Experience and Education
- B.S. or Five years or more hospital collection experience. - Minimum of ten (10) years of hospital billing / operations to include federal, state, third party payors, research & transplant. Must have min of three (3) years of progressive supervisory / management experience with extensive knowledge of Patient Financial systems & processes including the healthcare revenue cycle, coding & billing compliance. Proven record of identifying PI opportunities. Requires strong negotiating, analytical & organizational skills as well as the ability to be
1. Demonstrate continuous performance improvement in targeted areas of responsibility in alignment with the overall annual Hospital performance improvement targets. a) Manages daily operation of all Hospital Billing to ensure all charges are processed and billed in a timely manner to include Federal, State, and Third Party Payors. (Billing and Collections of all Federal/State Payors i.e. Medicare/Medicaid). Responsible for daily exporting of claims from billing system to claim editor. Daily reconciliation between systems. \nb) Manages research and client billing & collections. Maintaining appropriate fee schedules. c) Manages billing/collection of Solid Organ & BMT services to include acquisition, pre/post transplant. Manages Special Billing protocols to include package plans, self pay, intl. patient billing, purchased services, workers comp & occupational billing, & other clinical departments, etc. Maintains appropriate fee schedules.
2. Coordinates all workflow issues and accounts concerns with Supervisors, peers, and leadership. Ability to properly delegate and prioritize work demands to meet or exceed financial goals and objectives of the department. This includes monitoring quality and quantity of work, performing Quality Reviews (QA's).
3. Manages, trains, and structures staff to achieve the quality and quantity of work and service provided by team to ensure team meets production, billing and cash goals set for the department. Ensures system work lists and settings are providing the best work source for staff. Conducts meetings and works with staff identifying payor reimbursement issues. Assist in performing analysis to determine root causes (payor or hospital), for payment variance issues and resolution.
4. Analyzes, recommends, & implements policies & procedures as needed to maximize reimbursement for services rendered in compliance with established government & third party guidelines. Close collaboration with hospital department managers to ensure timely charge submittal. Close collaboration with HIM/Coding Audit & Denial teams.
5. Acquires and maintains thorough knowledge of Federal & State Legislative & Administrative action affecting reimbursement; disseminates acquired knowledge to leadership. Risk Reporting monthly as outlined by Office of Compliance .
6. Audits posting of payments for purchased services, client & research billing. Coordinates all workflow issues & account concerns with PFS leadership.
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information
Performs other duties as assigned.
UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. In accordance with federal and state law, the University prohibits unlawful discrimination, including harassment, on the basis of: race; color; religion; national origin; sex; including sexual harassment; age; disability; genetic information; citizenship status; and protected veteran status. In addition, it is UT Southwestern policy to prohibit discrimination on the basis of sexual orientation, gender identity, or gender expression.