Under general direction of the Director, Revenue Cycle, the Manager, Patient Accounts manages the claim creation, billing and collection processes of his/her department. Responsible for the development, implementation and monitoring of a program to ensure that claims are paid accurately and timely. This position manages the day-to-day activities of his/her department in accordance with departmental and Hospital guidelines. Core Competencies. Ensures selection, training, orientation and assignmen... more details
Description
Under general direction of the Director, Revenue Cycle, the Manager, Patient Accounts manages the claim creation, billing and collection processes of his/her department. Responsible for the development, implementation and monitoring of a program to ensure that claims are paid accurately and timely. This position manages the day-to-day activities of his/her department in accordance with departmental and Hospital guidelines.
Core Competencies
Ensures selection, training, orientation and assignments of department staff; develops standards of performance and monitors and manages staff; evaluates performance and initiates or makes recommendations for personnel actions, promotions and disciplinary action; encourages professional development through in-service education; develops and maintains job description for all staff members; resolves staff grievances.
Maintains personnel records; approves CTO; and prepares work schedules for employees to provide adequate coverage for completion of required duties.
Mediates staff conflicts and problems; documents and counsels performance problems; and promotes teamwork.
Acts as a role model verbally and behaviorally.
Attends meetings, as required, and participates in committees, as directed
Acts as a liaison for the department with other Hospital departments, physicians, payors, patients, and patients' family members.
Participates in Finance Division Hoshin goals by assisting the Director, Revenue Cycle in establishing goals for the department; and assists staff in setting goals and meeting standards.
Uses KPIs to manage and monitor revenue cycle operations, such as cash collections.
Performs duties of department staff, as needed.
Utilizes an effective internal tracking and documentation process to retain communications with and information received from Government entities that includes CMS, Fiscal Intermediaries, Carriers, and the OIG
Participates in hospital performance improvement activities.
Utilizes hospital computer system to update, adjust, and process accurate patient accounts.
Department Specific Competencies
Develops, maintains and updates department policies and procedures; and develops and maintains training materials.
Assists in developing, implementing and coordinating a Denial Management process to improve denial outcomes; gathers information that will correct the denial and prevent future denials; and monitors regulations to ensure practices are current.
Educates management and office staff regarding the way in which claims are paid.
Works and assists staff in resolution of problem accounts.
Performs claims audits periodically to ensure that claims are paid accurately.
Monitors expenditures to ensure efficient use of resources to maintain budget.
Ensures equipment meets specifications to maximize productivity.
Assists in Disaster Drills, as needed, and follows Disaster protocols in the event of an emergency.
Monitors work queues to ensure that claims are being processed timely.
Maintains and follows-up on claims in medical review, claims holding various edit issues.
Serves as the point person for true Self-Pay, non-capitates PPO/HMO and other commercial insurance patient accounts.
Maintains the insurance master in Patient Accounting system.
Maintains advanced knowledge of commercial payer requirements.
Oversees the client billing process.
Oversees the uninsured/underinsured allowance process.
Attends meetings with outside providers/vendors regarding Revenue Cycle functions and processing of claims.
Education
Degree
Program
High School Diploma/GED or Higher Education
General Studies
Experience
Number of Years Experience
Type of Experience
5
Billing and collection of PPO and HMO accounts
Additional Information
Three or more years of supervisory experience in an acute care hospital with experience in admitting procedures/requirements, insurance billing procedures and requirements, patient accounting and collection procedures and electronic remittance advice and payment posting requirements.
Job Abstracts is an independent Job Search Engine. Job Abstracts is not an agent or representative and is not endorsed, sponsored or affiliated with any employer. Job Abstracts uses proprietary technology to keep the availability and accuracy of its job listings and their details. All trademarks, service marks, logos, domain names, and job descriptions are the property of their respective holder. Job Abstracts does not have its members apply for a job on the jobabstracts.com website. Additionally, Job Abstracts may provide a list of third-party job listings that may not be affiliated with any employer. Please make sure you understand and agree to the website's Terms & Conditions and Privacy Policies you are applying on as they may differ from ours and are not in our control.
Welcome to Job Abstracts
We would like to take a second to Welcome You to Job Abstracts, the nation’s largest Pure Job Board. With over 3.1 million job listings from 15,000+ Companies & Organizations, we help job searchers find careers that match their interests. As an anonymous user, you have probably discovered how easy our system is to use. However, you have just scratched the surface of what we can offer.
We encourage you to Register so you can use our most powerful features: searching with multiple terms, setting up multiple locations, establishing favorite companies, and accessing your search history. If you find a job you like, you can apply directly for it, and then, keep notes on it. We will also keep a lookout for jobs that match your search terms and email you when we find something you may like.
You can register for free and the system is free to use. If you like our system so far, click on Register and unlock the power required by serious job searchers.
Any time you conduct a search, the system shows you job matches, ranked by their Relevance Score (RS).
The score is calculated by a proprietary algorithm that uses Intelligent Machine Learning.
The Relevance Score tells you how well the job opportunity matches your search term or terms.
When not logged in, the system is limited to one search term. Scores for single term matches are usually lower.
When you register, log in, and set up multiple terms prioritized by importance, the jobs found for you will receive a much higher Relevance Score.