The Patient Financial Services Manager ensures maximum cash flow and protects AAMC from losses by development of process and sound application of technology within the revenue cycle functions of Claims Submission, Insurance Validation, Financial Counseling, Collections, Cash Posting and Cashiering. Interacts with industry-wide peers, state, federal and local regulatory agencies to ensure compliance with reimbursement requirements and statutes. There is a strong compliance emphasis and need for appropriate interpretation of Medicare and federal technical billing regulation. Acts as a leader in recruitment, retention and enrichment of PFS staff.
Essential Job Duties:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Actively adheres to regulatory and governmental agency requirements regarding billing and reimbursement. Implements and remains current on regulatory updates and changes in a proactive manner.
- Supervises Billing Coordinators and facilitates workflow issues. Conducts follow up or coordinates staff selection, orientation and coaching.
- Manages accounts receivable and billing trends. Oversees billing operation including control of unbilled and unprinted receivables and ensures that all billing meets third party payor’s clean claims requirements and billing statutes.
- Prepares analysis of revenue, cash, loss and receivables trends and implements changes as needed to improve the health system’s cashflow and decrease bad debts. Analyzes and reports data to various internal and external counterparts to demonstrate accounts receivable and compliance impact.
- Supervises staff performing financial counseling, cash posting and cashiering in a timely manner. Recommends and implements accounting controls in cashiering area. Performs routine audits.
- Recommends & implements processes for insurance validation. Provides leadership and guidance to Team Leader of Insurance Validation Unit.
- Protects hospital from losses by implementing frontend processes to help patients understand the extent of their financial responsibility and assist with application for available state, federal and AAMC internal programs.
- Interact with AAMC and external peers. Act as liaison with third party payors, vendors and auditors. Actively participates in activities designed to motivate and enrich industry-wide knowledge at AAMC and PFS department.
- Troubleshoot equipment problems and supply inventory.
- Maximizes available systems resources to the fullest extent to improve staff productivity, compliance and accounts receivable performance. Maintains system dictionaries in manner which promotes access to financial and other PFS related statistics. Works closely with management and information systems counterparts to implement and maintain sound application of state of the art technology.
- Bachelors Degree in Business or related field required.
- Five years of experience in hospital billing in automated setting.
- Minimum of five years’ supervisory experience in healthcare business office setting.
- Numerical skills and previous Billing/Accounts receivable systems experience required.
- Excellent verbal and written communication skills.
Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.
Physical Demands –
Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.
The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.