Manager Patient Financial

Chesapeake Regional Healthcare•Chesapeake, VA

46d

About The Position

The Manager of Patient Financial Services is responsible for developing initiatives to improve third party and insurance account follow up, denials management and resolution of account issues. In addition, the Manager develops cost effective processes to increase efficiency, and acts as a point of contact for various outsourced vendors. These duties and responsibilities described below represent the general tasks performed on a daily basis. Any other duties as needed to drive to the vision fulfill the mission and abide by the values of the organization.

Requirements

Bachelors Degree in Business, Healthcare Administration, or related field
5+ years in an acute care setting with extensive background in billing and follow up
Prior experience in Home Health/Hospice billing, collections, and payer relations
Applicant must be licensed to work as a Certified Revenue Cycle Specialist (CRCS) at time of hire; if registry eligible, licensure must be obtained within 1 year of start date.

Nice To Haves

Master’s Degree
professional certifications

Responsibilities

Manage the activities of employees and vendors to ensure adherence to CRMC standards
Monitor and track staff productivity and quality to collect cash and resolve Accounts Receivables
Provide continued education to staff with regards to healthcare reform, payer updates, and system upgrades
Work collaboratively with the Senior AR Systems Manager and Director to meet departmental goals and objectives
Works with other Revenue Cycle Departments, such as Care Management, the CFO, HIM, Finance, Patient Access, or others within Revenue Cycle
Assist Senior and Executive Management in the successful development and execution of CRMC strategies to support CRMC's mission and goals
Manage all aspects of insurance account follow up for approximately 40,000 accounts for $200 million in accounts receivable
Review, monitor, and validate staff or vendor-initiated adjustments for certain dollar thresholds
Collaborate with the Director of Patient Financial Services to assign goals for the Insurance Follow-up and Denials management
Monitor levels of productivity for each specific individual through productivity, quality, and AR aging reports
Review of ATB and Work Ques Management, adjusting and conducting Quality Reviews to optimize operations and workflows, for maximizing revenue and adjustments
Month End Reporting to capture and consolidate issues and trends recording for Finance
Monitor daily volumes and statistics for incoming phone calls, website usage and system notes.
Monitor and maintain strict compliance with Medicare and Medicaid Quarterly Credit Balance Reporting.
Prioritize all work for the Follow-up and Denial areas to meet the goals as assigned via the Leadership systems and in other IT systems.
Always strive for excellence in the resolution of all claims and ensure that all regulations are followed for compliance.
Attends as an expert witness for Bad Debt and Court Cases (affidavits) in legal instances.
Liaison for current Vendors, EPIC, and systems operations.
Exercise quality judgment in handling of patient questions or complaints, physician requests/contacts, and internal interaction with other hospital departments or vendors.
Resolve patient complaints, vendor relations, charging issues, and interdepartmental concerns in a timely and professional manner
Incorporate all new programs and procedures into the routine of the department, and keep the employees and stakeholders aware of all changes
Oversee the training and orientation of all new employees and vendors within the department
Prepare daily, weekly, and monthly reports that track the progress of the department's follow up, denials and customer service
Understand and use the department computer systems in an effective and proficient manner
Actively participate in service recovery and customer service activities to ensure a superior customer contact
Adhere to CRMC's confidentiality policy for all information related to patients, family and friends, hospital employees, physicians, and clients
Maintain effective interdepartmental communication
Conduct employee interviews/employment recommendations
Maintain employee scheduling/general staffing
Complete time and attendance records/payroll discrepancies
Conduct and monitor employee annual performance evaluation/in-service/competency testing/disciplinary action
Complete other duties as assigned by the Director of Patient Financial Services or CFO
Consistently demonstrate excellent techniques in work performance through quality assurance reviews
Demonstrate knowledge of contract terms for insurance carriers and vendors
Stay current with insurance program changes and offer suggestions to ensure the efficient running of the department
Attend required departmental and hospital-wide orientations, meetings, and in-services
Demonstrate a commitment to flexible work scheduling when necessary to ensure patient care
Manage the daily activity of Insurance Account follow-up, denials, and customer service