Position: Manager - PFS & Vendor Management
Department: PFS Operations
Schedule: Full Time
POSITION SUMMARY:
Responsible for interacting with internal and external customers of Boston Medical Center to support appropriate handling of all patient and vendor inquires and promptly resolve any escalated patient complaints. Works collaboratively with internal and external stakeholders to coordinate seamless transition of account handoff activities. Works with internal stakeholders within Patient Financial Services to address systemic issues impacting patient billing practices and vendor placements. Works cooperatively with Patient Financial Services' employees and managers for the purpose of achieving the departmental goals, providing excellent customer service, partnering with our vendors, and maximizing revenue opportunities for the Hospital. He/she is a key member of patient-friendly billing practices initiative for BMC.
JOB REQUIREMENTS
EDUCATION:
- Bachelor's degree or equivalent relevant work experience.
EXPERIENCE:
- 5 years or more in a fast paced, Customer Service-driven business, preferably in a healthcare environment.
KNOWLEDGE AND SKILLS:
- Work requires customer service experience, knowledge of business management principles and the ability to communicate effectively orally and in writing; at a level generally acquired through the completion of an undergraduate college degree or extensive work experience with demonstrated leadership, staff performance improvement and project management skills.
- Work requires demonstrated organizational skills, the ability to multi-task, effective time management, understanding labor relations, and strong analytical skills
- Work requires knowledge of consumer health/dental insurance options and plans, BMC revenue cycle from insurance identification to accounts receivable, and cash collection policies and procedures.
- Work requires knowledge of rules and regulations pertaining to insurance claims submission, bad debt, and self-pay options.
- Work requires the ability to: plan and supervise the work of team members and initiate change to meet targeted goals, prepare oral and written reports for presentation to management and staff, audit applications and patient accounts, identify and resolve operational and staffing problems; and to make a variety of judgments relating to insurance eligibility, the billing and collection/cashiering process, associated eligibility and regulatory compliance.
- Work requires interpersonal and analytical skills necessary to supervise employees and gain their respect as an expert, a mentor, and a resource with the ability to effectively address questions and concerns. The Supervisor will promote open communication and team building within the work group and between teams in Patient Financial Services, other departments, and affiliated vendors.
ESSENTIAL RESPONSIBILITIES / DUTIES:
- Works with internal BMC stakeholders, and serves as an escalation point for third party vendors, to review and resolve escalated patient complaints.
- Serves as liaison for presenting patient related concerns to Cash Processing, Billing, Coding and Follow-up teams.
- Engages with vendor partners to ensure prompt coordination of accounts requiring internal follow up activity.
- Monitors vendor performance and participates in regular performance reviews.
- Completes regular reconciliation of account placements with vendors and validates account level detail on monthly invoices.
- Works with Customer Service team supervisor to assure a positive customer service experience, providing appropriate billing and insurance information to patients, family members, hospital clinicians and staff, billing vendors and third parties, e.g., attorneys and insurance companies.
- Performs work queue review to ensure accounts are worked timely and accurately within service level agreements.
- Works collaboratively with clinical and administrative staff to review and work to reduce barriers to patient satisfaction and streamline communication and system workflows.
- Monitors self-pay accounts to verify that cash posting and adjustments are consistent with contractual agreements and BMC self-pay discount policy.
- Identifies and communicates to management team problems with systems in order to expedite their resolution.
- Routinely provides status of key accounts to customer service supervisor and Director of PFS.
- Directs third-party inquiries either by telephone or my mail; routes any inquiries when it is appropriate to do so to staff within or outside the department.
- Arranges for collection of debt or arrangement for payment, whichever is appropriate to resolve problem accounts. IND123
Req id: 31393