This position is responsible for overseeing the billing function including the establishment of policies and procedures. The incumbent is responsible for maintaining current knowledge of federal, state and third party billing requirements, providing technical information to peers, subordinate staff and ancillary departments. This position coordinates with various departments within the hospital and/or ambulatory departments to ensure all billing information is available to complete the billing process in a timely manner.
The major challenges to this position are maintaining an active knowledge of the changing regulations affecting federal, state and third party billing and reimbursement; keeping the employees’ morale up when work-flow increases due to program changes or staff reductions; and reducing accounts receivable and increasing cash flow by initiating ideas which will impact these areas. Other related duties and overtime may be required.
This position has the authority to authorize write-offs and adjustments to patient’s accounts in compliance with department policies; to plan, develop, and implement billing procedures; to hire, commend, evaluate, discipline, and terminate employees under direct supervision; schedule employees; designate work, and schedule meetings with other departments and outside agencies.
Decisions that must be referred to the Business Office/Admitting Services Manager or other reporting structure as listed above are those outside approved budgetary restraints; and policies limiting approval of adjustments and refunds to patient accounts must be followed.
It is common to encounter potential hazards in the healthcare environment. Some of these hazards could include, but are not limited to: Radiation, Toxic Chemicals, Biological Hazards, Heat, Noise, Dust and Stress. Renown Health has a Safety Management Program in place addressing these issues.
KNOWLEDGE, SKILLS & ABILITIES:
1. Adopts a philosophy consistent with the Standards of Conduct.
2. Leadership qualities to promote a team effort.
3. Ability to train others and implement procedures.
4. Skills for effective discussions with staff; listen and respond with empathy; ask for help in solving the problem.
5. Ability to motivate individuals.
6. Skills for adequate judgment and decision making. Ability to effectively prioritize.
7. Skills to anticipate people’s needs, deal with the unexpected, investigate and establish effective priorities.
8. Computer, typing and calculator skills.
9. Ability to keep confidential information confidential.
10. Working knowledge of all governmental programs available to the public.
11. Working knowledge of all aspects of the insurance field.
12. Working knowledge of changing regulations for federal, state and third party payers, which would include Medicare, Medicaid, Medi-cal, Champus, Indian Health Service and commercial insurance.
13. Knowledge of coding requirements. Ability to use ICD9 and CPT4 coding books.
14. Knowledge of basic accounting principles.
This position (does not) provide patient care.