Bachelor of Science
Supervises the Patient Financial Services functions of all inpatient and outpatient accounts within designated third party reimbursement. Responsible for billing compliance, monthly review of trial balances and follow up collection activities. Must maintain close working relationship with other departments to review and resolve unbilled patient accounts. Oversees Admitting department to ensure proper demographic and physician assignment is obtained.
1.Oversees Charity Care policy to assure policy and procedures are followed. Adjudicates applications for appropriate adjustment, obtains written authorization from Director Patient Financial Services, CFO and CEO as needed.
2. Compiles and transmits required information to CompData to meet State of Illinois requirements.
3. Reviews and updates Chargemaster to ensure compliance in coding and accurate reimbursement.
4. Is responsible for verification of third party coverage and initiates appropriate insurance plans commensurate with current types of coverage for proper prorations on itemized bills.
5. Works closely with Medical Records and Utilization Review to resolve all unbilled patient accounts.
6. Oversees billing activities in order to assure proper handling and directs activities of billers to assure timely billing and reimbursement.
7. Refers account, after third party reimbursement or denial of coverage to collection staff; handles all problem cases in area and consults with Director Patient Financial Services.
8. Reviews monthly trial balances for accuracy and aging; supervises follow-up collection activities with third party payers and patients.
9. Compiles statistics required by Business Office and performs other duties requested by Director Patient Financial Services.
10. Oversees Admitting department to ensure financial viability, patient and physician relations.
11. Manages department dynamics and interpersonal relationships. Communicates regularly with departmental personnel.
12. Organize work procedures to generate acceptable levels of productivity.
Bachelors Degree required
Masters in Health Administration or Business Administration preffered.
3-5 years managing compliance with Medicare, Public Aid, and other governmental agencies required.
Loretto Hospital - 21 months ago