process improvement & best practices.
  • Monitors & tracks ongoing departmental performance through key performance indicators (KPI) in comparison to industry benchmarks.
  • Cultivates effective collaborative relationships with departmental teams to seek resolution of issues identified through monthly monitoring of KOIs/KPIs.
  • Works closely with department management to facilitate root issue remediation. Collaborates closely with peers to develop, validate, & maintain meaningful report sets.
  • Maintains knowledge of Medicare, Medicaid & commercial reimbursement. Stays abreast of group payer contracts, payer policies, payer plans, & member benefits. Keeps apprised of rules & regulations affecting reimbursement.
  • Manages special projects & duties as needed or assigned.
  • Serves as first point of contact & support for staff on billing & collection questions.
  • Manages staff schedules, approves timecards, tracks attendance, handles PTO requests & fills in when staff is unavailable.
  • Responsible for orienting & training all new team members.
  • Participates in interviews & hiring process.
  • Assists in preparation of annual performance reviews for staff.
  • Supports/conducts departmental huddles, staff meetings & communications.
  • Able to communicate effectively with staff & the public in person & over the phone under stressful situations.
  • Keeps Director informed of appropriate matters.
  • Management & supervision of AR clean-up projects.
  • Management of internal processes & workflow implementation.
  • Assists in development & revision of departmental policies & procedures.
  • Conducts research & resolution activities on insurance claims.
  • Track & trend revenue cycle data including, but not limited to, staff productivity, denials, clean claim rates & bad debt.
  • Management & supervision of project/program implementation.
  • Assists the Director of Revenue Cycle to identify & implement solutions & system wide education.
  • Maintains, updates & reports KPI.
  • Functions as the program coordinator of the Indiana Navigator program.
  • Obtain & maintain certification from the State of Indiana Navigator's program.

Required Skills/Abilities:
  • Strong customer service, time management & decision-making skills.
  • Able to multi-task; detail oriented.
  • Highly organized, self-starter.
  • Demonstrated analytical skills-ability to break down & quantify problems & processes.
  • Excellent written & verbal communication skills.
  • Demonstrated ability to manage a process & timelines effectively.
  • Must be able to operate a computer & other basic office equipment.

Education and Experience:
  • Bachelor's degree in Accounting or Finance, Health Information Management, Health Administration, Computer Science or related field (in lieu of degree, at least 10 years healthcare revenue cycle experience.)
  • Minimum of 5 years revenue cycle, medical billing or follow-up experience.
  • Minimum of 3 years relevant supervisory experience; revenue cycle supervisory or managerial experience preferred.
  • Medical Coding Certification through the American Academy of Professional Coders (AAPC), and/or the American Health Information Management Association (AHIMA).
  • Coding or billing experience required; Certified Revenue Cycle Representative (CRCP or CRCR) preferred.
  • Cerner/Cerner Community Works experience & expertise preferred.
  • Proficient in MS Office Suite including Excel, Word, Visio, & PowerPoint.
  • Knowledge of patient accounting systems, contract management &/or claims scrubber software.
  • Experience reporting from healthcare decision support, patient accounting, contract management &/or claims scrubber systems.
  • Knowledge of CPT, HCPCs & ICD-10 coding principles.
  • Expert knowledge of inpatient & outpatient billing requirements (UB-04, 837i); specifically, how claims information impacts & drives reimbursement.
  • Expert knowledge of Medicare, Medicaid & commercial reimbursement methodologies.
  • Beginner to intermediate proficiency in database reporting queries.

Physical Requirements:
  • Constant sitting, talking & use of hands.
  • May need to lift up to 25 lbs.

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