Manager Patient Financial Services

Children's Healthcare of Atlanta - Atlanta, GA4.2

Full-timeEstimated: $54,000 - $70,000 a year
EducationSkillsBenefits
Work Schedule/Days: Day / Monday - Friday
Employment Type: Full-Time
Requisition #: 29402

JOB SUMMARY

The Manager of Patient Financial Services is responsible for the oversight and resolution of accounts receivable assigned to the team. Provides daily monitoring and management of area of oversight including claims billing and collection activities. Responsible for proactively identifying and addressing account aging, payer trends in relation to zero payment, payment variance, billing and denials. Is responsible for taking action to address accounts receivable and individual account issues, working closely and partnering with IS&T, Revenue Cycle Analytics, Patient Access, Coding, HIS, Reimbursement, Finance, Managed Care and other departments. May be asked to lead projects sponsored by VP Revenue Cycle or Directors within the Revenue Cycle. Works closely with system and Revenue Cycle leaders to develop and implement quality measures related to billing compliance and collection activities. Sets and manages productivity and other performance indicators, providing feedback to staff related to performance throughout the year. Proactively monitors regulatory requirements and works to ensure compliance. Communicates any changes identified that may impact customer service, patient throughput, patient billing and collections.

EDUCATION

Bachelor’s degree in Healthcare, Business Administration, or related field
CERTIFICATION SUMMARY

No professional certifications required
EXPERIENCE*

A minimum of five years’ management experience in provider accounts receivable management required.
Detailed knowledge of accounts receivable key performance metrics—including accounts receivable days, account agings, collection and denial rates, cost to collect—and demonstrated success in managing to those metrics.
Knowledge of Coding, Reimbursement and clinical documentation a plus.
Demonstrated change management experience, including leading teams during system implementations and upgrades, preferred.
Must possess and demonstrate excellent communication, organizational and interpersonal skills.
Proven aptitude for problem-solving and critical thinking.
Knowledge of key Children's Healthcare of Atlanta Patient Accounting or comparable applications: EPIC Resolute, Xactimed, nThrive.
Demonstrated understanding of provider Finance, Reimbursement, Managed Care Contracting and Revenue Cycle processes and indicators.
Able to function in a dynamic environment subject to impromptu changes in schedules and priorities.
Ability to communicate well and present findings verbally and via presentations, spreadsheets and written documents.
Ability to multi-task and work both independently and within teams.
Demonstrated ability to develop and manage budgets and other financial skills.
High level of proficiency in the use of Microsoft Excel, Word, Access and Power Point.
PREFERRED QUALIFICATIONS*

Master’s degree
Experience in change management, including leading teams during system implementations and upgrades
Experience in working with finance, reimbursement, managed care contracting, and revenue cycle leaders to present key performance indicators with accounts receivable analysis and recommendations for improved reimbursement
Knowledge of key Children's Healthcare of Atlanta patient access and accounting or comparable application, e.g., Epic Resolute
KNOWLEDGE SKILLS & ABILITIES*

Detailed knowledge of eligibility screening and Medicaid application processing
Knowledge of key performance metrics, including self-pay percentage, price estimate accuracy rate, and pending Medicaid aging and demonstrated success in managing to those metrics
Knowledge of charity, financial assistance, health insurance exchange, insurance guidelines and regulations, point-of-service collections, and payment plans
Must possess and demonstrate excellent communication, organizational, and interpersonal skills
Proven aptitude for problem-solving and critical thinking
Detailed knowledge of state Medicaid eligibility requirements with strong understanding and interpretation of Children’s Healthcare of Atlanta contract as relates to benefit/eligibility/authorization requirements to oversee the price estimate process
Maintains working knowledge of industry standards and local/federal regulatory requirements for billing and collection activities
Demonstrated understanding of provider finance, reimbursement, managed care contracting, and revenue cycle processes and indicators
Able to function in a dynamic environment subject to impromptu changes in schedules and priorities
Ability to communicate well and present findings verbally and via presentations, spreadsheets, and written documents
Ability to multitask and work both independently and within teams
Demonstrated ability to develop and manage budgets and other financial skills
Proficient at a high level in the use of Microsoft Excel, Word, and PowerPoint
JOB RESPONSIBILITIES*

