Address
Form of work
SalaryOverview:
Provide appropriate and effective management for the Patient Financial Services (PFS) Department, as part of the Revenue Cycle for Mercyhealth. Requires close communication with related Revenue Cycle areas such as Patient Access and Admissions, Coding and Data/Charge Entry, Managed Care Contracting and Denials Management along with leadership from departments across the system. Patient Financial Services is the centralized billing, d claims processing cash, refunds and customer service departments that support professional and facility billing and collections system-wide. This position requires a high level of project management, professional awareness, emotional intelligence, analytical abilities and technical knowledge related to software and other information systems used within the Revenue Cycle. Other duties and projects as assigned. Responsibilities:
Culture of Excellence Behavior Expectations
Education and Experience
Certification and Licensure
Skills and Abilities
Ability to think independently. Must use good judgment extensively. Very high degree of analytical and trouble-shooting skills required.
Ability to take initiative by identifying problems, conceptualizing resolutions to the problems and implementing change.
Solid understanding of the information systems used in the billing and collection process.
Analytical - Collects, analyzes and researches data to problem-solve and make sound decisions; Uses intuition and experience to complement data.
Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in groups to find solutions to difficult or complex problems; Uses reason even when dealing with emotional topics and does not allow emotion to drive decisions.
Project Management - Applies processes, methods, skills, knowledge and experience to achieve specific project objectives. Develops and coordinates project plans; Communicates effectively throughout project lifecycle on risks of project deliverables.
Technical Skills - Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and obtains clarification; Responds well to questions; Participates in meetings; Demonstrates group presentation skills.
Written Communication - Edits work for spelling and grammar; Presents numerical data effectively; Able to read and interpret written information; Can prepare clearly written procedures for others.
Change Management - Communicates changes effectively, monitors transition and communicates results while mitigating disruption.
Leadership - Exhibits confidence in self and others; Effectively influences actions and opinions of others; Accepts feedback from others.
Ethics - Treats people with respect; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
Organizational Support - Follows policies and procedures; Supports organization's goals and values.
Judgment - Displays willingness to make difficult decisions understanding overall organizational impacts; Exhibits sound and accurate judgment;
Motivation - Sets and achieves challenging goals; Measures self against standard of excellence.
Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Develops realistic action plans and communicates with leadership.
Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. Takes initiative to maintain and enhance technical and interpersonal skills.
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent.
Dependability - Follows instructions, responds to management direction; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
Initiative - Volunteers readily; Undertakes self-development activities; Seeks increased responsibilities; Looks for and takes advantage of opportunities; Asks for and offers help when needed.
Mathematical Skills - Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Language Skills - Ability to read, analyze, and interpret general business periodicals and technical and manuals. Ability to write reports and procedure manuals.
Reasoning Ability - Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Computer Skills - To perform this job successfully, an individual should be familiar with automated accounting systems and be proficient in Excel and Access. Knowledge of word processing software and PowerPoint is helpful. Requires extensive knowledge of the types of programs used in healthcare and the ability to learn new software.
Special Physical Demands
Level of Supervision
Supervises
This position is Hybrid. The expectation is for the manager to be in the Rockford office (JBH Rockton) one day a week, and in the Janesville office (MCB) one day a week.
Provide appropriate and effective management for the Patient Financial Services (PFS) Department, as part of the Revenue Cycle for Mercyhealth. Requires close communication with related Revenue Cycle areas such as Patient Access and Admissions, Coding and Data/Charge Entry, Managed Care Contracting and Denials Management along with leadership from departments across the system. Patient Financial Services is the centralized billing, d claims processing cash, refunds and customer service departments that support professional and facility billing and collections system-wide. This position requires a high level of project management, professional awareness, emotional intelligence, analytical abilities and technical knowledge related to software and other information systems used within the Revenue Cycle. Other duties and projects as assigned.
Essential Duties and Responsibilities
- Strong leadership, management, judgement, and presentation skills
- The manager will be articulate, analytical, and a team player who understands the power of data in healthcare.
- In-depth working knowledge of all applications used by PFS partners such as: Epic, Vispa, ArcProtect, Mercyhealth intranet, Mercyhealth SharePoint, Kronos, Halogen, HRLink, Onbase, and Rightfax.
- Travels to staff locations to serve as support to teams.
- Maintains open communication with extensions of the Mercyhealth's Follow up efforts through the use of extended business office resources when applicable.
- Responsible for management and supervision of all third-party accounts receivable and staying aware of all current third-party reimbursement requirements. This includes but is no limited to Medicare, Medicaid, Blue Cross, Workers' Compensation, Commercial and Managed Care.
- Responsible for the oversight of Patient balances, statement processes and self-pay collections, including any extended business office oversight.
- Responsible for the oversight of cash posting processes to ensure proper balancing and application of funds.
- Responsible for the oversight of refunding both patient and payer refunds within policy guidelines.
