Job Summary:
Maintains responsibility for oversight of timely and accurate pre-registration, insurance verification, precertification's and authorizations for the department. Supervises business office personnel including direct supervision of day-to-day secretarial, scheduling and patient financial services functions. Manages accounts receivable and payable, cash management and month-end close on practice management systems. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.
Job Requirements:
Education and Work Experience:
- Bachelor's Degree or equivalent combination of education/related experience: Required
- Master's Degree: Preferred
- Five years' technical experience: Preferred
- Experience in a healthcare setting: Preferred
Essential Functions:
- Audits staff monthly to ensure best collections practices and appropriate follow-up. Oversees and ensures timely claim submission and monitoring, and assists with delinquent accounts. Reviews monthly supply usage and reports on spending/trends. Understands and oversees managed care contracts and assists contracted companies with updated changes in terms. Assists with Joint Venture meetings and business, as needed.
- Receives and answers inquiries from patients, insurance companies and other parties regarding charges, policies and procedures. Completes carrier requests for additional information according to payer guidelines. Refers all private pay and under insured patients to the Financial Counselor. Assists with the coordination of submission of claims and follow-up for timely payment. Provides appropriate reports to management. Maintains responsibility for adherence to budget for specific projects. Participates in the preparation of the department budget.
- Oversees and coordinates day-to-day agency functions of medical records, computer processing, billing, collections and documentation processing with delegation of appropriate duties. Provides assistance with the patient registration process during periods of peak volume and cross-trains to other related areas, providing staffing back up.
- Analyzes patient's account activity and determines/processes transactions. Maintains responsibility for management of Quality Assurance data and reports including staff/patient surveys, benchmarking and reporting. Assists with marketing and business development, as needed. Reconciles statements including banking. Ensures checks and balances per policies and procedures. Ensures payment and adjustment posting is accurate. Approves all adjustments requested, and coordinates with contracted services. Exercises independent judgment in recruiting, training, coaching, supervising and directing assigned staff. Coaches and counsels as needed to improve performance, and asks for management or human resources assistance for unusual situations. Ensures documentation of all staff encounters is completed. Completes periodic evaluations of personnel supervised. Trains and educations staff, as needed.
- Performs other job-related duties as assigned.
