Job Summary

Utilize billing systems to their maximum potential to coordinate and manage the day-to-day functions of billing, and collection of patient receivables. Plan, organize, and implement policies and procedures to ensure effective collection of patient account receivables and minimize bad debt while remaining responsive to state and federal billing and collection regulations as well as new developments in the industry. Supervise Accounts Receivable staff to ensure productivity goal are being met. 

Responsibilities

Monitor aged AR balances as well as DNFB and DNFC to ensure discrepancies are resolved in a timely manner and claims are billed timely and accurately

Establish appropriate procedures for follow-up with payers

Perform Quality Assurance audits to ensure proper billing and follow up procedures are being followed.

Develop and monitor goals and objectives for Patient Accounts department and provide honest and constructive feedback.

Analyze claim denials, identify trends, and implement strategies to prevent future denials

Hold staff accountable for meeting established billing and follow up productivity goals

Plan for changes in third part reimbursement mechanisms, in advance of their occurrence whenever possible, and adjust departmental policies and procedures accordingly

Prepare monthly, quarterly, annual, and adhoc reports as requested.

Exhibit professional competence and assume responsibility for maintaining professional growth and development

Ensure billing and follow up procedures are in compliance with HIPAA and other healthcare regulatory guidelines.

Monitor KPI such as Days in AR, clean claims rate etc. to ensure department goals are being met. 

Preferred Skills:

Strong analytical skills to interpret financial data, identify trends, and make informed decisions to promote optimal AR strategies

Proven ability to lead and motivate a team to achieve performance goals

Ability to troubleshoot complex billing issues, resolve disputes with payers, and identify solutions to improve AR performance

Effective communication skills to interact with patient, insurance companies, internal stakeholders and healthcare providers.

Familiarity with healthcare billing software, electronic claims submission platforms, and data analysis tools.

HFMA CRCR Certification is a plus, but not required.

Knowledge, Skills & Abilities

Patient Group Knowledge (Only applies to positions with direct patient contact)

The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department’s identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients.

Competency Statement

Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.

Common Duties and Responsibilities
(Essential duties common to all positions)

1. Maintain and document all applicable required education.
2. Demonstrate positive customer service and co-worker relations.
3. Comply with the company's attendance policy.
4. Participate in the continuous, quality improvement activities of the department and institution.
5. Perform work in a cost effective manner.
6. Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations.
7. Perform work in alignment with the overall mission and strategic plan of the organization.
8. Follow organizational and departmental policies and procedures, as applicable.
9. Perform related duties as assigned.

Education 

• Bachelor's Degree (Required) Education: Bachelor Degree can be in Business, Healthcare Admin, or related field. May substitute 10 yrs of Accounts Receivable Managment Experience

Credentials 

• No Certification, Competency or License Required

Work Schedule: Days

Status:  Full Time Regular 1.0

Location: General Hospital

Location of Job: US:WV:Charleston

Talent Acquisition Specialist: Tamara B. Young tammy.young@vandaliahealth.org