Manager Patient Accounts (Commercial & Government)

University Hospital, Newark NJ•Newark, NJ

40d•$96,417 - $144,628

About The Position

The primary purpose of the Manager Patient Accounts (Commercial & Government) position is to plan, organize, staff and direct the Patient Account Department’s Charity Care Self Pay and Bad Debt operations at University Hospital. The position is also responsible for managing special projects within the Department, with an overall goal of assisting the organization to meet its strategic objectives. Takes charge of the department in the absence of the Assistant Director.

Requirements

Bachelor’s degree in Business Administration, Finance, Hospital Administration, or a related field required.
Minimum of five (5) years of experience as a Supervisor or Manager in Patient Accounts, Hospital Billing, or Patient Financial/Business Services required.
Proficiency in personal computers and supporting software in a Windows-based environment, including Microsoft Word, Excel, PowerPoint, and Outlook.
Thorough knowledge of Charity Care, UB-04/CMS-1500 billing forms, healthcare claims processing, ICD-10, CPT, and HCPCS coding.
Strong knowledge of Charity Care, Medicare, Medicaid, commercial insurance, and federal and state regulations and guidelines.
Knowledge of intranet and internet applications.
Excellent oral and written communication skills.
Ability to effectively interact with internal and external departments.
Ability to represent the department professionally and effectively at meetings.
Proficiency in department-specific software applications.
Ability to prioritize projects and manage multiple responsibilities.
Excellent customer service skills.
Outstanding interpersonal and leadership skills.
Ability to work effectively in a team-oriented environment.
Demonstrated knowledge and success working in a unionized environment.
Additional related experience may be substituted for the required degree on a year-for-year basis

Responsibilities

Monitors monthly follow-up on unpaid claims and take appropriate action to correct and re-bill for timely reimbursement.
Manages and pulls daily facility (UB04) (837-I) and physician (HCFA-CMS 1500) 837-P claims submission and 835 errors, andrejections from the Clearinghouse.
Performs regular audits of daily billing reports to identify billing errors. Works with the billing team and other department staffto address; notify on-site management of problems and troubleshoot as needed.
Manages the zero, partial, denials (credentialing, COB and any carrier issues) payment reports monthly to identify trends andunderpayments; investigate causes and take appropriate steps toward resolution using professional judgment.
Develops and Implements quality assurance measurements and standards, including completion of internal and external auditsfor Medicare, Medicaid, Commercial, Charity Care, Worker Compensation, No Fault, self-pay, refunds, write offs and bad debtaccounts. Responsible for yearly external audit or other entity engaged to conduct the yearly audits as it relates to revenuerelated questions and respond to payer audits requests as needed.
Directly manages account receivable units to ensure maximum efficiencies and productivity by prioritizing work activities.Responsible for weekly/monthly/status and reconciliation report (development/preparation/maintenance/analysis of reports)