Supervises the department that is responsible for the creation of claims, reimbursement follow-up, denials, customer service, cash flow, and receivables as assigned.
REQUIRED SKILLS, KNOWLEDGE AND ABILITY
- ASSURES BILLING AND COLLECTION PROCEDURES ARE TIMELY AND COMPLIANT WITH REGULATORY AUTHORITY.
- Maintains in-depth knowledge of all billing and collection regulations and makes recommendations for policy and procedure changes.
- Resolves escalated billing, reimbursement, and customer service issues in accordance with established policies and procedures.
- Monitors results of quality assurance reviews and sets goals for improvement and training requirements.
- No compliance reporting issues are identified.
- EVALUATES CORRESPONDENCE, DENIALS, REIMBURSEMENT AND CUSTOMER REACTION TO IDENTIFY NEED FOR PROCESS CHANGES.
- Reviews trend analysis of charge and billing issues, reimbursement, denials, and customer responses and initiates process corrections.
- Coordinates with appropriate vendors and payer representatives to clarify and resolve billing and reimbursement issues.
- Interprets customer feedback into enhanced customer service.
- SUPERVISES FOLLOW-UP OF CLAIMS AND ACCOUNTS.
- Monitors target files, worklists and phone calls to assure policies and procedures are followed and adjust directions accordingly.
- Coordinates with various Scott & White departments to identify issues and improve data capture and data sharing.
- A/R days are within targeted levels.
- MONITORS ACCOUNT PAYMENT, ADJUSTMENT AND REIMBURSEMENT ISSUES.
- Notifies management of any changes in reimbursement and after thorough research makes recommendations to rectify the issues.
- Reviews worklists and reports to insure timely and appropriate application of payments and adjustments.
- Monitors credit adjustment transaction reports and assures employees comply with departmental procedure.
- Provides reports to manager.
- PROJECTS ARE COMPLETED AS ASSIGNED BY THE MANAGER.
- Participates in the development, installation, and training of all new system software applicable to the department.
- Specific assignments are finished on time and are thorough and complete.
- Escalates to the manager any system issues beyond the scope of their peers.
- ATTRACTS AND RETAINS QUALIFIED STAFF.
- Hires and insures appropriate training of qualified staff.
- Consistently follows department specific policies and procedures such as time and attendance, security, food, appearance, etc..
- Maintains open communication with staff and provides detailed and thorough policies and procedures.
- Mentors and empowers staff to make them successful.
- PERFORMS OTHER POSITION APPROPRIATE DUTIES AS REQUIRED IN A COMPETENT, PROFESSIONAL AND COURTEOUS MANNER.
- Three to five years experience in health care related field required. Three to five years previous supervisory leadership experience preferred.
- Knowledge of Healthcare Accounts Receivable management required.
Experience: 3+ Years
Degree: H. S. Graduate/GED Equivalent
Department: LlnHos Admit-Reg
Standard Hours Per Week: 40
Job ID # 292987
Scott & White - 18 months ago