Under general direction of the director, develops departmental policy; is responsible for the billing, collection, financial counseling, cashiering process; manages and coordinates resources and activities of teams to ensure departmental goals are met; performs trend analysis and produces reports; identifies and resolves problems, for the purpose of achieving the departmental goal of ensuring maximum revenue and a cash flow benefit to the hospital.
ESSENTIAL RESPONSIBILITIES / DUTIES:
Manages and coordinates, through supervisory personnel, activities of teams engaged in billing and collecting in order to achieve the departmental goals for billing cycles, expeditious collection of outstanding patients, and reduction of bad debt. Responsible for managing day to day activities of the billing department. Monitors billing and collections to ensure achievement of goals and compliance with policies. Interacts with payer representatives concerning payer specific issues. Develops reporting tools for management use.Develops, under the guidance of the Director, programs, policies, processes and procedures to carry out strategies for achieving short and long-term goals.Documents processes in standardized manual between inpatient, outpatient and financial counseling areas and recommends changes in policies, processes and procedures in response to operational needs and to ensure continuous quality improvement.Consistently manages all team activities so that quality billing, collecting and financial counseling services are provided in a efficient and effective manner, meeting all applicable federal, state, and third-party payor guidelines and regulations. Schedules team assignments and reviews with supervisors.Oversees activities to ensure goals and objectives are met by specified target dates or investigates alternatives and suggests adjustments as necessary.Develops and maintains productivity measurements and adjusts resources to meet hospital and departmental standards, as requested by the Director.Demonstrates ability to implement problem-solving mechanisms in routine and emergency situations and to initiate and implement changes in systems and procedures as required.Responsible for effective human resource management within the Patient Financial Services Department to achieve quality billing, collection, financial counseling services and positive employee relations.Maintains effective and appropriate staffing as evidenced by on-going budgetary analysis.Conducts employee disciplinary procedures up to and including termination with appropriate documentation according to Human Resources policy and employee relations laws and guidelines.Monitors employee turnover, overtime and absenteeism for department and provides justification as requested by the Director.Responsible for effective fiscal management of departmental operations to ensure proper utilization of departmental financial resources.Develops departmental budget within designated deadlines according to budgetary procedures.Investigates and suggests alternatives to the established budget depending on shifting demands of resources.Effects unanticipated cost savings or revenue generation through innovative methods within inpatient area.Analyzes data and produces a variety of reports to determine whether goals are being met by the respective teams and the overall effectiveness of the unit.Collects accurate and timely information and creates reports that highlight activity trends in the unit such as receivable trends and the relationship between the census, bed occupancy, discharge and billing activity. Analyzes trends and interprets results.Identifies, reports and resolves issue relating to the Hospital I.S. systems.Reviews operations and uses statistics to determine overall performance, team performance and error rates, deficits in systems, etc.Prepares ad hoc and standard reports to communicate and interpret results of analysis for use by the Director in problem-solving. Recommends solutions to problems using existing resources in compliance with budgetary constraints.Acts as resource person on changes in billing regulations and systems procedures and provides technical expertise in the Patient Management system.Assists supervisors in identifying problems and formulating solutions by providing a global perspective of systems and operations and through knowledge of third-party payors, etc.Has a secondary area of proficiency, such a training, Hospital I.S., Human Resources, or electronic billing collection on which to act as a consultant to the department.Responsible for communication within the Patient Financial Services area to ensure information is shared for effective operations.Confers with supervisors to explain program and individual responsibilities for phases of program and daily operation of department.Holds regularly scheduled staff meetings as demonstrated by minutes submitted to Director.Investigates and responds appropriately to all complaints and takes effective corrective action when necessary.Consistently demonstrates tact, courtesy and a positive attitude in communication and interaction with other employees, third-party payor representatives, physicians and patients. At all times presents the department and the hospital in a positive manner.As part of the Fiscal Department Management Team, collaborates with managers, and directors in Patient Financial Services, Patient Access Services, all related departments, MIS and other departments as necessary to resolve issues and concerns relative to service quality, systems, and billing and collection activities. Represents the department on committees.Meets weekly with managers within BMC from Admitting and Medical Records to review preprocessing and missing element reports and resolve problems.Communicates information to Vice President of Finance and managers within and outside the department in written and verbal forms to promote understanding of operations and resolve problems.Represents the department at meetings and on committees participates in the decision and policy-making process on hospital-wide issues, particularly those which relate to billing and collecting, as assigned.Develops training materials and seminars independently and in conjunction with the Training and Development Department. Participates in the establishment of training modules and competencies for the accounts specialists and supervisorsParticipates in employee training.Ensures on-going training for employees including orientation and in-services according to hospital policy and employee and organizational needs.Responsible for professional development to ensure appropriate knowledge of systems and advances in the administration of billing and collection activities.Attends seminars and reads reports and publications issued by regulatory agencies, third-party payors, etc., to maintain and display appropriate knowledge of developments to the regulatory environment and billing and collecting activities.Identifies personal and professional areas for improvement and actively seeks out ways to meet developmental needs.
Knowledge of accounting, finance, and business management; and ability to prepare clear and comprehensive oral and written communications at a level generally acquired through completion of a Bachelors degree in accounting, business or financial management or related field required, MBA preferred.
Requires an extensive knowledge of policies, procedures, systems and equipment relating to pre-admission, billing and collection; of regulations and guidelines pertaining to third-party payors and self-payors; of personal computer software spreadsheet programs; of supervisory techniques and performance management at a level generally acquired through seven to ten years of experience of which (7) must have been in a supervisory capacity.
Requires the ability to develop policies, procedures, processes and programs; to maintain a budget and monitor expenditures in compliance with budgetary guidelines; to analyze data and interpret statistics; to create a variety of narrative, statistical, and budgetary reports, including trend analysis; to identify and resolve problems; and to interpret guidelines and regulations
Experience with Epic is highly desirable
KNOWLEDGE AND SKILLS:
Work requires interpersonal skills necessary to provide leadership in team building endeavors; to collaborate with other managers and directors in support of hospital and departmental goals and objectives; to establish and maintain effective, cooperative working relationships with employees and managers; to act as a liaison to third-party representatives and represent the hospitals interests while negotiating and obtaining contracts; and to train employees.