Kalispell

Patient Accounting Operations Manager

US-MT-Kalispell
Requisition ID
2017-3366
# of Openings
1
Category
Accounting / Financial Services
Pay Period Status
80
Shift
Days

Overview

This position is responsible to provide operational management for all aspects of assigned pillar within Patient Accounting. Ensures that department is adhering to the philosophy, policies, procedures, goals and budget of the office and Kalispell Regional Healthcare (KRH) in performing billing, denials, credit and accounts receivable functions. Ensures exceptional customer service and solid understanding of State and Federal regulations and requirements to assure compliance.

Responsibilities

Strategic Execution
Drive organizational objectives by operationalizing the department effectively and efficiently. Proactively anticipate both the needs of KRH and the impact the department has on the organization’s success. Collect and analyze data, prepare options, present recommendations, and explain associated benefits and risks.

Business Acumen
Practice and further develop competencies in the areas of general management, financial management, human resources management, organizational dynamics and governance, organizational communication, strategic planning, information management, risk management and quality improvement. Demonstrate professional ownership, self-development and a desire for life-long learning.

Emotional Intelligence
Serve as a role model for others by exhibiting the KRH core values: integrity, compassion, service, excellence and ownership. Lead and influence the team to provide outstanding customer service. Develop and foster relationships with other KRH leaders, departments and members of the team to support open communication, trust and collaboration.


1. *Human Resources: Creates a supportive department culture by fostering individual motivation, coaching and training for optimum job performance. Collaborates with Human Resources to ensure each employee has the required and appropriate license and certification(s). Gives direction without conflict. Anticipates staff problems and takes preventive measures. Analyzes and responds to employee turnover taking appropriate steps to maintain high employee morale and satisfaction. Educates employees on timekeeping policies and procedures to ensure accuracy. Reviews and approves the bi-weekly payroll for department employees. Responsible for completing 6-month and annual performance evaluations with employees on or before their due date for all employees supervised by the unit manager. Creates job descriptions and job standards for each position and monitors to ensure accuracy. Plans work schedules and assigns work to staff to ensure adequate service and coverage.
2. *Leads, trains and mentors 20-40 highly trained personnel in assigned aspects of the healthcare revenue cycle depending on pillar that is managed.
3. *Ensures that assigned pillar in Patient Accounting is providing optimum service and that customers receive outstanding service in a timely manner from the first contact with the office to the last.
4. *Institutes policies and protocols designed to provide appropriate telephone management, employee scheduling and work flow. Monitors and optimizes staffing patterns to provide necessary services and feedback.
5. *Institutes and monitors proper procedures to ensure communication between Hospital, Clinic and other system entities, as well as the customer, are of the highest quality. 
6. *Responsible for all staffing decisions within assigned pillar of Patient Accounting department, including creating and monitoring job descriptions and job standards for each position, review annual performance evaluations according to HR guidelines, and monitors needed training and quality to be provided for all assigned Patient Accounting employees.
7. *Participates in budget processes. Monitors and provides statistical reporting and implements changes necessary to comply with the budget, maximize revenues and maintain adequate cash flow. Processes accounts payable invoices in a timely manner for prompt payment of creditors.  Compiles, interprets, analyzes and communicates reports and information clearly.
8. *Works with Director of Patient Accounting, peers and system administration to ensure the highest standards of business performance by providing timely information regarding current status of business and by suggesting future plans of action to improve overall business practice.  Builds a collaborative team culture, high employee engagement and satisfaction.  Provides constructive feedback and timely responses to all customers.
9. *Serves as the key resource for all information systems/technology for the office. Is aware of system capabilities and works to implement new technology to meet needs.
10. *Monitors appropriate A/R indicators including, but not limited to; billing and collection queues, selected account reports, and suspended billing reports. Assists Director of Patient Accounting in the preparation of annual budget. Monitors and provides statistical reporting, implements necessary changes to comply with the budget, maximize revenues, maintains adequate cash flow and ensures compliance with all applicable government regulations.
11. *Works with Director of Patient Accounting to ensure the highest standards of performance by providing timely metrics regarding current status of system resources.  Suggests future plans of action to improve the overall business plan and KRH goals. 
12. *Responsible for the evaluation, development, implementation and revision of policies and procedures related to billing and reimbursement activities. Supports confidentiality and follows standard accounting procedures within all departmental operations. Assures timely and accurate billing and collecting practices. Reviews departmental goals and objectives; establishes methods for evaluating effectiveness of resource utilization in all aspects of the revenue cycle.

Qualifications

  1. Bachelor’s degree preferred or equivalent of five years management experience leading teams, including three years managing in a medical billing facility.
  2. Comprehensive knowledge of reimbursement regulations for Medicare, Medicaid and other third party payors as relevant to KRH operations required.
  3. Ability to communicate effectively, both written and verbally, take initiative, exercise independent judgment and problem-solve; ability to work effectively with staff, public and external agencies; possess skills in planning, organizing, delegating, supervising and interpreting data.
  4. Skilled in researching, preparing and presenting comprehensive reports.
  5. Familiarity with basic budgeting processes and ability to master budgeting skills.
  6. Knowledge of organizational policies, procedures and systems; knowledge of reimbursement methodologies in including both professional and facility issues and the various data elements of the UB-04 (CMS 1450) and CMS 1500 claims forms required; knowledge of health care administration practices; knowledge of computer systems and medical software and applications. Knowledge of HIPAA, ERISA and other Federal guidelines.
  7. Demonstrated proficiency with PC skills with various Microsoft Office programs and Outlook, as well as internet browsers and other software applications.

Experience with Meditech software platform preferred or five years of billing system or EMR use. Possess a strong aptitude for learning and using new information systems.

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