Manager of Patient Accounts - Beacon Health System : Job Details

Summary

The Manager of Patient Accounts is primarily responsible for organizing, planning and managing daily collections and billing activities. This position maintains responsibility for the overall level of dollars and days outstanding in both patient receivables and insurance receivables along with the control of uncompensated care.

Detailed Responsibilities

Manages all activities related to self pay collections and external collection agencies by:

* Acting as a liaison with collection agencies and evaluating their performance regarding bad debt accounts.

* Preparing and analyzing reports and recommending strategy changes designed to improve such things as collection procedures.

* Ensuring external collection agents are operating within the values and mission of Beacon Health System.

* Monitoring the performance of external collection agents to ensure the maximum return of investment for Beacon Health System.

* Maintaining good working relationships with all collection agents to ensure all problems are addressed in a timely manner and also ensuring that outstanding customer service is provided.

Coordinates the daily activities of Customer Service and Cash Application assigned areas by:

* Addressing and resolving patient and third-party questions, concerns, complaints and requests in an efficient, prompt and courteous manner.

* Establishing payment plans and responding to questions for related information by explaining payment options and alternatives to patients and guarantors in accordance with Hospital policy.

* Ensuring that patient financial history is gathered and completed in a timely manner. Also ensuring the information is correct and documented in order to optimize reimbursement and minimize payment denials and delays.

* Ensuring that the needs of the Organization and the Department are met while also maintaining alignment with the financial performance goals of the Department and the organization.

* Developing strong working relationships with local and state agencies to ensure maximum communication and the coordination of requirements that are necessary to qualify patients for assistance.

* Overseeing the functions of cash application, bank deposit, record keeping, daily posting records and deposit files.

Coordinates the daily activities of Billing and Third Party Follow-up assigned areas by:

* Monitoring the quality and quantity of billing to ensure departmental and Hospital standards are met or exceeded.

* Coordinating third-party follow-up, as needed, to help reduce accounts receivable.

* Facilitating the staff's investigation and response to inquiries and problems to ensure consistent and timely resolution.

* Communicating updates about governmental regulations (and Medicare/Medicaid) to the staff in order to ensure compliance; also utilizing websites to obtain these updates.

* Monitoring reports to ensure all the appropriate charges are correct and the claim is ready for billing.

* Monitoring staff productivity by running aging reports and following up with them.

* Monitoring write-offs to ensure proper approvals have been obtained and written off to the appropriate transaction codes.

* Overseeing the insurance audit process to ensure the external auditors follow our policies and procedures.

* Managing all activities related to the transmission of all electronic claims (i.e., edit problems or edit changes and the daily download of claims).

* Identifying download problems and coordinating the resolution of these problems with the Information Systems Department.

* Managing all activities related to the refunding of overpayments and refunds (for example, patients, third-party payers and governmental agencies).

Manages the daily activities of assigned areas by:

* Assists with the development and administration of the departmental budget to provide efficient and cost effective utilization of resources to achieve agreed upon goals and objectives.

* Monitoring the quality and quantity of billing to ensure departmental and Hospital standards are met or exceeded.

* Providing ongoing technical guidance and assistance to the staff (for example, providing training regarding departmental policies/procedures and practices).

* Planning and coordinating ongoing job-related training and education for the staff and providing a comprehensive orientation for new staff.

* Developing short and long-term goals and objectives for assigned areas and implementing departmental policies and procedures that will ensure goals and objectives are met.

* Preparing and conducting Performance Reviews for the staff. Also providing feedback related to job performance and productivity to the staff.

* Providing ongoing support and maintenance of various computer systems (and overseeing the resolution of problems as necessary).

* Ensuring compliance with the requirements of various regulatory agencies.

Qualifications

Education and Experience

* The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a Bachelor's degree in Business Administration, Finance or equivalent. Demonstrated successful billing and/or credit collection experience is required. Preference will be given to candidates with three to five years of management experience in a healthcare environment.

Knowledge & Skills

* Requires a thorough knowledge of consumer credit laws and the laws and regulations pertaining to the extension of credit to patient.

* Requires knowledge of Medicare/Medicaid and third-party payer practices and procedures and ICD CM coding, as they apply to patient account billing and automated information systems.

* Requires a solid understanding of the Star system.