PFS Billing & Denials Manager (FT Salaried)
Blanchard Valley Regional Health Center

Findlay, Ohio

Posted in Medical and Nursing


This job has expired.

Job Info


PURPOSE OF THIS POSITION

The purpose of this position is to develop, organize, implement, and direct the day-to-day activities of the Patient Financial Services Department in accordance with Federal, State, and local guidelines as well as BVHS and Patient Financial Services established policies and procedures.

JOB DUTIES/RESPONSIBILITIES

Duty 1: Recommends and implements approved departmental policies, procedures, and staffing; reviews annually, and recommends changes. Is required to maintain or improve financial progress within the Patient Financial Services department.

Duty 2: Assists in the recruitment, selection, and training of competent department employees, in conjunction with Human Resources. Delegates appropriate authority, responsibility, and accountability to employees. Review's employees' performance, recognizes good performance, addresses substandard performance through coaching/counseling. Initiates discipline if no improvement. Investigates rule violations and initiates discipline, when appropriate. Reviews all suspensions or terminations with Revenue Cycle Director, Patient Financial Services Director and Human Resources.

Duty 3: Manages the billing function related to all patient accounts including the creation of a detailed bill and all required insurance regulations and forms. Manages all changes to be made to the billing master files.

Duty 4: Participates in meetings, representing Patient Financial Services, including but not limited to Risk Committee, Revenue Regulatory, and Corporate Compliance.

Duty 5: Communicates using various methods such as department meetings, huddles, email, and Microsoft Teams. Regularly holds department meetings to communicate, identify and correct problem areas and/or to solicit recommendations on improvements of service. Documents meetings appropriately.

Duty 6: Works with the Patient Financial Services Director in maintaining budget. Assists the Patient Financial Services Director & Revenue Cycle Director in the strategic initiatives of BVHS.

Duty 7: Acts as a liaison between all departments and provides education to clinical staff, corporate compliance, physicians and other personnel regarding payer changes and regulations. Promotes service oriented and team approach within department staff.

Duty 8: Collaborates with the Patient Financial Services, Billing and Credit and Collections Managers & Supervisors, Patient Financial Services Educator & Compliance Specialist, Patient Financial Services Director and Revenue Cycle Director on all denial, billing and collection functions within the Patient Financial Services Division.

Duty 9: Establishes, in conjunction with the PFS Director, Revenue Cycle Director, HIS Director and Revenue Integrity Coordinator, adequate internal control procedures to assure the proper recording and billing of all patient charges. Assist in defining policies & procedures for charge entry, late charges and charge capture for compliance with current regulations.

Duty 10: Establishes with the leadership of Accounting and Credit and Collections, adequate internal control procedures to assure the proper recording and posting of all insurance payments and denials.

Duty 11: Manages the Patient Financial Services Denial management program to include benchmarking, targets and reporting for appropriate management of accounts receivables.

Duty 12: Assures confidentiality of patient information. Adheres to all HIPAA related privacy, security and transaction & code set regulations

REQUIRED QUALIFICATIONS

  • Bachelor's degree in related field or significant related experience
  • Mastery of desktop applications including MS Office (Word, PowerPoint, Excel and Access) and data base management applications.
  • Highly developed and positive service-oriented interpersonal and communication skills required to effectively interact with diverse team members throughout the organization.
  • Demonstrates principles, knowledge and research skills to participate in the organization's corporate compliance program. Keeps abreast for federal, state and local rules and regulations.
  • A valid driver's license is required (if you do not have a valid Ohio driver's license you must obtain one within 30 days of your residency in the state). You must also meet BVHS's company fleet policy and insurance company requirements, and any other requirements that may be required to operate a vehicle.
PREFERRED QUALIFICATIONS
  • HFMA Certification
  • AAPC Coding Certification
  • Demonstrated management skills, 2-3 years preferred
  • Hospital Patient Accounting experience, 5 years preferred
PHYSICAL DEMANDS

This position required a full range of body motion with intermittent activities in walking, lifting, bending, squatting, climbing, kneeling, twisting and standing. The associate will be required to walk for up to one hour a day, sit continuously for six hours a day and stand for one hour a day. The individual must have good eye-hand coordination and fine finger dexterity for simple grasping tasks. The individual must have excellent verbal communication skills to perform daily tasks. The individual must be able to operate a motor vehicle for business travel and community involvement.

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