Under the supervision of the Chief Financial Officer, manages the daily operations for the Billing and Reporting Unit and all patient accounting functions. Develops and monitors department policies and procedures. Ensures departmental compliance with local, state and federal standards, policies and guidelines. Negotiates and monitors contracts. Oversees hiring, firing and training of operational staff. Represents the department at various meetings.
Essential Functions
- Manages and oversees the operations of the Billing and Reporting unit. Performs personnel functions such as hiring, training, performance evaluations and disciplinary actions.
- Develops, implements and monitors policies and procedures for the unit.
- Monitors, negotiates and maintains contracts with commercial and public payers. Ensures contract compliance throughout the unit.
- Identifies, establishes and maintains relationships with third-party insurers to improve revenue. Responds to third-party problems and concerns.
- Resolves issues and concerns as they relate to the Billing and Reporting unit.
- Coordinate the document flow process as it relates to billing and patient accounts. Correlates records and registration information. Forwards specific registration information to third-party billing and provides adequate follow-up.
- Supervises the monitoring and reconciliation of third-party insurance remittances and cash collections. Develops new or modified patient billing procedures. Institutes payment plans for patients who have delinquent accounts.
- Advises patients of insurance options offered by the state.
- Prepares, analyzes and distributes reports, graphs, charts and other data.
- Attends various internal and external meetings regarding program goals, objectives and outcomes. Serves as the primary liaison for internal staff and external organizations.
Other Functions:
- Performs other duties as assigned.
- Must adhere to departmental standards in regard to HIPPA and other privacy issues.
- During a public health emergency, the employee may be required to perform duties similar to but not limited to those in his/her job description.
(The above statements are intended to describe the general nature and level of work being performed by the people assigned this classification.They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.)
Employment Qualifications
Education: A minimum of a Bachelor's Degree in Business, Accounting or a related field is required. A Master's degree is preferred.
Experience: A minimum of three to five of health care accounting is required. Must have experience with 3rd –party payers, Medicaid, Medicare and managed care concepts such as HMO, PPO, POS and capitation, Coding/Billing certification, within one year of hire, through a recognized Coding/Billing Accreditation body.
Requirements and Working Conditions
Other Requirements:
(The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job-related selection or promotional criteria.)
Physical Requirements:
- Ability to sit, stand, walk, bend and stretch in order to retrieve supplies and operate standard office equipment. Must be able to operate court equipment including recording devices & technology.
- Ability to lift, hold and carry objects weighing up to 25 pounds.
- Ability to communicate and respond to inquiries both in person and over the phone.
- Ability to operate a PC/laptop and other office equipment.
- Ability to handle varying and often high levels of stress.
(This job requires the ability to perform the essential functions contained in this description.These include, but are not limited to, the requirements listed above. Reasonable accommodations will be made for otherwise qualified applicants unable to fulfill one or more of these requirements.)
Working Conditions:
- Works in a standard office environment.
- May attend meetings and seminars in the community.
MAY 2010
MCF 10
