Exceptional candidates will also have meaningful experience in supervising transactional workflows in the revenue cycle including but not limited to cash posting, patient account refunds and adjustments, patient customer service, billing and collections.
Experience in navigating both the clinical and billing areas of EHR systems, medical coding and billing, KPI/Dashboard/Scorecard development and reporting, operational analysis assessment, strategy development for maximizing revenue and cash collection realization, and tactical execution of related sensible policies and procedures. Ensures the accuracy, the timeliness and appropriateness of the billing, posting and collections functions.
Develop, implement and maintain a comprehensive training program for all new and existing staff within the cash management function. Develops reports to regularly provide feedback to staff to diagnose problems, find areas of opportunity, and set goals for immediate improvement. Ensure performance goals are set and monitored and regular communication about performance and development occurs. Resolve monthly outstanding balances in Dummy accounts. Ensure cash reconciliation process between deposits and posting of accounts and any unresolved issues are followed up on and escalated. Coordinates and assists with the annual audit. Partnering with finance, reimbursement, accounting and vendors to resolve escalated issues. Oversee daily operations by removing barrier to production, ensure adequate staffing level through work assignment, time off management and shift schedules. Review and interpret Electronic Remittance Advice (ERA) files or Explanation of Benefits (EOB) to ensure they balance to the corresponding Electronic Transfer Fund (EFT) Deposits. Contact insurance carriers and utilize payer websites to obtain necessary information for processing of EFT deposits. Review and update patient accounts to reflect the correct Financial Classification (FC), Contract ID (CID) and Insurance key based on the Electronic Remittance Advice Query to ensure accounts reflect payment from the correct payer. Review outstanding Electronic Remittance Advice (ERA) batches for assigned payers to ensure timely posting and aging requirements are met. Aging is to be kept within 45 days of creation date. Post Electronic Payments and Denials in the Electronic Funds Transfer (EFT) tab in Payment Automation Reconciliation Manager (PARM) application and CPU/AS400 Billing System. Review Open Batch Query to resolve outstanding aging electronic batches. Review proposed refunds for appropriateness. Oversee the funds verification and paper to electronic processes. Complete activities related to Billing Team inquiry on payments pending for outstanding patient accounts receivable. Liaison with outside agency companies to ensure statement processing and payments on individual patient accounts flow timely and are accurate. Outreach to patients to avoid collection agency referrals. Monitor and report out daily call volumes. Monitor and report out call abandonment rate. Work with staff to understand adverse trends for patient calls. Remain current on federal, state and hospital regulations and policies associated with patient reimbursement through a variety of educational methods. Maintain current knowledge of payment posting practices by attending meetings, training sessions and seminars. Maintains policies and procedures for cash management functions (posting, refunds, adjustments and patient collections) DCH Standards: Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation. Performs compliance requirements as outlined in the Employee Handbook Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self. Performs essential job functions in a manner that ensures the safety of patients, visitors and employees. Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees. Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees. Requires use of electronic mail, time and attendance software, learning management software and intranet. Must adhere to all DCH Health System policies and procedures. All other duties as assigned. Bachelor's Degree in Business, Finance, Accounting or Health Management preferred.
Two years supervisory experience required.
Strong analytical skills required.
Good communication skills.
Must obtain CPAR certification.
Knowledge of health care revenue cycle is preferred.
Must be able to read, write legibly, speak, and comprehend English.
WORKING CONDITIONS: WORK CONTEXT Coordinate and lead others Deal with external customers/vendors Provide business appropriate letters, memos, and emails Public speaking Work well within a group or team Freedom of decision making without supervision Understanding impact of decisions on the Health System Fast-paced and under time pressure PHYSICAL FACTORS The Americans with Disabilities Act (ADA) requires the job description to document physical factors, including ability, activities, and requirements. Ability: Gross Body Equilibrium and Coordination. Activities: Talking, hearing, walking, repetitive motion, standing, and/or using hands to handle, control, or feel objects, tools or controls. Requirements: Please indicate the physical requirements of the job as one of the following: Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work. Must be able to perform the duties with or without reasonable accommodation. Hearing and vision must be normal or corrected to within normal range. Physical presence onsite is essential. OTHER JOB FACTORS Deductive reasoning, fluency of ideas, problem sensitivity, oral comprehension, oral expression, written expression, speed of closure. Achieve goals set forth in job, ability to adapt to surroundings and continuous change, attention to detail, initiative, independence, stress tolerance, leadership, integrity and cooperation. Ability to build relationships, create a support structure for those in the Health System, provide recognition to those achieving the accolades, and satisfy work task independently.
