Patient Financial Services Manager

Description:

Job Title: Patient Financial Services Manager

Location: 1575 Blue Hill Avenue, Mattapan, MA 02126

Reports To: Chief Financial Officer (CFO)

Type: Full Time

Salary: Salary and benefits for this position are competitive and commensurate with experience.

Summary

The Patient Financial Services Manager position is responsible for overseeing contracting, credentialing, eligibility verification, resolving billing issues, denials and appeals analysis, reporting on payer performance, and accounts receivable management. The Patient Financial Services Manager also supervises the reconciliation of payments, monitors refund requests, and addresses escalated patient concerns. Additionally, this role involves collaboration with external medical billing vendor for optimal cash collection, accounts receivable and denial management. Assists department Directors by identifying and sharing healthcare industry changes impacting their assigned areas of FQHC Billing Revenue Cycle. Serves as a primary point of contact regarding matters that relate to assigned areas within FQHC Billing Revenue Cycle and partake in FQHC Billing Revenue Cycle Management workgroup meetings.

Responsibilities:

Revenue Cycle Management:

• Oversees and supports registration staff and the Revenue Cycle Management operations.
• Provides coding expertise to all clinical areas of the company, calling on outside experts as needed.
• Works closely with other departments and outsource medical billing company to streamline processes that will help ensure accurate billing to patients and payers in a timely manner, thereby expediting receivables.
• Responds personally to concerns and/or complaints expressed by patients, visitors, practice staff, and physicians in effort to support optimal operations and excellent customer service.
• Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.
• Maintains appropriate internal controls for the safeguarding of cash.
• Monitors key performance indicators including payer mix, A/R, collection rates, adjustments, bad debt write off, estimated collections, appeal success rates, and other requested parameters. Regularly provides upper management with revenue cycle status' including reports and metrics.
• Maintains extensive knowledge of revenue cycle including managed care
• Monitors A/R effectively and ensures aging categories are within established goals and established benchmarks.
• Responsible for maximizing the collection of patient services payments and reimbursements from insurance carriers, patients, and guarantors. Ensures accuracy of all third-party adjustments and sliding fee discounts.
• Identifies, explains, and recommends accounts to be written off.
• Monitors aged accounts and verifies appropriate collections procedures are being followed.
• Responsible for maintaining accurate records for program audits. Assists in annual year end audit of the accounts receivable. Assists with UDS data collection and ensures accuracy.
• Reviews, monitors, and recommends updates to the organization's fee schedule.
• Analyzes cash receipts and outstanding balances. Keeps the Accounting Department informed of trends and expected cash flow.

Requirements:

• Education

  • Bachelor's degree in accounting or business administration, or equivalent experience in a health care setting preferred. Additional training in the areas of coding and data analytics is a plus.

• Experience

  – 5 years or more in medical billing management, preferably in a health center setting. Experience with EPIC OCHIN is a plus.

• Clinical Knowledge

  • Requires knowledge of all aspects of payer reimbursement, including Medicare, Medicaid, commercial, managed care, worker's compensation, and self-pay. Knowledge of medical terminology is preferred.

• Communication and Interpersonal Skills

  • Excellent communication skills, both written and verbal, to effectively interact with staff, physicians, patients, and external stakeholders.

• Analytical Skills

  • Strong analytical and data interpretation skills. Strong Excel and Microsoft Office skills are essential.

• Adaptability and Resilience

  • The ability to thrive in a fast-paced and evolving healthcare environment, adapt to changing priorities, and manage multiple projects simultaneously.

• Ethical and Professional Conduct

  • Demonstrated commitment to ethical practices, patient-centered care, and maintaining confidentiality.

Compensation details: 80000-85000 Yearly Salary

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