Patient Accounts/Billing Mgr

POSITION SUMMARY:

Coordinate and provide direction, supervision and monitor performance of accounts receivable, provider enrollment with payers, and medical billing and collections. Assist the Director of Finance in overseeing revenue cycle operation programs that establish and maintain standards, systems and processes that are effective. Provide ongoing guidance and feedback for issues surrounding revenue cycle performance. Provide expertise on organization's revenue compliance and revenue enhancement initiatives. Answers questions about billing procedures, diagnosis codes and payment posting. Oversees the handling accounts receivables for third party billing, and correspondence related to patient accounts.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Directly supervises employees and consultant(s) in the Patient Accounts/Billing Department. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
• Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
• Responsible for managing accounts receivable including identifying accurate payment in accordance with terms, regulatory requirements and conditions.
• Maintain database integrity, including maintenance of practice management system for optimum patient financial services utilization.
• Identify and manage payer issues, working with each payer to improve collections and reduce accounts receivable days, including reconciling remittance statements and updating payer information.
• Educate and participate collaboratively with revenue cycle participants and providers in the development, execution and follow-up of revenue cycle activities.
• Meet or exceed monthly cash goals and works within pre-established productivity guidelines.
• Prepare and distribute a variety of accounts receivable and revenue cycle reports to provide for timely information for decision-making.
• Maintain up to date information on community health center/non-for-profit best practices and state and federal law.
• Oversees daily balancing of accounts receivable ledger (i.e. Charges, payments, and adjustments)
• Oversees and, if necessary, codes and enters encounter and charge data, CPT and ICD codes, and patient demographic data into patient accounting system in a timely and accurate manner.
• Oversees collection and billing procedures on all insured and non-insured accounts with the assistance of the Patient Account Representatives and Director of Finance.
• Responds to and follows through on patient inquiries to assure patient satisfaction.
• Develops and implements policies and procedures that support quality improvement.
• Provides financial and statistical support to the Director of Finance which includes, but is not limited to, analyzing receivable ratios, coding variances, rejections tracking, and preparing necessary department reports.
• Reviews reimbursement from third party payers to ensure payment through proper use of codes.
• Attends in-service, training seminars, and departmental meetings as assigned.

COMPETENCIES:

Collaborative

• Displays willingness to make decisions, resolve conflict and delegate work assignments in a timely manner
• Adapts to change, takes responsibility for own actions to advance team goals
• Speaks and writes clearly and persuasively in formal and informal presentations
• Actively participates in meetings and uses listening skills to keep an open mind
• Solicits input from appropriate stakeholders, explains reasoning for decisions and uses strong interpersonal skills to communicate and influence others
• Gives recognition to others for results

Solid Character

• Balances team and individual responsibilities while assessing own strengths and weaknesses
• Exhibits objectivity and openness to others' views
• Welcomes feedback, builds positive team spirit, supports all team members
• Develops alternative solutions, supports and share expertise with other team members while building positive morale
• Demonstrates knowledge of company policies and treats people with respect
• Works ethically and with integrity, upholds organizational values
• Keeps commitments, shows respect and sensitivity for cultural differences
• Educates others on the value of diversity, promotes a positive work environment where all feel free to contribute

Organizational Support

• Completes administrative task correctly and on time, and develops strategies to achieve organizational goals and values
• Supports affirmative action and respect diversity, understands organization's strengths and weaknesses, analyzes market and competition, and identifies external threats and opportunities while adapting strategy to changing conditions
• Prioritizes and plans work activities while understanding business implications of decisions
• Demonstrates accuracy and thoroughness within approved budget and displays original thinking and creativity
• Displays knowledge of market and competition that aligns with strategic goals
• Meets challenges with resourcefulness, generates suggestions for improving work, develops innovative approaches and ideas

Leadership

• Displays passion and optimism while exhibiting confidence in self and others
• Inspires respect and trust while motivating others to perform well and influencing actions and opinions of others
• Coordinates projects, develops workable implementation plans, includes staff in planning, decision-making, and process improvement
• Communicates and completes changes and progress of projects on time and on budget while managing project team activities to overcome resistance
• Makes self-available to staff, provides regular performance feedback
• Develops individual team member skills and encourages growth

Safety and Security

• Promotes safety precautions and security measures to ensure the safety of both staff and patients
• Adheres to data security guidelines, including appropriate use of EMR systems and IT resources

TYPICAL WORKING CONDITIONS:

• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• The noise level in the work environment is usually quiet to moderate.

TYPICAL PHYSICAL DEMANDS:

• While performing the duties of this job, the employee is regularly required to use hands for use of Personal computer as well as other office equipment.
• The employee is frequently required to stand; walk; sit and talk and use hearing to listen. The employee is occasionally required to reach with hands and arms and stoop, and kneel. The employee must occasionally lift and/or move up to 25 pounds.
• Specific vision abilities required by this job include close vision, color vision and ability to adjust focus.

QUALIFICATIONS:

• CPC certification within 6 months of employment required.
• Ability to speak Spanish is highly desirable.
• Ability to deal with problems involving several concrete variables in standardized situations.
• Must be able to effectively utilize electronic health records software to manage the patient account information for billing purposes.
• To perform this job successfully, an individual must have an intermediate level knowledge of Microsoft Office utilizing Excel Spreadsheet software and Word processing software.
• Ability to write reports and business correspondence.
• Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

EDUCATION/EXPERIENCE/CERTIFICATIONS/LICENSES:

• Associate's degree required. Bachelor's degree in business administration, finance, accounting or healthcare administration desired. Minimum of three years supervisory experience in health care.
• A combination of progressive experience and education would be considered.
• Comprehensive knowledge of medical coding, billing, CPT, ICD-9, ICD-10, HCPC's coding books, and federal/state regulations is requisite.