Manages the third party receivables operation for the billing and collection of all Government and 3rd party payers for the 7 member hospitals of MaineHealth and all of the member Physician Practices of Maine Health. Manages the CBO Patient Accounts Supervisors and Team Leads. Develops reimbursement strategies to expedite payment from our Government and 3rd party payers. Develops work flows and controls to increase the accuracy and productivity of Billers and Follow-up staff . Works with the Revenue Control Manager to ensure the integrity of any data that interfaces with our receivables system. Ensures all claims and processes are compliant with the rules and regulations of our Government and 3rd party payers. Develops monthly A/R performance reports for MaineHealth senior management. Represents Maine Medical Center at State meetings and professional organizations including MaineCare, AHA and the State Uniform Billing Committee.
Minimum Knowledge, Skills, and Abilities Required
Bachelor's degree in Business, Finance or Health Care Administration.
Extensive knowledge of Managed Care payers authorizations, billing and collection guidelines.
Extensive knowledge of CPT, ICD9, HCPCS and Revenue Codes.
Epic Certification in Billing/Follow-up in HB or PB systems within 9 months of your hire date
Extensive knowledge of the rules for billing and reimbursement of Medicare and Medicaid.
CHFP National certification and Managed Care Specialty certification through HFMA and/or certification in other health care professional organizations
CHFP National certification and Managed Care Specialty certification through HFMA and/or certification in other health care professional organizations.
7 years supervisory experience in a Patient Accounting office.
Extensive knowledge of the revenue cycle, including Admissions, Registration, Patient Accounts, Charge Master Development and Revenue Departments.