Responsible for the daily operations and the management of effective claims creation and filing, reimbursement, follow-up and denials management for the accounts receivable.
WHAT IS EXPECTED (Essential Functions):
Ensures billing and collection practices are compliant with regulatory authority to ensure that Baylor Scott and White health is in compliance with federal, state and other regulations.
Establishes policies, procedures and various tools and processes to monitor quality and productivity and to ensure ethical and compliant processes and guidelines are followed for billing and follow-up.
Monitors new requirements in the billing and collection process and successfully implements changes as needed.
Reviews payer announcements correspondence samples of denials and reasonable charge issues to ensure efficient, billing and collections.
Ensures follow-up of claims of accounts to ensure maximum collections.
Establishes a work environment that reduces obstacles and promote staff initiatives and performance at a maximum level.
Performs all human resource functions, including interviewing, hiring, counseling, and terminating employees. Develops employee goals and assist employees with creating career development plans.
Understands reimbursement results to provide expertise and knowledge to the reimbursement process.
Proactively identifies trends including denials and underpayments that require collaboration with other areas to resolve, communicate, cross functional department leaders and develop action plans to address in a timely manner.
Prepares reports and/or presents relevant data in a timely, accurate and user-friendly format that is appropriate for the desired result.
Investigates and resolves complex problems and coordinates efforts to provide innovative strategies and solutions. Lead process improvement initiatives in the business office to eliminate redundancies, reduce costs through process improvements, contract negotiations, and system consolidation/optimization.
Performs other position appropriate duties as required in a competent, professional and courteous manner.
KNOWLEDGE, SKILLS, and ABILITIES:
Proficient with MS Office applications required.
Degree in related field (Finance, Accounting, Business) preferred.
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!