WA State Applicants ONLY!
JOB OVERVIEW: Provides the overall management and supervision for the Patient Financial Services department and will be responsible some or all of the following functions: timely and accurate submission of claims, follow-up on unpaid third-party claims, denial follow-up, customer service, payment posting, collections, credit balances/refunds, and management of charity care programs. All of these functions must be accomplished while operating within the guidelines of Federal and State agencies as well as within the confines of contractual agreements with insurance companies. The Managers are also responsible to oversee staff recruiting, hiring, training, productivity tracking and evaluation.
PREREQUISITES:
- College Degree preferred.
- Minimum 3 years healthcare patient accounts experience.
- Minimum 2 years healthcare patient accounts experience as a lead, supervisor, or manager.
- Able to use various computer applications, including Microsoft EXCEL or WORD.
- Familiarity with hospital ADT (Admission/Discharge/Transfer) and hospital patient account management systems, desirable.
- Able to train new employees and create teamwork among groups of staff members.
- Demonstrates ability to communicate in writing and verbally in the English language in an effective manner.
QUALIFICATIONS:
- Previous experience in healthcare related/management business setting.
- Demonstrates excellent team skills as a member or leader.
- Neat, well-groomed, professional appearance.
- Organizational skills to facilitate departmental functions.
- Able to use Microsoft Excel, Word, and Outlook, and learn hospital, clinical and financial systems. McKesson Star System experience would be preferred, or the ability to quickly learn the McKesson Star System.
- Able to set priorities, produce accurate work and process all work tasks in a timely, comprehensive manner.
- Knowledge of claims submission, insurance follow-up, customer service, collections, cash posting and credit balance resolution.
- Familiar with State and Federal regulations as they relate to healthcare HIPAA and billing requirements.
- Able to function in a setting with a wide variety of duties and numerous interruptions.
PERFORMANCE RESPONSIBILITIES:
Manages staff issues in a manner that ensures effective recruitment, training, retention, and employee satisfaction. Manages department in a cost-effective manner in compliance with the annual department budgets, including the preparation of detailed budget variance explanations where needed.
Manage all aspects of Patient Financial Services billing, follow-up, and cash posting functions, in a manner that is compliant with Medicare, Medicaid, L&I and all other payer requirements, including timely claim submission.
Provide training and billing training for new employees and ongoing education for staff. Provide needed training for billing and cash posting regarding Medicare and Medicaid compliance.
Responsible to create management reports to assist in the process of monitoring data accuracy and managing the productivity of the Patient Financial Services staff.
Works with the IT Department and the PFS System Administrator and Patient Financial Supervisors to resolve system issues and implement system upgrades.
Ensures timely and accurate processing of accounts for self-pay, collections and insurance follow-up.
Keeps staff informed of their progress through productivity feedback reports as well as documented annual performance evaluations.
Responsible to review incoming bulletins and educate staff about new or changing billing requirements for all payers.
Understands and oversees that appropriate cash control procedures are followed within the cash posting and cashiering processes.
Maintains confidentiality of the lock combination for the safe.
Responsible to hire, train, evaluate counsel and build teamwork for staff responsible for all Patient Financial Service functions.
Works with Contract Manager to assure that reimbursement to the hospital follows contractual guidelines within limitations of current systems.
Maintains storage of reports, EOB’s according to record retention guidelines for the State of Washington.
Ensures accounts are sent to collections appropriately and according to policies.
Regularly attend educational seminars and professional meetings related to Patient Financial Services and other relevant healthcare topics.
Responds to complaints from customers within 10 working days.
Ensures emergency and safety procedures are reviewed at least yearly and are available if needed.
Ensures refunds and credit balance reporting to Medicare is handled appropriately and timely.
Responsible to provide information to ancillary departments regarding charges, billing and claim denial issues.
Meets with Director at least weekly for review of the status of operations and key performance indicators.
Ensures that regulatory compliance and JCAHO standards are reflected in all department polices and procedures.
Represents the PFS department at meetings, both internal and external.
* Maintains and updates Administrative Policy, Emergency Preparedness and Quality Management Manuals.
* Maintain current knowledge of Insurance Plan and Charge Master updates to ensure that bills produced are compliant with Medicare, Medicaid and other payer billing requirements.
Responsible for assignment and maintenance of User logons and passwords for staff.
Maintains confidentiality of all protected health information.
Demonstrates the awareness of the importance of cost containment for the department. Responsible to implement process or quality improvement solutions.
* Performs all job functions in a manner consistent with Valley’s cultural expectations defined as Valley Values. These characteristics include quality performance, demonstrating compassion, respect, teamwork, community-centered awareness and innovation.
Job Type: Full-time
Pay: $86,267.00 - $129,401.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Health insurance
- Life insurance
- On-site gym
- Paid time off
- Referral program
- Vision insurance
Schedule:
Work setting:
Education:
Experience:
- healthcare patient accounts: 3 years (Required)
- healthcare supervisory patient accounts: 2 years (Required)
- hospital ADT: 1 year (Required)
Ability to Relocate:
- Renton, WA 98055: Relocate before starting work (Required)
Work Location: Hybrid remote in Renton, WA 98055