Manage the day-to-day activities of the staff supervised on site or remotely for a client hospital.
Focus the team’s efforts and ensure diligent team follow-up are crucial to this position.
Leadership capabilities such as answering relevant questions, setting goals, allocation of resources, monitoring, trending of AR and staff accountability are essential.
Hands-on training of staff is a key element of this role.
Monitor the status of outstanding patient accounts, identifying and resolving billing errors and claim denials.
Conduct weekly team meetings driving revenue cycle performance needs and continued training, maintain and track SOP’s and process improvement processes.
Conduct thorough reviews of patient accounts to ensure accuracy of billing codes, patient demographics, and insurance information.
Implement strategies to improve collection rates and reduce outstanding accounts receivable.
Follow up on complex payer trends, communicate with Management the volume and specific issue along with researched payer specific guidelines.
Generate regular reports on team performance, including key metrics performance, data to identify potential issues and develop solutions to improve efficiency and revenue cycle management working with Management and escalate trends to Management.
Mentor and monitor team performance against key metrics goals and monthly collection goals, reduced denials, and productivity met 95% or better.
Identify areas for improvement and implement action plan to resolve payer and denial challenges.
Provides information regarding patient accounts in response to inquiries, safeguarding confidential information in verbal replies and correspondence.
Overseeing daily billing and collections for all AR financial classes (Medicare, Medicaid, Worker’s Compensation, BCBS, HMOs/PPOs, commercial insurance, self pays, etc.)
Interprets and follows up on contracts with insurance companies pertaining to rates, discounts and filing instructions.
Proper utilization of federal and state credit collection regulations and guidelines
Properly handles HR related issues including but not limited to new hire orientation, staffing coverage, time off approvals, timecards, counseling/discipline, and evaluations.
Monitor staff productivity
Coordinates agenda(s), presents findings on all scheduled conference calls
Requirements
Minimum five (5) years of general hospital business office billing and collections experience, with at least 2 years of Manager level experience
A proficient understanding of medical office or medical terminology training
Strong analytical skills to identify and resolve complex billing issues
Ability to read and write to perform calculations, prepare reports with supporting documentation
Intermediate Excel skills preferred.
Direct experience in leading teams of 10+ members to collect insurance A/R, drive cash, and increase productivity
A high level of professionalism displayed by appearance and conduct
Understanding of relevant RCM KPIs to analyze and plan strategies to increase cash and reduce AR and AR concepts.