SUMMARY: Under limited supervision, directs and coordinates the daily administrative operation and staff of Cash Posting, Collections, and Customer Services and works closely with the Billing Manager, Patient Access Manager, Pre-Certification/Financial Coordinator. Establishes and interprets policies, in addition to recommending policy changes to the Manager, PFS. Responsible for interviewing/ hiring new employees, preparing /conducting performance evaluations, responsible for reviewing/monitoring monthly ATB/Bad Debt reports. Prepare monthly analysis of AR for Manager PFS, responsible for assisting Manager with establishing/achieving AR collection goals/objectives, as well as, assisting with Collection agency placements, collections and reconciliations.
Under general supervision, responsible for billing and following up on claims electronically or manually on a timely basis, for training staff members in all aspects of billing, follow-up and collections. This training will include Medicare, Blue Cross/Blue Shield, Commercial and Medicaid. Ensures assigned team work all rejections, correspondence and follow-up accounts according to policy and procedures.
EDUCATION AND EXPERIENCE: To qualify for the position, the candidate must have a Bachelor’s Degree in Management or 3 years leadership experience in Billing, Pre-Certification and Customer Service, in a hospital setting, coupled with at less 2 years cash posting experience both electronic and manual posting. Some experience in charge posting, adjusting, and updates helpful.
SKILLS & ABILITIES:
~ Extensive knowledge of hospital electronic billing and correcting Medicare rejections requiring use of FISS (Fiscal Intermediary Share System).
~ Extensive knowledge of UB92 - 8371 required.
~ Knowledge of manual/electronic procedures for all insurance companies, government programs and third party payers.
~ Knowledge of ICD9, CPT/HCPCS coding.
~ Knowledge of HIQA/ELGA. Knowledge of follow-up/collection practices with Medicare, Medicaid, Blue Cross/ Blue Shield and Commercial Payers.
~ Demonstrated proficiency in Microsoft Word and Excel.
~ Ability to ensure the confidentiality and rights of all patient, health system and departmental documents is required.
~ Demonstrated knowledge of Consumer and Collection Laws in Health Care setting i.e. Fair Credit Billing Act, Telephone Collections Guidelines.
~ Demonstrated ability to proactively identify and implement effective strategies to enhance the financial performance of the department and the organization.
~ Ability to effectively evaluate complex systems/processes, develop a course of action and follow through to resolution.
~ Knowledge of third party payers’ regulations and billing requirements. Ability to ensure the confidentiality and rights of patients and the confidentiality of hospital and departmental documents required.
~ Understand the legalities related to credit balances and refund processing.
CERTIFICATES, LICENSES AND REGISTRATIONS: CPAM is preferred.
University of Maryland Charles Regional Medical Center
- 2 years ago - save job