This position will manage the administrative and financial support service functions for an extremely complex clinical, research or income-supported division.
Essential Duties and Responsibilities
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.
• This position is responsible for all aspects including directing, planning and overseeing activities related to department revenue cycle management and enhancement.
• Provides key leadership consultation and expertise regarding all pre and post patient access activities, financial counseling, POS collections, denials management, payer relations, charge master maintenance and systems.
• Makes recommendations for improvements to business systems and processes including formal proposals and or presentations to management.
• Monitors key practice financial performance and revenue cycle indicators and makes periodic reports on revenue cycle performance and key financial indicators.
• Continuously keeps abreast of regulatory and reimbursement matters affecting revenue cycle operations.
• Supervises the front end clinic support staff to ensure an accurate and timely patient registration and charge capture.
• Represents Division of Hematology / Oncology on issues related to professional billing. Coordinates overall support of Department of Medicine Initiatives around MFA.
• Oversees the professional billing for the infusion area to assure that there is accurate capture of charges for technical services being provided.
• Supervises the Pre-certification Unit to assure that the accurate and timely pre-certification of treatment for drug administration and radiological tests are preformed.
• Supervises the Scheduling Unit in performing all scheduling for professional encounters.
• Develops and maintains patient tracking mechanisms for physician referrals.
• Works in conjunction with the Director of HemOnc Operations to assure an environment focused on good customer service
• Participates in the development, implementation, and evaluation of measures to enhance services provided in the Cancer Service line.
• Exemplifies standards in all activities and holds staff accountable for conformity with those standards in all activities.
• Serves as administrator for a professional division in supervising financial and office support,
• Recommends supply and equipment purchases, salary expenditures and office service expenses.
• Establishes, with executive approval, internal administrative procedures and controls.
• Conducts special administrative studies and prepares recommendations as assigned.
• Identifies uninsured and underinsured patients prior to the onset of treatment
• Verifies coverage details for potentially underinsured patients, identifying atypical gaps in coverage
• Estimates patients financial obligations to the institution
• Educates patients regarding insurance coverage and out-of-pocket expenses owed to the institution
• Protects the financial standing of the MFA by determining appropriate payment plans and arranging payment on deposits due
• Counsels patients who cannot pay according to the payment schedule, determining appropriate internal and external patient assistance programs to contact for additional support
• Contributes to department goals by making 100% financial arrangements for each patient prior to the onset of treatment when possible
• Adheres to the MFA corporate compliance plan, and to all applicable rules and regulations outlined by accrediting bodies and local, state, and federal agencies
• Conducts patient financial assessment and planning
• Facilitates patient collections
• Supports efficient department operations
• Assumes other duties and responsibilities that are appropriate to the position and area.
The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
A Bachelor’s degree in business administration or an equivalent combination of training and experience is necessary.
Four years of progressively responsible experience in business management, including heath care billing and reimbursement activities and administration is necessary. Similar experience with a Hematology/Oncology practice highly desirable. Supervisory experience is necessary for this position.