Description

Job Summary: 

This position is responsible for the day-to-day overall management of all Self-Pay performance, and uncompensated care operation analysis for Patient Accounts and Collection Receivables.  This role includes collaborative oversight of third-party vendors, productivity management (work queue), analysis of self-pay operations, KPI reporting, and research of escalated grievances forwarded from GoHealth executives, and regulatory agencies such as the Department of Justice, Attorney General, and Better Business Bureau.

Education:

• High School Diploma or GED required
• Associate’s or bachelor’s degree in Business Administration, Healthcare Management, or five (5) or more years of related field experience preferred Associate’s or Bachelor’s degree in Business Administration or a related field

Work Experience: 

• 5 years of healthcare experience required
• 3 years of progressive management experience required

Required Licenses/Certifications

• CPAR – Certified Patient Account Representative preferred by Georgia
• CRCR – Certified Revenue Cycle Representative preferred by HFMA (National Healthcare Financial Management Association)

Additional Knowledge, Skills, and Abilities RequiredStrong knowledge of the Accounts Receivable process

• Strong knowledge of the Accounts Receivable process. 
• Strong knowledge of Patient Access or Patient Account Review.
• Analytical skills related to key performance indicators relevant to this role.
• Strong knowledge of process and understanding of practice management system

• EPIC and/or eClinicalWorks experience preferred
• Experience with Excel (VLookUp and Pivot tables) preferred

Essential Functions: 
Administrative:

• Assists with the implementation of new markets and partnerships for the Patient Account Services and Medical Records Release teams.
• Interviews, hires, and evaluates the performance of the department and team members.
• Establishes and achieves goals and objectives for the department that are consistent with Go Health initiatives.
• Prepares work schedules, makes job assignments, and prepares and approves the weekly payroll for department staff.
• Provides guidance and oversees EMR training and Access for the PAS Team.
• Identifies areas of improvement for current protocols, workqueu productivity, and processes.

 Compliance and Policies:

• Develops, establishes, and maintains policies and procedures for the PAS department (ie. Call Center, Financial Assistance, Medical Records Request).
• Manages the department’s adherence to policy compliance according to Go Health mission.
• Oversees Go Health’s credit and collection policy and administers self-pay adjustments or discounts in accordance with the Go Health mission.

Department Specific:

• Manages the Financial Assistance and Bad Debt process for the PAS department.
• Collaborates with departments' quality assurance of team’s adherence to script, customer service quality (recorded phone calls), and system documentation.
• Reviews resolves and coordinate response to patient complaints from government agencies.
• Collaborates monthly performance meetings with collection vendors and partners.
• Produces, analyses, and maintains PAS and Self-Pay key metrics (ie. statement collection rate, abandonment rate, self-pay aging, calls, and email resolution rates).
• Collaborates with the medical records request process with outside vendor(s).

 Required knowledge, skills, and ability:
Customer service skills: 

• Motivates staff and maintains a high level of morale in the department.
• Proven track record of driving change and results in a call center environment.
• Ability to handle service issues professionally.
• Ability to follow through with customers.

Communication Skills: 

• Ability to communicate effectively with patients about the financial aspects of their care.
• Effective management skills, verbal and written communication skills, interpersonal skills, leadership skills, analytical skills, and organizational skills.
• Ability to communicate effectively to patients, centers, and staff regarding departmental policy.

 Teamwork: 

• Ability to function effectively as an extension of the Center
• Be flexible and open-minded in thought processes
• Maintain focus under pressure
• Share relevant information with other team members

Medical Terminology & Insurance

• Ability to understand medical terminology
• Ability to calculate deductible and co-insurance correctly
• Ability to read and understand carrier Explanation of Benefits

All other duties as assigned.

Note: This job description is not inclusive of all the duties of the position.  You may be asked by leaders to perform other duties.  Management reserves the right to revise this position description at any time.