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Manager, Patient Accounts
2 months ago
At White Plains Hospital, you have an opportunity to work side-by-side with some of the most talented people in the world.
We have been widely recognized for our exceptional culture, world-class physicians, Magnet-designated nurses and passionate employees who make a real difference in our community. With tremendous growth opportunities, great benefits, and flexible work schedules, it is no wonder why we are consistently recognized as a Great Place To Work.
Position Summary
The Manager of Patient Accounts is responsible for all aspects of the revenue cycle. They will implement development of department strategies to maintain and mange key performance indicators to high performance and best practice, they will support the development of strategic direction for department operations and manage the patient accounts team and operations to high performance standards. Responsible for direct oversight and management of billing, follow-up, denial's and payment review teams. They are responsible to assure all teams are functioning at a high level with the result of best practice in compliance, cash flow and overall revenue. The Manager of Patient Accounts will align with departments throughout the facility to assure timely release of claims with appropriate codes aligning to optimal reimbursement and compliance.
Essential Functions and Responsibilities Includes the Following:
1. Directs and oversees the overall objectives, policies and initiatives of WPH revenue cycle activities to optimize workflow, performance and overall billing collections for the facility
2. Demonstrates leadership skills with the ability to guide, direct, train and interact with management on a regular
basis
3. Reviews, designs and implements processes surrounding billing, third party payer relationships, compliance, collections, account resolution and other financial analysis to ensure that revenue cycle is effective and properly
utilized
4. Monitors and supports daily functions of all related staff
5. Tracks numerous metrics related to the revenue cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting
6. Compile and analyze information identified through A/R reports through A/R Pivots, Business Objects or specified billing platforms for current and/or potential billing issues specific to outstanding receivable and denial
management
7. Compile and discuss various reports/metrics to senior Administrative staff
8. Responsible for reporting and tracking department performance metrics
9. Develop necessary summaries or reports using Microsoft-Excel/Word
10. Presents data to appropriate parties and partners to develop resolutions with affiliates as necessary
11. Independently works to ensure that daily team operations flow smoothly; to include, but not limited to daily production assignments that will continue to develop understanding and knowledge of processing guidelines and expectations of respective payer mix
12. Works in collaboration with peers, Manager(s) and Director(s) for guidance and reorganization of workflow to ensure internal and external business needs are met
13. Participate in meetings with Payers, internal departments, contact(s) and Management, etc. to address trends in denials or unprocessed claims
14. Creates and distributes department wide communications or pathways, notifying staff of updated insurance guidelines/processing information
15. Holds regular staff meetings to communicate changes in process, business results, organizational changes or environmental changes
16. Identifies and facilitates individual and/or team training needs for new or established team members
17. Handles escalated issues that include but are not limited to unhappy patients/callers and client contacts that may require additional system or technical knowledge
18. Ensures the effectiveness of the talent management process for the team by anticipating staffing needs, effective interviewing and on-boarding of new staff. Conducts timely and effective quarterly an annual performance reviews, and creates staff development plans to promote competency/skill development.
19. Engages in employee performance management; to include, but not limited to creation, maintenance and delivery of performance documents and appraisals for direct reports, routine review of productivity utilizing applicable reports and systems available
20. Reviews quality assurance reports with team leaders and employees; providing feedback on areas of success and improvement for staff
21. Responsible and accountable for the overall operations of their assigned department. Overall operations of the department include development of department goals and objectives that are consistent with the hospital mission, the management of personnel, preparing/monitoring of and accountability for the department budgets
22. Understands and adheres to the WPH Performance Standards, Policies and Behaviors.
23. Assures the delivery of quality department /clinical services in accordance with established hospital and regulatory/accreditation agency standards.
24. Assures employee compliance with hospital and Human Resources policies and procedures
25. Responsible for development and execution of corrective action measures
26. Assures that employee competency and education requirements are satisfied as per hospital policy.
27. As required, participates in the Performance Improvement Program as defined by the organization.
28. Attends Management/Leadership meetings as scheduled/required and communicates hospital policies, performance improvement initiatives and all other required information to their staff.
29. Responsible for participation in committees, task forces and projects as appropriate.
30. Works collaboratively with all levels of the hospital interdisciplinary team and promotes the team concept within their department and hospital wide.
31. Demonstrates positive customer service fosters positive employee relations and assures that staff adhere to the
Customer Service Behavioral Standards.
