Plans, organizes, staffs and is otherwise responsible for operations and activities of the Medicare Unit and Commercial Collections Billing Unit of Patient Financial Services in support of the organization’s goal of obtaining appropriate and timely reimbursement of Medicare accounts receivable while meeting all related regulatory and compliance standards. Identifies and provides appropriate solutions regarding the Medicare and commercial billing. Identifies and provides appropriate solutions regarding the Medicare follow-up practices of the unit. Ensures applicable regulations and requirements are met as set forth by outside governing agencies and contractual obligations. Provides an exceptional level of customer service. Uses exceptional interpersonal skills with both internal and external customers and staff often using conflict management expertise. Serves as role model in promoting respect for others, while assisting staff to understand the purpose and importance of ethics and policy standards consistent with MHS mission and core values. Develops departmental policies/procedures and revisions. Continually works to improve workflow processes maximizing resources to achieve Best Practices and Work Standardization.
Monitors activities of unit to ensure all aspects of areas of responsibility operate efficiently and effectively including Budget and productivity standards. Manages daily operations with minimal guidance. Responsible for hiring, training, performance review. Can recommend disciplinary actions, of staff to retain high-quality personnel. Works independently under the management of Director.
Principal Duties and Responsibilities:
This position works independently under the guidance of a Director and is responsible for MHS Medicare and commercial billing account receivable as follows:
Manages daily operations with minimal guidance. Works effectively with both internal and external executive directors, directors, managers, and staff to ensure timely Medicare and commercial claim billing and Medicare collection.
Ensures compliance with federal, state, local and other payer legal requirements governing Medicare and commercial billing and Medicare collection activities.
Recruits, hires, trains and retains high quality personnel.
Participates in multi-disciplinary teams to resolve issues relating to billing and reimbursement.
Demonstrates initiative through performance improvement projects to increase staff productivity through streamlining activities and the appropriate use of systems and automation, employing Best Practice and Work Standardization principles.
Ensures that an exceptional level of customer service for patients, physicians, and employees and other stakeholders is provided promptly and appropriately.
Responsible for effective leadership within the Unit, either personally or through delegation as evidenced by:
Developing and implementing policies and procedures that guide and support the department.
Continuously assessing and improving performance.
Maintaining quality control programs
Orienting and providing training and continuing education of all persons in the Unit
Serves as role model in promoting respect for others by exhibiting courtesy and cooperation to patients, visitors, physicians and other customers, Responsible for staff understanding the purpose and importance of ethics and policy standards consistent with the MHS mission and core values
Participates in developing and adheres to the PFS budget.
Keeps current on the latest business and technical developments through continuing education and educates staff accordingly.
Conducts employee performance appraisals according to MHS guidelines.
Provides both positive and disciplinary counseling in a manner consistent with MHS guidelines, and Gallup guiding principles
Reviews and responds to employee grievances in a timely manner per MHS guidelines.
Updates procedure manuals and job descriptions as operations and requirements change.
Demonstrates effective and appropriate oral and written communications.
Accepts special assignments from upper management and completes projects in a timely manner.