Manager, Outpatient Billing
Found in: Resume Library US A2 - 7 days ago
St. John's Riverside Hospital is a leader in providing the highest quality, compassionate health care utilizing the latest, state-of-the-art medical technology. Serving the Westchester community from Yonkers to the river town communities of Hastings-on-Hudson, Ardsley, Dobbs Ferry and Irvington, St. John's Riverside has been and continues to be a unique and comprehensive network of medical professionals dedicated to a tradition of service that spans generations.
St. John’s has been an integral part of the community since the 1890's and its’ commitment to provide the community with the most advanced medical services available continues to be the hospitals’ vision, mission and value. St. John's Riverside Hospital built itself around an early foundation of nursing and community service. In 1894, the Cochran School of Nursing, the oldest hospital-based school of nursing in the metropolitan area, was founded, thus making the St. John's Nursing Staff more than just the backbone of the hospital, but the heart and soul. St. John’s dedicated nurses give superior attention to those who need it most with a strong emphasis on patient and family-focused nursing care.
St. John’s Riverside Hospital staff is committed to making life better for all patients. The hospital continues to elevate the services provided with the goal of increasing the quality of life for all who entrust St. John's Riverside Hospital to their care.
Personalized care together with advanced technology is what it means to be Community Strong
Responsibilities:
Supervises and coordinates activities of medical billers and collectors to obtain and record financial data for statistical records. Determines work procedures, prepares work schedules and expedites work flow. Assigns duties and examines work for exactness, neatness and conformance to policies and procedures
Directs and coordinates the patient accounting function in order to consistently produce accurate bills which are paid in a timely manner.Effectively utilizes and understands the departmental computer system in order to realize its optimal potential and to be able to evaluate and answer staff member questions regarding the mechanics of the system.Works effectively with auditors in locating various patient bills as required; demonstrates cooperation and responsiveness.Responsible for billing practices including standard codes sets (CPT4 & ICD-9 coding, UB 04 & 1500 forms, 837 and 835 requirements).Maintains appropriate internal controls over cash posting and reconciliation functions.Maintains a current awareness of third-party reimbursement regulations and contractual arrangements with HMOs and PPOs.Effectively maintains all required records for the department; demonstrates good organizational skills.Coordinates training and supervises the medical billing, cash posting, self pay, and collections personnel.Reviews adjustments and refund requests to insurance companies for overpaid accounts.Reviews Business office denials, payments and adjustments reports. Creates Billing reports as required.Assists with, and responds to inquires from patients, insurance companies, Medicare, and other parties regarding charges and/or billing activity reports.Contacts third party payers to identify and resolve account collection problems for maximum collection resultsAttends meetings and participates on committees as directed.
Schedules and evaluates the work of assigned staff members.Counsel employees as needed and handles disciplinary action as necessary.Completes annual review of employees as required.Assigns Patient Medicaid and Hospital Charity Care applications and collects associated reports.Coordinates monthly staff meetings. Assists in any other projects assigned by the Director of Patient Accounts when necessary.Keeps Directors of Patient accounts informed of all issues related to billing operations and staffing.Completes mandatory and unit-specific competencies. Demonstrates knowledge, skill, and ability to assist and interpret age-specific data. Demonstrates knowledge, skill, and ability to assist and interpret age-specific data. Possess communication and assessment skills necessary to interpret age-specific responses to treatment and involve family/S.O when applicable.
Qualifications:
High School graduate, with some college courses is required. Preferred: Bachelor’s degree. Minimum three (3) or more years of previous hospital experience in all aspects of business office functions is required. Ability to read, write and communicate effectively in English is required. Knowledge of MS Word, Excel, Power point, Access and Outlook is required.
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