32. Is supportive of hospital initiatives and projects and functions as a positive change agent.
33. Promotes a positive and professional image and is a role model, coach, mentor and resource for staff and peers.
34. Develops and submits departmental goals and objectives as required by the Division Administrator.
35. Interviews, hires, evaluates, counsels and terminates employees as per hospital policy.
36. Schedules staff based on budgeted staffing plan and department needs.
37. Manages relationships with outside vendors to ensure effective performance
38. Assures compliance with state regulations and accreditation standards.
39. Assures completion of staff orientation, annual and ongoing competency and education requirements.
40. Attends and participates in educational programs or activities to maintain current level of knowledge or expertise to manage department.
41. Participates and assures department involvement in ongoing Performance Improvement initiative as required. Submits reports as required.
42. Responsible for audit and upkeep of charge master.
43. Ensure proper billing protocols and guidelines are followed.
44. Works in conjunction with members of the management team to upkeep system dictionaries.
45. Develops and implements policies and procedures to streamline and standardize workflow as well as improve current operations to best practice.
46. Monitors staff and workflow to insure hospital policy, procedures and protocol are followed accordingly.
47. Attends Management/Leadership meetings as required.
48. Conducts monthly staff meetings to update staff and/or address department issues and records meeting minutes for all staff.
49. Utilizes multiple methodologies to communicate information.
50. Adheres to safety standards for employees and patients.
51. Interacts with hospital ancillary revenue departments, patient registration, and case management to ensure compliant practices and streamline revenue.
52. Participates in committees, task forces, projects, etc. as required.
53. Submits all other work reports as required/requested by the Division Administrator.
54. Designs, implements and maintains procedure manuals for all areas of responsibility.
55. Design and implement control systems to assure the most efficient use of employee's time including mail and follow-up procedures.
56. Oversees all patient accounts activity and staff performance to insure effective and efficient use of resources to maximize cash collections
57. Maintains the integrity of the accounts receivable to insure optimal cash flow and timely account resolution.
58. Responsible for submitting bi-weekly payroll and maintaining records of holiday, sick and vacation time for all personnel.
59. Assures staff is up-to-date on all courses, including HBI/Clarivate.
60. Performs all other related duties as assigned
61. HBI certification certificate required prior to end of probationary period
Education & Experience Requirements
•Graduate of an accredited College or University with a B.S. in Business or Health Administration; Masters preferred.
•Minimum of (6) to (10) years in Patient Accounting required, preferably in a hospital setting.
•Knowledge of hospital billing and reimbursement of insurance as well as third-party billing.
•Knowledge of front-end practices as it relates to Patient Access
•Proficiency with Microsoft Office/excel to include reporting, Executive level required
Core Competencies
1. Strong leadership and organizational skills
2. Proficient in Excel and preparation of reports and presentations
3. Strong analytical and troubleshooting skills
4. Knowledge of hospital billing and reimbursement of insurance as well as third-party billing.
5. Ability to understand payment methodology and utilize formulas
6. In-depth knowledge of the complete healthcare revenue cycle
7. Experience/knowledge of contract language and payment methodology
8. Strong communication skill sets and abilities
9. Ability to establish two-way communication by clearly defining expectations, using a variety of methods, actively listening to ideas and concerns and responding in an appropriate manner
10. Demonstrates ability to delegate responsibilities appropriately
11. Ensures compliance with state regulations and accreditation standards.
12. Participates in ongoing Performance Improvement initiative as required. Submits reports as required.
13. Utilizes multiple methodologies to communicate information.
14. Establishes and maintains an in-depth knowledge of revenue cycle principles, practices, procedures, regulatory compliance and internal controls.
15. Submits all other work reports as required/requested by the Division Administrator.
16. Keep the Assistant Vice President Revenue Cycle informed at all times of the status of third-party plan payments and analysis progress
17. Integrity to handle the confidential aspects of work.
18. Retains composure under stress
Physical/Mental Demands/Requirements & Work Environment
•May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital's SDS (Safety Data Sheet) data base and may be accessed through the hospital's Intranet site (Employee Tools/SDS Access). A copy of the SDS data base can also be found at the hospital switchboard, saved on a disc.
•Must be able to remain in stationary position 50% of the time
•The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc.
•The person in this position frequently communicates with patients who have questions, must be able to exchange accurate information in these situations.
•Must be able to detect and greet patients arriving.
Primary Population Served
Check appropriate box(s) below:
•Neonatal (birth - 28 days) •Patients with exceptional communication
needs
•Infant (29 days - less than 1 year) •Patients with developmental delays
•Pediatric (1 - 12 years) •Patients at end of life
•Adolescent (13 - 17 years) •Patients under isolation precautions
•Adult (18 - 64 years) •Patients with cultural needs
•Geriatric (> 65 years) • All populations
•Bariatric Patients with weight related comorbidities
•Non-patient care population
The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of White Plains Hospital.
