Manager of Patient Accounts

Hutchinson Regional Medical Center, Inc.•Hutchinson, KS

About The Position

Overseeing various revenue cycle functions and analysts. Essential Responsibilities: Responsibilities listed in this section are core to the position. Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position. Oversees the Patient Accounts/Business Office team. Maintains the team’s work schedules, completes timekeeping and sets priorities and expectations for team members Monitors productivity, accuracy and quality of work for both team members and vendors Provides input and helps develop policies and procedures for the department Reviews and provides input on daily, weekly, and monthly reports Addresses department issues, e.g. disciplinary, hiring, and evaluations Collaborates with departments where necessary Meet productivity expectations/department performance goals Process various insurance claims and denials from follow up to final reimbursement; take corrective action on repetitive denials Maintains a working knowledge of payer contracts, copays/coinsurance/deductibles, and eligibility requirements to accurately process remittance advices Notify leadership of any trends or changes in payer requirements Resolves account discrepancies, to include but not limited to, credit balances, merge/audit requests, corrected claims, and insurance over/under payments; Documents all action taken on the patient account in the Revenue Cycle module Act in accordance with the established mission, vision, and values. Abide by the Health Insurance Portability and Accountability privacy and security regulations regarding all aspects of Protected Health Information (PHI). Maintain effective communication and professional working relationships with patients/clients and their representatives, team members, contractors, physicians, peers, outside agencies, and the public. General Responsibilities: Perform other duties as assigned. People Management Responsibilities: Does this position have people management responsibilities?: x Yes No “Yes” indicates that this position entails overseeing and guiding team members, encompassing employment decisions and/or suggestions, as well as conducting formal performance assessments. "No" indicates that this position does not involve managing team members.

Requirements

Bachelor’s degree in Accounting, Finance, or Information Technology.
Basic computer skills, including Excel
Successful practices in customer service and problem resolution
Display critical thinking skills
Payer specific knowledge regarding rules and regulations – at least 1 payer
Knowledge of insurance verbiage, claims processing and explanation of benefits
Must display a high degree of independent judgment and professional skepticism to enhance the work performed in order to achieve success in the Multi-payer Billing Specialist position
Recent hospital-based 1 year patient accounting experience
Recent hospital-based 1 year medical insurance appeals and preauthorization experience
Recent government payer insurance billing experience, including insurance follow-up on DDE/C-SNAP
Working knowledge and understanding of where to locate/how to read payer policies
Extensive knowledge of the Medicare website and the Learning Network
Working knowledge of medical necessity, LCD/NCD
Working knowledge of CPT, HCPCS, ICD-10 CM, DRG and Modifiers
Knowledge and experience with appeals, RAC’s and/or ADR’s
Possess the ability to lead, teach and guide others effectively when presented with a challenging government or commercial payer task and/or situation
Light Work: Occasionally exerting up to 25 lbs - frequently exerting up to 10 lbs. 11-25% of the day may be standing or walking.

Nice To Haves

Advanced expertise in Excel, BI, EHR/EMR, and Report Writing
Six years’ healthcare industry experience (finance, IT, revenue cycle, billing, coding, etc.)
Demonstrated leadership and project management ability.

Responsibilities

Oversees the Patient Accounts/Business Office team.
Maintains the team’s work schedules, completes timekeeping and sets priorities and expectations for team members
Monitors productivity, accuracy and quality of work for both team members and vendors
Provides input and helps develop policies and procedures for the department
Reviews and provides input on daily, weekly, and monthly reports
Addresses department issues, e.g. disciplinary, hiring, and evaluations
Collaborates with departments where necessary
Meet productivity expectations/department performance goals
Process various insurance claims and denials from follow up to final reimbursement; take corrective action on repetitive denials
Maintains a working knowledge of payer contracts, copays/coinsurance/deductibles, and eligibility requirements to accurately process remittance advices
Notify leadership of any trends or changes in payer requirements
Resolves account discrepancies, to include but not limited to, credit balances, merge/audit requests, corrected claims, and insurance over/under payments; Documents all action taken on the patient account in the Revenue Cycle module
Act in accordance with the established mission, vision, and values.
Abide by the Health Insurance Portability and Accountability privacy and security regulations regarding all aspects of Protected Health Information (PHI).
Maintain effective communication and professional working relationships with patients/clients and their representatives, team members, contractors, physicians, peers, outside agencies, and the public.
Perform other duties as assigned.