Responsible for the management of the billing, collecting, post payment review, credit balances and correspondence functions of all aged government, non-government and Patient accounts. This position is responsible for managing and coordinating team efforts toward a specific service delivery function of CHRISTUS Health. The position provides coaching, feedback, and corrective action to PFS Associates where needed. Responsible for assuring that standard process discipline is adhered to. Assures that high performance work team is developed through coaching, mentoring and daily shift briefings.
Supervises the work of PFS employees by empowering, coaching, answering questions, giving guidance, and leading by example
Maintains detailed knowledge of state and federal laws. Ensures that current processes are reviewed and updated to meet regulatory requirements.Rev: 04/06/06 Market Review: 03/22/08
Maintains ongoing knowledge of all standard bill forms and other mandatory state billing forms and filing requirements. This includes 837, 835, 272 and 276 HIPAA transactions.
Identifies possible trends or issues and provides possible solutions. Communicates and escalates information to Leadership and internal/external Customers.
Exhibits an understanding of CPT, HCPCS and ICD9 coding regulations and guidelines.
Monitors billing, collections, post payment review, and correspondence activities to ensure timely completion and identify any improvement opportunities.
In coordination with the unit Manager, monitors and conducts performance reviews and provides feedback to team members. Works with team members to improve, track, and develop in areas of poor performance.
Actively participates in PFS projects and system upgrades.
Proactively evaluates processes to identify progressive solutions.
Ability to identify issues and determine appropriate levels of escalation.
Communicate issues effectively and professionally to all levels within the organization.
Evaluates key performances indicators to ensure they are meeting business needs.
College degree and/or minimum of 4 years healthcare supervisory experience.
5 yearsâ€™ experience providing leadership related to billing, collection and post-payment review of Government/Non-Government patient accounts, preferably within a multi-facility environment.
5 yearsâ€™ experience and excellent working knowledge of payer regulations including Medicaid, Medicare, Federal & State Funded programs and thorough understanding of Managed Care contracted plans. Experience and knowledge of Patient Accounting Systems in a multi-facility environment preferred.
Demonstrated success with building and guiding a team to develop and monitor collection processes to meet organization goals and objectives required. Experience with providing visible sponsorship and guidance of major change initiatives preferred.
Management by Fact process skills to develop root cause and corrective actions for teams (can be trained within 3 months of hiring).
Lean Six Sigma skills (possess or obtain within 3 months of hiring)
PFS System applications and MS Office Applications
Understanding of Revenue Cycle
Understanding of coding requirements
Medicare, Medicaid, Managed Care and Commercial Insurance/Self-Pay, and Third Party regulations and outcomes.
Ability to lead teams, mentor and support development of resources.
Must have professional and courteous skills.
Must have ability to make independent decisions that are generally guided by established procedures and/or collection process.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.