Job Summary
Responsible for managing accurate, timely completion and submission of all billing, collections, and accounts receivable functions for the agency.
DUTIES & RESPONSIBILITIES
- Ensures reimbursement through efficient billing and collections operations and effective accounts receivable management.
- Provides oversight and approval of claims audits and processing. Conducts final billing audit and issues assignments to pre-billing team when findings require further documentation.
- Ensures that billing and patient accounts record systems are maintained in accordance with generally accepted accounting principles and in compliance with state, federal and Joint Commission regulations.
- Maintains comprehensive working knowledge of payer contracts and ensures that payers are billed according to contract provisions. Represents and acts on behalf of agency in resolving conflicts with payers.
- Advises Executive Director in matters of accepting/declining problematic payers.
- Maintains comprehensive working knowledge of government billing regulations including Medicare and Medicaid regulations and serves as a resource for appropriate agency personnel.
- Monitors aged accounts receivables and resubmit bills to overdue accounts, submits seriously overdue accounts to collection agencies for collection, and prepares bad debt reports for weekly meetings.
- Gathers, collates, and reports key billing information to billing team. Works with Executive Leadership Team in strategizing monthly, quarterly and annual goals for optimized billing efficiency.
- Collaborates with the Executive Director in successfully reconciling the billing system reports with the general ledger.
- Reconciles Medicare quarterly reports produced by the fiscal intermediary with the billing information system, and prepares the annual Medicare cost report for Executive Director review.
- Supervises the use of the billing information system and maintains a comprehensive working knowledge of the system including upgrades and enhancements.
- Supervises and reconciles cash receipts and bank deposits according to policy.
- Establishes and maintains positive working relationships with patients, family members, payers and referral sources.
- Protects the confidentiality of patient and agency information through effective controls and direct supervision of billing operations.
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.
JOB REQUIREMENTS (Education, Experience, Knowledge, Skills & Abilities)
- Associate degree in accounting, Business Administration or related field, Bachelor’s degree preferred.
- At least three years’ experience in health care billing and collections management preferably in home care operations. Billing information systems knowledge required.
- Knowledge of corporate business management, governmental regulations and Joint Commission standards.
- Ability to exercise discretion and independent judgment and demonstrate good communication, negotiation, and public relations skills.
- Demonstrated capability to accurately manage detailed information.
- Able to deal tactfully with patients, family members, referral sources and payers.
- Demonstrates autonomy, assertiveness, flexibility and cooperation in performing job responsibilities.