The Patient Receivables Manager is responsible for ensuring that the financial systems are operational and effective ensure fee-for-service estimates are correct, analyze payer contracts, revenue cycle, operations, and decision support to resolve net revenue issues.
BENEFITS
- Free Medical, Dental & Vision
- 13 Paid Holidays + PTO
- 403 (B) retirement match
- Life Insurance, EAP
- Tuition Reimbursement
- Flexible Spending Account
- Continued workforce development & training
- Succession plans & growth within
QUALIFICATIONS
Education and Experience
- Five (5) years of experience with revenue cycle operations management. With excellent presentation and writing skills. Advanced skills in analysis and MS Office suite. eClinical Works experience is preferred.
- Required bachelor’s degree in business, Finance, Accounting, Healthcare Administration or equivalent.
- Demonstrated knowledge of all Insurance companies, HMO’s, PPO’s Government and State programs Medi-Cal and Medicare, and third-party payers.
- Experience with managing revenue cycle processes including Medicaid and Medi-Cal eligibility, health information management and billing, and charge capture processes.
- Experience responding to government and financial Audits is a plus.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Performs a combination, but not necessarily all, of the following duties:
- Maintain knowledge of, Medicare, Medi-Cal, HMO, PPO and publicly funded programs Family PACT and grants.
- Communicate to Director of Patient Receivables and Billing and other colleagues to stay informed of payer and/or regulatory updates and create action plans to accommodate changes as needed.
- Engage colleagues to facilitate educational and workflow/process opportunities identified by team to improve documentation, billing, and clinical operations.
- Continually develop processes, policy procedures and controls to drive revenue integrity.
- Analyze insurance contracts/contract requirements, and fee schedules.
- Maintain positive external contacts, attending all pertinent meetings and trainings related to billing.
- Create and expand procedures of Revenue Cycle Department including cross training of Revenue Cycle personnel.
- Assist with the filing of Medi-Cal Reconciliation, and Medicare Cost Reports and HRSA site visits. This also includes researching discrepancies and reconciling of the prior years’ reports.
- Support staff with training and communication of pertinent information affecting the team and other stakeholders.
- Collaborate with Clinical Management Team on workflow and ensures that office-oriented directives and policies and procedures are implemented in a timely manner. This role has the primary responsibility of creating all necessary procedure guidelines to instruct the Billing and Clinic Support Staff on all revenue-oriented tasks.
- Assist with Payer Enrollment planning, direction, control, and evaluation of the Payer Enrollment Department.
- Attend administrative meetings and participate in committees as requested. Conduct special projects and studies as directed.
- Assist in maintaining eClinical Works patient accounting and registration system tables for registration, patient accounting, eligibility, charge master’s maintenance, billing, claims editing, and account follow-up.
- The Patient Receivables Manager oversees the day-to-day leadership and management of the collections, accounts receivables, and account resolution management.
- Display independent judgement by willingness to make timely and accurate decisions based on available information that is sometimes vague or limited in nature.
- Strong research and auditing skills.
- Ability to prioritize tasks and projects with limited direction, while understanding and contributing to the success of the organization.