Washington Hospital Careers

Qualifications

·   Education

·   Licensure

·   Work Experience

·   Skills/computer/ specific technical

§ Other qualifications, miscellaneous 

Specify if qualifications are Required or Preferred 

Required: Bachelor of Science or Arts degree, major in Accounting or Business or related area of study.

Desired: Certification of "Manager of Patient Accounts" from the Healthcare Financial Management Association.

Required: Five to seven years of management in a hospital and professional billing office setting of which two to three years should be in the position of Director responsibilities. Experience of two to three years direct responsibility for hospital and professional Accounts Receivable, Patient Financial Services and/or Admitting, Familiarity and expertise regarding Medicare/Medi-Cal reimbursement and regulations. Knowledge of collection activities and associated regulations pertaining to self-pay, government and commercial insurance.

Required: Demonstrates ability to successfully perform duties through knowledge of patient and third party billing, Strong leadership, managerial and interpersonal skills, Computer skills/competency in HER, preferably EPIC, electronic billing and follow-up systems in all areas of responsibility.

Essential Job Responsibilities

Achieving Results 

Key Components: assess, plan, evaluate, demonstrate initiative, quality of work, productivity 

1. Develops departmental goals and objectives for all areas of responsibility including financial counseling, insurance verification, cashiering, billing and follow-up/collections.
2. Assists area managers in establishing reasonable goals and objectives as well as consistent reporting tools. Monitors reports to ensure revenue and cash integrity. Conducts periodic reviews and provides constructive feedback on performance or training issues. Develops, updates and implements all policies and procedures for areas of responsibility.
3. Facilitates the incorporation of regulatory requirement changes into operational procedures for revenue cycle departments, provides guidance in implementation of new requirements or applicable laws. Maintains and disseminates regulatory requirements and communicates changes timely and effectively.
4. Responsible for monthly financial and statistical reporting, budget variance explanations and communicating barriers to goal achievement.
5. Distributes information to educate, monitor, and provide feedback to employees and physicians regarding their involvement and impact on revenue cycle, including any impact on reimbursement for services rendered.
6. Facilitates implementation of automation or electronic data exchange throughout the revenue cycle process, including CDM updates, insurance verification, bill holds and CCI edits, claims submission and payment remittance, bad debt referrals and recoveries.
7. Monitors Payor performance related to accurate and timely payment, and denial tracking to provide feedback to Contract Management.
8. Anticipates and plans accordingly to respond to changes in the reimbursement environment, and plans the appropriate procedures to be followed by revenue cycle departments to ensure maximum reimbursement for services rendered.
9. Evaluates utilization of systems and whenever possible and reasonable maintains standardization for systems related to revenue cycle. Recommends and facilitates new and current system development specific to the needs of revenue cycle.
10. Provides guidance and assists in development of protocols and procedures to address coding and clinical documentation processes, physician record completion and by-law compliance with regards to bill holds and CCI Edits, including tracking, monitoring and feedback to all revenue departments and physicians.
11. Coordinate with Revenue Integrity Director to ensure standardization of CDM, including utilization of systems, pricing and mark up policies and charge processing policies and procedures.
12. Identifies and mediates problem situations, and analyzes cause(s). Reviews late charge and other revenue reports to identify charge processing issues, plans and assists resolution implementation.
13. Interfaces with physicians, clinical departments, third party payers, fiscal intermediaries, government and other pertinent agencies as appropriate to facilitate effective working relationships and partnerships in order to maximize reimbursement.
14. Investigates and applies appropriate resolution of patient billing issues, including design, timing and messaging of patient statements in coordination with WHHS leadership.
15. Monitors and approves material write-offs, adjustments, and refunds within limits per policy.
16. Approves purchase orders and requisitions within limits established by policy.