Patient Financial Operations Manager

6 days ago


Bronx, New York, United States St. Barnabas Full time
Job Summary

The Patient Financial Operations Manager is a critical role at St. Barnabas, responsible for overseeing the efficient processing and reporting of claims, denials, and appeals. This individual will ensure that identified claim categories are prioritized to resolve billing-related issues and manage staff to minimize bad debt, improve cash flow, and effectively manage accounts receivables.

Key Responsibilities
  • Ensure timely and accurate processing of claims, denials, and appeals.
  • Prioritize identified claim categories to resolve billing-related issues.
  • Manage staff to minimize bad debt, improve cash flow, and effectively manage accounts receivables.
  • Stay up-to-date on coding and revenue trends, and educate billing staff accordingly.
  • Communicate professionally with various payers as needed.
  • Participate in Joint Committee Meetings with contracted payers to identify and resolve billing, claims payment, and claim denial issues.
  • Develop, evaluate, implement, and revise Departmental policy and procedures related to billing, reimbursement activities, and improvement strategies.
  • Conduct monthly analysis of Medicare/Medicaid/Third Party Payers.
  • Review and resolve issues related to claim generation and rejected/denied billings.
  • Maintain confidentiality and adhere to HIPAA and security guidelines when accessing and sharing patient information.
  • Stay current with all reimbursement billing procedures of third-party and private insurance payers and government regulations.
  • Maintain internal controls over accounts receivables.
  • Monitor accounts sent for collection and reimbursement from insurance companies and other third-party vendors.
  • Reviews, monitors, and evaluates third-party reimbursement and researches variances.
Requirements
  • Bachelor's degree in Accounting, Finance, Healthcare Administration, or related field.
  • 4+ years of on-the-job experience in hospital revenue cycle management, including understanding of hospital reimbursement and facility claims submission, collection, and analysis (DRG, APC, Managed Care contracting).
  • Experience with managed care contracts, reimbursement, and administrative terms and terminology.
  • High proficiency in utilizing and/or configuring hospital patient accounting, claims scrubber, and contract management systems.
  • Excellent communication and interpersonal skills.
  • Experience working with Epic and ability to prepare Epic Revenue Cycle Reports.
  • Knowledge and experience with Excel.
Estimated Salary Range

$85,000 - $110,000 per year, depending on experience and qualifications.



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