Required Qualifications :|
Bachelor’s Degree in business administration, health care management or related health care field.
Minimum of five years’ experience in registration or patient financial services, with at least three years in a lead or supervisory position.
Ability to read, analyze and interpret financial reports, contracts, and other legal documents.
- Thorough knowledge of PFS processes and standards related to billing, collections, and cash posting. General knowledge of patient registration, finance, and data processing.
- Knowledge of regulatory requirements related to patient accounting, including a solid understanding of Medicare, Medicaid and managed care processes.
- Ability to work and communicate effectively with a diverse group of people including other department managers, staff,physicians, patients, and the public.
- Ability to direct, control and supervise the Revenue Cycle Operations.
Intermediate computer skills including email, word processing, spreadsheets, and working with graphics.
- Ability to present detailed information to executive leadership in an effective, organized manner that is high-level and easy to understand.
- Outstanding ability to work independently to achieve results. Often, there is no precedent for and little help in carrying out assigned tasks. Must originate, plan, adapt and invent to accomplish tasks.
- Ability to set and maintain priorities when dealing with multiple demands and interruptions.
- Strong analytical and problem solving skills.
- Ability to establish and control an operating budget
- Dedication to the development of others and a willingness to coach and mentor people as necessary to promote their personal and professional growth.
- Excellent customer service skills.
Knowledge of medical terminology.
Preferred Qualifications :
Additional coursework in business administration, health care administration, accounting, and/or personnel management
Advanced leadership skills
- Experience with the Meditech patient accounting system and/or other patient accounting systems
- Advanced computer skills
Duties and Responsibilities :
Oversee and support the daily operations of all Patient Financial Services functions, including billing, follow-up and collections, and cash posting.
Establish and maintain departmental policies and procedures. Communicate relevant information to other hospital departments. Establish controls and review mechanisms to ensure procedures are being followed correctly. Recommend policy changes to the Director of Business Services.
- Work closely with other departments (Patient Registration, HIM, Case Management, Information Technology, Nursing, and Ancillary departments) to streamline procedures that will help ensure correct billing to patients and payers in a timely manner, thereby expediting hospital receivables.
- Leads a matrix relationship involving coding, compliance, billing, charge capture and others regarding resolution and prevention of billing related compliance issues.
- Ensures payments of the reimbursement are in compliance with contractual terms and conditions of each payer, such as Medicaid, Medicare and Commercial Insurance.
- Oversee work schedule and direct changes in priorities and schedules as needed to assure work is completed in an efficient and timely manner and to improve the department's performance and service.
- Direct the selection, supervision and evaluation of staff. Ensure performance evaluations are conducted in a timely manner according to hospital policy and initiate disciplinary actions as warranted. Resolve grievances and other sensitive personnel matters.
- Oversee orientation and continuing education for all staff. Ensure mandatory and relevant training is provided to staff in a timely manner.
- Implement a Quality Assurance program for PFS functions and monitor staff and team performance, making changes, when required, to support accurate billing to payers and patients in a timely manner and compliance with laws and department procedures.
Safety Courtesy Effectiveness Stewardship
- Collaborate with Billing and Collection Managers to plan, organize, and deliver regular staff meetings for the department.
- Participate in committees and task forces in order to improve the hospital's overall service to patients, physicians and guests.
- Assist with the development of budgets and monitoring of department operations to achieve goals within budget.
- Complete monthly and quarterly performance reports, as assigned.
- Respond personally to concerns and/or complaints expressed by patients, visitors, hospital staff, and physicians in effort to support optimal operations and excellent customer service.
- Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.
- Ensure compliance with hospital policies and standards, safety, environmental and infection control policies and procedures.
- Maintain appropriate internal controls for the safeguarding of cash.
- Follow and monitor compliance with hospital policies and standards, safety, environmental and infection control policies and procedures.
- Each employee is responsible for implementing SJRMC’s Service Standards into their daily work.
Other duties as assigned.
Physical Demands and Environmental Work Conditions :
Advanced Technical Experience
- Must be able to walk, sit, and stand for long periods of time
- Must be able to work under stress
- Vision and hearing acuity must be within normal range
- Microsoft Outlook
- Microsoft Office
- Meditech Magic
San Juan Regional Medical Center - 14 months ago