Purpose of Position:
Under direction, plans, organizes and directs all functions of patients accounts relating to accounts receivable control, billings, collections and eligibility determination. Implements policies, systems and procedures relating to staffing, supervision of personnel, coordination, control, audit. Ensures department is aligned with goals established by the System and maximizes reimbursement for both inpatient services, outpatient services, in accordance with System policies, guidelines and processes.
Essential Duties and Responsibilities:
1. Directs financial investigation to identify parties responsible for inpatient and outpatient bills.
2. Directs the assessment of third-party eligibility status, verification of coverage, preparation of third-party approval forms documentation of eligibility data, and maintenance of documentation flow for third-party reimbursement.
3. Coordinates liaison activities with various units, including Admissions, Emergency, Outpatient, Nursing, Medical Record, and other services to manage patient's accounts transactions for preparation, delivery and control.
4. Directs review of adjustments, credits and payments to patients accounts.
5. Directs periodic review of accounts to determine status of open accounts, by source of payment, and date of discharge or treatment; establishes and directs mechanism for collection efforts of delinquent accounts. Refers delinquent accounts for write-off, accumulates data regarding third-party bad debt accounts.
6. Directs all activities for collection and control of cash receipts of patients prepayments.
7. Serves as a liaison with other units to ensure processes and procedures are up to date relating to changes in rates, medical data required, procedural changes; reviews work activities.
8. Develops, recommends and implements new procedures to improve operations efficiency.
9. Reviews policy and procedural changes with supervisory staff; recommending improvements to programs and practices.
10. Recommends, prepares, administers, evaluates training programs.
11. Evaluates personnel performance, progress of work; makes recommendations regarding placement.
12. Recommends work performance standards, resolves employee complaints, provides supervisory leadership to attain effective productivity; initiates action to accomplish objectives.
13. Directs the preparation of data, reports, surveys, and management information on billings, collections, accounts receivable and all employee relations activities. Prepares status reports, analyses; provides recommendations to obtain optimum utilization of total resources and to maximize reimbursements.
14. Performs other related duties, as assigned.
