Manager Patient Financial Services Hb Government Billing

Job Description:
Under the general supervision of the Director-Patient Financial Services (PFS), directs, plans, organizes and controls the activities and functions related to the billing and follow up of assigned payer group (e.g., non-government). Provides PFS operational oversight as needed; and monitors daily work activities including work queues and dashboards. Provides direct supervision of the assigned billing supervisor, and has oversight of and responsibility for 15 to 24 FTE.
Duties and Responsibilities

1. Responsible for the overall billing and follow up of all Non-Government related payers including all commercial, Blue Cross, Highmark, HMO as other miscellaneous payers classified as Non-Government payers, including denial work queues.
2. Ensures all regulatory guidelines are being met in all phases of the Non-Government Billing revenue cycle.
3. Monitors productivity and work standards and compares to benchmarking data.
4. Monitors daily Workqueue activity and review and analyze daily/weekly/monthly billing reports to ensure timely filing.
5. Directs the audit activity for payments, allowances and rejected claims to identify and resolve problems.
6. Promotes/organizes staff development via in-service workshops and external educational opportunities.
7. Assists the Director in the development, implementation and analysis of protocol standards/work methodology consistent with industry trends and departmental objectives.
8. Researches policies/procedures for third party payers. Make changes to established workflows consistent with the payer policies/procedures in order to assure accurate billing and correct reimbursement.
9. Represents PFS on various committees as assigned.
10. Acts on behalf of the Director as needed and serves as a liaison between PFS and other departments to ensure a consistent flow of information.
11. Assists with system conversion activities as needed.
12. Provides PFS operational supervision (in absence of Director) as needed.

Qualifications

• Minimum Experience:
  • 3 - 5 years
  • Experience with Medicare Billing and Regulations
  • Experience with Medicaid Billing and Regulations
  • Experience with Medicare/Medicaid Managed Care Billing and Guidelines
  • Strong attention to detail
  • Experience with RTP's and Payor Rejection Resolution
  • Epic experience preferred
  • Epic dashboards/reporting a major plus
  • Experience with AR mgmt.

• Min Field of Expertise: Accounting; business administration

• Minimum Education:
  • Bachelor's Degree

• Preferred Certification:
  • Certified Revenue Cycle Professional (CRCP) or Certified Revenue Cycle Executive (Preferred)
  • Certified Healthcare Financial Professional (CHFP) or Certified Revenue Cycle Representative (CRCR)

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