• Job Description

  Req#: 839123719

  JOB SUMMARY

  • Responsible for managing the day to day operations of the Patient Finance Department to maximize financial returns, maximizing efficiency though technology and management of the Accounts Receivable and all applicable systems.

  ESSENTIAL FUNCTIONS OF POSITION

  • Maximizes recoveries on insurance receivables using effective and efficient practices, policies and procedures
  • Maintains knowledge of and adheres to all third-party billing guidelines and implements procedures for the staff to follow to insure proper reimbursement
  • Maintains an intimate knowledge of receivables, payers, contracts and all other issues impacting billing operations; maintains good working relationships and open communications with third party payers
  • Trains staff as appropriate and maintains ongoing education so that the Patient Accounting Department can stay current on all aspects impacting 3rd party billing
  • Monitors employee performance and provides annual evaluations as prescribed by hospital policy. Makes recommendations on disciplinary actions, hiring, firing and relocation of duties
  • Sets performance goals for the staff and monitors the staff to ensure that goals are met using technology to generate measurable outcomes
  • Maintains information systems used by Patient Accounting to perform operations functions. Serves as a liaison between billing staff and IS staff or outside vendors. Ensures that the systems are set up properly to affect proper billing.
  • Assists in the development of policies for the billing and collection activities to ensure maximum reimbursement.
  • Develops and implements procedures for the department for all billing activities including claims processing, A/R follow-up and collections.
  • Reports to the Director of Patient Accounting any issues impacting operations or state of the accounts receivable, and makes recommendations for improvement.
  • Establishes implements and monitors controls to ensure that all accounts are established properly, billed in a timely manner and collected within the prescribed time frames.
  • Completes special projects as directed by the Director of Patient Accounting.
  • Facilitates billing communications between ancillary departments, registration and Patient Accounting.
  • Displays an understanding and awareness of, and performs all duties in accordance with, the hospital's mission and vision statements. Pro-actively supports the goals of the Director.
  • Works in partnership with other staff members, various hospital departments and multiple levels of management
  • Serves as model for positive interaction and cooperation with patients, families, visitors and co-workers at all level; Uses CARES program to reward customer service excellence

  POSITION REQUIREMENTS

  • Educational Requirements

  Minimum Associates Degree (required)

  • Licensure, Certification and Registration

  NA

  • Work Orientation and Experience

  5 years minimum hospital collections experience (required). 5 years minimum management experience (preferred)

  • Knowledge, Skills and Abilities

  · Knowledge of Maryland Medicaid billing requirements

  · Knowledge of federal and state collections and billing requirements

  · Knowledge of third-party billing guidelines

  · Excellent computer skills – heavy use of Outlook, Word and Excel

  • Other Requirements Specific to Assigned Area

  REPORTING RELATIONSHIPS

  • Supervision Received

  Supervised by Patient Accounting Director

  • Supervision Exercised

  Supervises Patient Accounting staff

  INTERPERSONAL RELATIONSHIPS

  • Must work closely with clinical departments as well as front end areas. Must develop a strong working relationship with provider representatives.

  TOOLS/EQUIPMENT USED

  • PC, Outlook, Excel, Word, Adding Machine/Calculator, Fax machine, Copier.

  PHYSICAL ENVIRONMENT/WORKING CONDITIONS

  • Business office environment. Occasional travel may be required This job description identifies the general nature and level of work to be performed. It is not to be considered an exhaustive list of responsibilities, duties or skills required of an incumbent.

• About the company

  Mt. Washington Pediatric Hospital is a 102-bed non-profit children's hospital set in the scenic neighborhood of Mt.

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