Location: NHRMC Business Center A
Department: Patient Accounts
Full Time Equivalent: FTE: 1.000000
Work Type: 64 to 80 Hours Pay Period
Work Schedule: STD HRS - Standard-Exe or Office w flex
Exempt from Overtime: Exempt: Yes
Works under the supervision of the Director of Patient Financial Services to plan, coordinate, implement, control, and evaluate the operations of Patient Accounts. The daily operations will be managed to ensure patient satisfaction, employee satisfaction and maximum reimbursement for hospital services rendered to patients. Also, helps coordinates physician and staff education regarding the compliance requirements for government and commercial payors. Reviews government regulations as they concern coding guidelines, billing changes and assists with implementation of necessary changes to keep the organization in compliance with these regulations. Responsible for 52 FTEs and budget of 2 million.
1. Identifies and implements solutions to performance issues consistent with the organization’s vision and values that affect patient outcomes and reimbursement.
2. Maintains excellent working relationships with Medical Center departments, while representing the department’s interest in interdepartmental activities to anticipate and respond to changes occurring within the Medical Center. Works collaboratively and effectively with other departments in achieving Revenue Cycle goals and objectives.
3. Provides management and coordination of activity to ensure the department moves toward the same goal, consistent with the philosophies and mission of the medical center.
4. Takes necessary actions to ensure goals are met/surpassed in the following areas: Cash collections, A/R aging, A/R days, Denials and Bad debt.
5. Ensures that underlying problems represented by customer inquiries of concerns are identified, addressed and resolved; analyzing the current hospital environment for needs that the department can address to improve the experience of patients and physicians related to billing and reimbursement.
6. Ensures efficient cost effective use of department resources (system capabilities, staff, and non-staff costs) and maintenance of department expenditures within budget.
7. Supervises, manages, and evaluates staff responsible in Patient Accounts. Develops qualifications and job descriptions for staff involved in these activities. Communicates timely to the Director any variance in staffing required to perform necessary PFS functions.
8. Assumes responsibility for ensuring adequate and competent staff through on going performance feedback, timely review of performance, and appropriate disciplinary actions within the hospital policies and procedures.
9. Initiates and monitor the ongoing training and education of staff to maintain competency and regarding process and regulatory changes. Ensures on-going staff competency and productivity for all assigned areas of responsibility.
10. Promotes employee satisfaction by responding to and resolving personnel requests and concerns when they occur.
11. Monitors and evaluating the changes in regulatory and reimbursement environment and help develop strategic plans to deal with these changes as they impact the Medical Center.
12. Monitors vendor activities on a regular basis addressing and documenting performance issues timely.
13. Creates/updates departmental policies and procedures. Develops and maintains tracking tools needed to monitor billing, collections, and cash activities.
14. Coordinates efforts to assure government regulatory compliance guidelines are met to ensure services provided to patients are medically necessary and meet criteria under these agencies.
15. Provides education to physicians, as needed, to enhance clinical documentation to be compliant with regulatory agencies.
16. Maintains professional and regulatory compliance expertise, as it relates to billing and coding guidelines, through continuing education, attendance at conferences and workshops and review of current literature.
* Bachelors Degree
1. Education: Bachelor of Science/Bachelor of Arts degree required. Master’s degree preferred.
2. Licensure/Certifications: CPAM preferred
3. Experience: 5 years in healthcare finance and five years experience in management required.
Demonstrates standards of performance (ownership, teamwork, communication, compassion) that support patient satisfaction and principles of service excellence.
Performs other duties as assigned.
Individual will possess commensurate combination of education, experience and qualifications.