Patients' Account Manager - Outlier Unit, Revenue Cycle Admin - Nyc Health Hospitals : Job Details

Empower Every New Yorker - Without Exception - to Live the Healthiest Life PossibleNYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city's five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.Job DescriptionWithin the Centralized Billing and Follow-up Unit manage the Outlier Billing and Follow-up unit within the Revenue Cycle Services team. The Manager for the Outlier Billing and Follow-Up is responsible for daily operational performance of the unit's tasks; reviewing accounts, correcting claim edits, preparing and completing claims for submission to payers and updating patient accounting systems.Under the direction of the Director of Centralized Billing responsible for the performance of the Outlier Unit. Assign work queues, direct work, research and respond to claim escalations and guide the unit on daily production.General tasks and responsibilities will include:

• Provide overall supervision to the Outlier Unit staff
• Ensure unit's quality and timeliness of responses to IPRO and managed care plan requests for itemized bills, medical records and other documentation requests to achieve additional reimbursement.
• Identify payors and their vendors denial trends to proactively address issues
• Document and track the progress of appeals and give detailed updates on the status of cases
• Stay current with guidelines specific to Outlier workflow from CMS and eMedNY
• Lead unit huddles, workgroups and give feedback and insights on work processes
• Prepare and review reports on unit productivity
• Lead billing and follow-up special projects for revenue improvement
• Confirm timely follow-up with payers on unresolved issues
• Use work queue monitoring and dashboard tools to ensure unit claims are processed efficiently and with highest value claims receiving required attention.
• Interpret H+H, city, state & federal rules & regulations and apply appropriately to claims
• Seek to identify patterns and processes impacting outlier claims impacting reimbursement and escalate
• Perform customer service and/or billing inquires for patients presenting with account issues, billing issues, etc.
• Provides overall supervision to the unit; approve leave requests; ensure adequate coverage, post and fill for unit vacancies
• Performs annual and periodic performance evaluations of subordinate personnel, and sets team standards and priorities;
• Perform all other duties, as assigned by the Patient Account Director

Minimum Qualifications

A Baccalaureate degree from an accredited college or university with a major in accounting, finance, business administration or related field; and,

Four (4) years of experience in accounting, finance or business administration of which two (2) years must have been in a responsible and managerial capacity in areas normally related to a hospital, medical center or health care facility; and,

Two (2) years of experience as indicated in Item #2 in areas related to the management of patients' accounts or credits; or,

A satisfactory equivalent combination of experience, education and training.

If applying online, please include your cover letter in the same file attachment with your uploaded resume.NYC Health and Hospitals offers a competitive benefits package that includes:

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Loan Forgiveness Programs for eligible employees
• Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
• College tuition discounts and professional development opportunities
• Multiple employee discounts programs