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Patient Accounts Manager
2 months ago
We are seeking a highly skilled Patient Accounts Manager to join our team at NYC Health + Hospitals. The successful candidate will be responsible for managing the Inpatient Medical Necessity Denials, DRG change and IPRO Audits unit.
Key Responsibilities- Manage the tracking of all Inpatient Medical Necessity and IPRO retrospective denials, including appeals and correspondence.
- Coordinate the activities of the collection process related to Medical Necessity Denials and IPRO appeals under policies, guidelines and systems established by the Corporation.
- Liaise between Case Management, Finance and Corporate in reference to the process and implementation of Medical Necessity Denials and IPRO.
- Manage DRG Audits utilizing EPIC WO's and act as the Liaison between H.I.M., Finance and Corporate in reference to DRG changes.
- Manage an ADT/REG edits team to help reduce aged AR, maximize revenue and decrease timely filing denials.
- Manage the Commercial/Managed Care Billing team to help reduce aged AR, maximize revenue and decrease timely filing denials.
- Manage the Managed Care/Comm Outlier claim follow up process to help increase revenue.
- Participate in the development, recommendation and implementation of new processes and procedures in various areas to help improve productivity and collectability.
- Manage the NF/WC and Other Government Plans team.
- Oversee the billing and review of research accounts.
- Oversee SPARCS.
- Manage the underpayment, overpayment and credit balance payment variance team.
- Participate in the selection and appointment of personnel, personnel changes and placement activities for the areas under supervision.
- A Baccalaureate degree from an accredited college or university with a major in accounting, finance, business administration, or related field.
- Four (4) years of experience in accounting, finance or business administration, with two (2) years in a responsible and managerial capacity in areas normally related to a hospital, medical center or health care facility.
- Two (2) years of experience in the management of patients accounts or credits.
NYC Health and Hospitals offers a competitive benefits package, including comprehensive health benefits, retirement savings and pension plans, loan forgiveness programs, paid holidays and vacation, college tuition discounts, and professional development opportunities.