- Responsible for managing the performance, workflow and service standards of Patient Account Customer Service Representatives in a call center environment to resolve billing and payment issues and collect payment.
- Responsible for managing the oversight of Billing functions and Candidate for Billing metrics to ensure clean claim rates as well as the timely billing metrics are monitored.
- Responsible for handling escalated patient and customer issues ensuring customer satisfaction goals are maintained.
- Maintain formalized monitoring and measurement system to ensure that the revenue cycle process is achieving third-party collection goals.
- Responsible for ensuring compliance for billed accounts as well as ensuring quality and minimizing denials. Meets goals related to accounts receivable, bad debt, and other financial reporting measures.
- Identifies improvement opportunities and documents work-flow processes and procedures. When necessary, develops and implements policies to maintain proper workflow and accountability.
- Develop and maintain relationships with vendors and payers to facilitate collections.
- Maintain a thorough knowledge of Project Management principles and methodologies and skilled at participating in multi-disciplinary projects.
- Conduct employee performance reviews, discussing pertinent review findings and recommendations. When deficiencies are noted, develops performance improvement plans and monitors employee performance to assure that corrective action is taken.
- Responsible for ensuring that standard process discipline is adhered to. Ensures that high performance work team is developed through coaching or mentoring.
- Lead or participate in other system-wide committees to improve quality, compliance or other initiatives.
- Ability to effectively lead teams and meetings.
- Develops and remains accountable to budgets related to assigned cost centers.
Culture of Excellence Behavior Expectations
To perform the job successfully, an individual should demonstrate the following behavior expectations:
Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.
Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.
Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.
Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.
Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.
Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.
Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.
Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.
Education and Experience
Bachelor's degree in Business Administration, Health Care Administration, or related field required. Master's degree preferred. Three to five years of management experience in a healthcare or related field required. Experience in managing a variety of projects with successful outcomes. Must be fluent in information systems-Microsoft Office Word, Excel programs and reporting software. Knowledge of healthcare information systems environment, Epic preferred.
Certification and Licensure
N/A
Skills and Abilities
Ability to think independently. Must use good judgment extensively. Very high degree of analytical and trouble-shooting skills required.
Ability to take initiative by identifying problems, conceptualizing resolutions to the problems and implementing change.
Solid understanding of the information systems used in the billing and collection process.
Analytical - Collects, analyzes and researches data to problem-solve and make sound decisions; Uses intuition and experience to complement data.
Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in groups to find solutions to difficult or complex problems; Uses reason even when dealing with emotional topics and does not allow emotion to drive decisions.
Project Management - Applies processes, methods, skills, knowledge and experience to achieve specific project objectives. Develops and coordinates project plans; Communicates effectively throughout project lifecycle on risks of project deliverables.
Technical Skills - Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and obtains clarification; Responds well to questions; Participates in meetings; Demonstrates group presentation skills.
Written Communication - Edits work for spelling and grammar; Presents numerical data effectively; Able to read and interpret written information; Can prepare clearly written procedures for others.
Change Management - Communicates changes effectively, monitors transition and communicates results while mitigating disruption.
Leadership - Exhibits confidence in self and others; Effectively influences actions and opinions of others; Accepts feedback from others.
Ethics - Treats people with respect; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
Organizational Support - Follows policies and procedures; Supports organization's goals and values.
Judgment - Displays willingness to make difficult decisions understanding overall organizational impacts; Exhibits sound and accurate judgment;
Motivation - Sets and achieves challenging goals; Measures self against standard of excellence.
Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Develops realistic action plans and communicates with leadership.
Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. Takes initiative to maintain and enhance technical and interpersonal skills.
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent.
Dependability - Follows instructions, responds to management direction; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
Initiative - Volunteers readily; Undertakes self-development activities; Seeks increased responsibilities; Looks for and takes advantage of opportunities; Asks for and offers help when needed.
Mathematical Skills - Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Language Skills - Ability to read, analyze, and interpret general business periodicals and technical and manuals. Ability to write reports and procedure manuals.
Reasoning Ability - Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Computer Skills - To perform this job successfully, an individual should be familiar with automated accounting systems and be proficient in Excel and Access. Knowledge of word processing software and PowerPoint is helpful. Requires extensive knowledge of the types of programs used in healthcare and the ability to learn new software.
Special Physical Demands
The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.
While performing the duties of this job, the employee is regularly required to stand, walk, sit; handle, finger, feel, reach with hands and arms, talk, hear, and use hands to operate a keyboard repetitively. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus, particularly as it relates to computer screens.
While performing the duties of this job, the employee is regularly required to stand, walk, sit; handle, finger, feel, reach with hands and arms, talk, hear, and use hands to operate a keyboard repetitively. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus, particularly as it relates to computer screens.
Level of Supervision
Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems; employee adherence to annual education and certification requirements
Supervises
Directly supervises staff including supervisors, leads, coordinators. Supervisory responsibilities are conducted in accordance with directives of management, the organization's policies, and applicable laws.
