• PATIENT FINANCIAL SERVICES MANAGER

    Job Locations US-AK-Juneau
    Job ID
    2019-4096
    Category
    ACCOUNTING/FINANCE/REVENUE CYCLE
    Type
    Regular Full-Time/80hrs (1.0 FTE)
  • About Us:

     

    SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.

     

    Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health, dental, and vision benefits, life insurance and long and short-term disability, and more.

     

    Job Overview:

    The Patient Financial Services (“PFS”) Manager is responsible for the oversight of daily operations and functions of PFS. This individual provides the necessary support and leadership to achieve departmental goals and objectives. Oversees functions related to: insurance billing and follow-up, self-pay billing and follow-up, cash posting and ERA management, staff supervision and productivity, customer service and ongoing improvements to revenue cycle key performance indicators. 

    Responsibilities:

    • Staff Supervision: Determine the qualification and competence of PFS team members. Executes this tactically through orientations, training, and performance evaluations. Supervises schedule, time-off requests, and other administrative actions.
    • Insurance Billing and Follow-Up: Ensure proper charge capture, billing and adjudication of claims in accordance with federal, state and private billing guidelines. Identify, analyze, and reconcile billing errors or omissions. Monitors Discharged Not Final Billed (DNFB) to determine necessary actions required to minimize the volume and value of accounts being held. Review and approve payer refund request. Responsible for analyzing data, identifying trends and escalating for payer relation bulk resolution. Ensure maximization of reimbursement for all payers. Tracks and trends denials and provides feedback to Revenue Cycle divisions.
    • Cash Posting & ERA Management: Ensure accurate posting of all cash, checks, credit cards, and electronically transferred funds to beneficiary and non-beneficiary accounts within 3 business days of cash deposit. Ensure the accuracy and timeliness of updating the patient accounting cash log. Balance all deposits and transactions posted to systems against unallocated general ledger.
    • Self-Pay Billing and Follow-Up: Ensure validation of patient balances, billing and follow-up on accounts. Responsible for ensuring the Patient Billing Hotline is operating in accordance with policy. Review and approve patient refunds.
    • Escalation and Special Projects: The Manager is the primary point of escalation for priority work items from staff in the department and throughout the consortium. Acts as the primary point for issues that arise from customer service events. Monitor, track, trend, and resolve patient complaints in a timely manner. Identifies, recommends and implements value added process improvement within the department to increase efficiency or reduce waste. Assist with special projects as assigned from Revenue Cycle Leaders or CFO.
    • Compliance and Regulation: Maintains knowledge of current regulations and policies of the Federal, State and private payers. Stay current on changing regulatory and billing guidelines. Stays abreast of latest developments and trends in the field of Patient Financial Services by attending seminars/workshops. Keeps impacted departments informed of changes, revisions, and updates. Assists in the maintenance of organization policies, procedures, forms and manuals.   

    Qualifications:

    Education/Experience

    • Bachelor’s Degree*
    • 5 years’ leadership experience in a healthcare business office

    *Degree requirement can be waived on a year for year basis of combined relevant experience and education

    Certifications

    • Certified in CRCR or CRCS Required, or must be obtained within one year of hire
    • Cerner Revenue Cycle certification or experience preferred

    Knowledge, Skills & Abilities

    • Advanced knowledge and working ability in hospital and clinic billing as well as insurance follow up in those areas.
    • Knowledge of IHS and non-IHS insurance billings, and procedures, federal rules and regulations regarding hospital billing.
    • Advanced knowledge of payor remittances and cash posting
    • Advanced knowledge of major insurance companies billing policies to ensure compliance
    • Advanced knowledge of insurance claim forms
    • Knowledge of ICD-10, CPT’s, HCPCS, and Revenue Codes
    • Knowledge of medical terminology
    • Demonstrated experience in computerized revenue functions, KPI’s and trend analysis.
    • Knowledge of specific specialties within the hospital or clinic billing area
    • High aptitude to learn new concepts and adapt to changing regulatory/payor billing and follow-up rules
    • Proficient at reconciling and balancing of payments received against account receivables.
    • Proficient using a keyboard and 10-key.
    • Proficient in Microsoft Office programs (i.e. excel, word)
    • Highly motivated, self-starter
    • Attention to detail and accuracy
    • Good organizational skills
    • Good communication skills both orally and written
    • Problem solving and decision-making skills
    • Ability to work on different projects simultaneously
    • Ability to collaborate within cross-functional teams
    • Ability to work in a fast-paced setting

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