Has primary responsibility for the oversight of accounts receivable assigned, including all Billing and Collection activities as well as ensuring quality and collection goals are met.
Has primary responsibility for denial management for accounts receivable assigned with working knowledge of the appeal process including Reconsideration, Arbitration and Administrative law Hearing process.
Has detailed knowledge of payor policies with strong understanding and interpretation of Children’s contract as it relates to Billing requirements, Payment rates and appeals.
Maintains working knowledge of industry standards; Federal and local regulatory requirements for billing and collection activities.
Develops professional relationships with stakeholders within Children’s as well as payors to foster collaboration and partnerships for improved collection efforts.
Communicates with Reimbursement as appropriate to ensure reserve requirements are understood.
Approves risk and bad debt adjustments as outlined in department’s policies.
Partners with Coding department to understand requirements and ensure Claims resolution
Participates in internal and external audits as needed to ensure regulatory compliance.
Identifies trends, issues and concerns related to Claims and collaborates with Revenue Cycle and other leaders across the organization for resolution.
Works to achieve compliance with all governmental, payer and regulatory agencies’ requirements by routinely analyzing standards, regulatory rules and Children’s policies. Develops and implements activities and policies/procedures designed to meet requirements of these agencies. Directs formulation of responses to governmental, payer and regulatory audits and requests.
Manages the orientation, competency assessment and mandatory education for Patient Accounting staff. Ensures the development of educational programs needed for teams assigned.
Responsible for validating information system implementations and upgrade are completed successfully in conjunction with IS&T, Reimbursement, Managed Care and other areas/departments as needed.
Supports Patient Accounting Director in implementing and achieving Revenue Cycle goals and initiatives.
SYSTEM RESPONSIBILITIES*

Safety: Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system.

Compliance: Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Maintains records of compliance activities and reports compliance activities to the Compliance Office.

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.

PHYSICAL DEMANDS*

Ability to lift up to 15 lbs independently not to exceed 50 lbs without assistance

Bending/Stooping - Not Present

Climbing - Not Present

Hearing/Speaking - Effective communication with employees, supervisors/managers and staff. Effective communications with patients and visitors, as required.

Lifting - Occasionally (activity or condition exists up to 1/3 of time)

Pushing/Pulling - Not Present

Sitting - Constantly (activity or condition exists 2/3 or more of time)

Standing - Occasionally (activity or condition exists up to 1/3 of time)

Walking - Occasionally (activity or condition exists up to 1/3 of time)

WORKING CONDITIONS*

Some potential for exposure to blood and body fluids

About Us:
Children’s Healthcare of Atlanta has been 100 percent committed to kids for more than 100 years. A not-for-profit organization, Children’s is dedicated to making kids better today and healthier tomorrow.

With 3 hospitals, 28 neighborhood locations and a total of 638 beds, Children’s is the largest healthcare provider for children in Georgia and one of the largest pediatric clinical care providers in the country. Children’s offers access to more than 70 pediatric specialties and programs and is ranked among the top children’s hospitals in the country by U.S. News & World Report.

Children’s has been ranked on Fortune magazine’s list of “100 Best Companies to Work For” for thirteen consecutive years and named one of the “100 Best Companies” by Working Mother magazine. We offer a comprehensive compensation and benefit package that supports our mission, vision and values. We are proud to offer an array of programs and services to our employees that have distinguished us as a best place to work in the country. Connect to our mission of making kids better today and healthier tomorrow.

Have questions about the recruitment process? Check out What to Expect.

Location: Office Park (1455) - 1455 Tullie Circle NE, Atlanta, GA 30329
Function: Revenue Cycle - Patient Financial Services