The Manager Financial Patient Accounts may oversee the administration of claims follow-up, customer service/self-pay, claims billing, and /or cash posting, ensuring alignment with regulatory and payer requirements based on accountable area. This role is responsible for maintaining Revenue Cycle standards in accordance with regulatory and payer guidelines.
This role needs a very experienced Revenue Cycle leader that has good project management and Epic experience for our areas like Underpayments and Cash Management.
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Establishes Patient Accounting productivity and quality goals, identifies process improvements, conducts audits, monitors performance, provides coaching, and ensures compliance with regulatory requirements. Plans budgets, manages resources, monitors expenditures, adjusts staffing levels, and ensures financial efficiency while adhering to spending constraints. Directs, organizes and plans day-to-day operations of the department to ensure maximum reimbursement, productivity and efficiency. Manages audits of accounts receivable operations to assess compliance, effectiveness and accuracy of charges prior to issuing billing. Oversees that all patient charges/activities are properly coded and posted to the correct patient within the established time frame. Performs continuous quality monitoring of compliance with all regulatory requirements which may include compliance reports, denial reports, underpayment reports, credit balances (ensuring all self-pay refunds are completed within acceptable timeframes), vendor reconciliations and data requests. Communicates policies, conducts audits for adherence, resolves challenging accounts by applying health system procedures, ensures staff awareness of regulations, and develops training for legal and regulatory guidelines. Manages, hires, and leads a team, conducts meetings, rounding sessions, and performance evaluations to enhance engagement, performance, and retention. Performs other duties as assigned. |
EDUCATION: |
Required: Associates Degree (will accept certification in lieu of degree) Cert Required in lieu of degree: Certified Revenue Cycle Representative (CPCR) or comparable certification through American Association of Healthcare Administrative Mgmt. |
EXPERIENCE: |
Required: 7 years experience |
LICENSURE/CERTIFICATION/REGISTRY/LISTING: |
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