Essential Job Functions: Communicate with staff on a regular basis providing ongoing education and mentoring. Maintain positive relationships and communication with payers to ensure compliance, improve claim resolution and potential reimbursement. Maintain open communication with internal departments on issue resolution.
Effectively work with Team Lead(s) and Reps to ensure adherence to payer-specific billing and collection regulations. Seeks understanding of payer regulations via peers, payer reps, bulletins, payer handouts, websites, and remittances. Analyzes and resolves work problems and assists workers in solving problems. Demonstrates integrity in the billing/collection process in adherence with corporate compliance to eliminate risk. Assists with the Corporate Compliance work plan, including the reporting of any issues and ensuring timely repayments, if applicable. Ensures written policies and procedures are adhered to.
Completes assigned billing accurately and according to established procedures. Reviews claim processing problems and identifies actions necessary to avoid future claims processing delays. Monitors claims in biller-claim queues and reviews claims for accuracy. Performs required follow-up on assigned accounts according to established procedures and consistent with approved hospital collection policies. Assumes responsibility for designated area of accounts receivable as evidenced by timely and efficient follow-up of assigned accounts. Meets A/R goals and other related metrics. Monitors and reports on monthly denials to include ways to minimize denial risk. Collaborates with the Patient Access Manager in process improvements affecting Patient Financial Services.
Monitors, documents, and reports productivity of team personnel on daily basis. Performs quality checks to ensure volumes of accounts are completed and the appropriate action taken. Reviews reports based on aging and value of claims on a biweekly to monthly basis. Intervenes to resolve accounts as indicated.
With the assistance of the PFS Team Lead, coordinates all phases of training for new employees on billing process, systems, or enhancements to existing systems.
Performs other duties as assigned.
SKILLS AND CERTIFICATIONS
Hospital billing regulations, third party billing regulations
Knowledge of CPT and ICD10 coding
Leadership
SCREENING QUESTIONS
Does the candidate have an associate degree or technical school training?
Does the candidate have more than 1 year of leadership experience?
Does the candidate have more than three years of experience within Patient Financial Services healthcare revenue cycle?
IDEAL CANDIDATE
UR Medicine Finger Lakes Health is seeking a motivated and skilled leader to join our Patient Financial Service team! The perfect candidate would thrive to grow within our organization and seek out opportunities to further their leadership skills.
Prior healthcare experience is required.
Prior leadership or supervisory skills are required.
An associate degree or technical school training is required.
