Memorial Health Ohio · 4 hours ago
Manager, Patient Financial Services and Professional Billing | Full Time
Marysville, OH
Full-time
Onsite
Mid Level
4+ years expMemorial Health Ohio is seeking a Manager of Patient Financial Services and Professional Billing to enhance their collaborative team. The role focuses on overseeing initiatives to improve net revenues, managing billing practices, and ensuring compliance with regulations while leading various departments within the organization.
Health CareHospital
Responsibilities
Responsible for overseeing initiatives to improve net revenues, reducing receivables and improve compliance in support of organization goals
Ensures billing practices are consistent with internal policies and external requirements of payors
Identifies and analyzes revenue cycle trends and make appropriate recommendations to leadership
Monitors/identifies/implements improvements in Professional Billing and Patient Financial Services, working in concert with manager of Registration and Central Scheduling Departments
Maintains current working knowledge of federal and state regulations regarding the revenue cycle
Oversees projects related to revenue opportunities, management of charge master maintenance, pricing strategy, cash collections and patient estimates
Provides status of organization’s billing/claims collection performance to leadership
Informs leadership of any significant issues (i.e. bills in discharged, not billed (DNB) status, cash posting backlogs, cash delays, etc.) and monitor progress to resolution
Monitors team performance to ensure timeliness, accuracy, and compliance standards are being achieved
Facilitates timely and complete resolution of all customer questions and concerns
Motivate employees to accomplish department goals in support of the Hospital’s strategic plan
Monitors staffing productivity measures and ensure employee accountability
Provides mentoring, training and development for management team and staff
Monitors expenses to ensure within approved budget
Participates in staffing interviews, employee selection, performance evaluations, and disciplinary actions
Ensures adequate controls are in place for all reporting departments, e.g. develop and maintain policies, procedures, and guidelines
Provides subject matter expertise to ensure data validity and accuracy in payer reimbursement models
Develops and fosters strong payer relationships
Maintains a comprehensive knowledge and understanding of all Hospital payer contracts, terms and reimbursement
Maintains a comprehensive knowledge of medical policy as it applies to each payer
Collaborates with payers to resolve claim issues (authorization denials, claim rejections, claim denials, etc.) in a timely manner
Maintains knowledge of contract provisions in other third-party managed care contracts
Compiles data and provides key performance indicators to Director
Compile and prepare data, reports and analyses for various Hospital departments and directors
Prepare and send Credit Balance report to CMS quarterly. Oversight and assist with data collection for Hospital Care Assurance Program (HCAP), Hospital Charity Care (CC), Medicare and Medicaid Cost Reports, Bad Debt report and annual payer Credit Balance Reviews
Analyze reports and outcomes as they pertain to revenue cycle management; to include but not limited to monitoring of accounts receivable (A/R), claim denials and appeals, late charges, key performance indicators, ICD-10 financial monitoring, scheduling/call statistics, authorizations and registration quality. Report to leadership as appropriate
Creates ad hoc billing information and reports to facilitate decision making processes
Provides scheduled standard reports to leadership
Ensures systems dictionary files, data elements, interface and mappings are maintained
Facilitates successful system implementations, conversions, and upgrades for revenue cycle applications
Assesses new technology, performs vendor assessments, and creates ROI analyses and recommendations for leadership
Maintains oversight of staff access for all payer websites
Ensures adherence to regulatory and compliance
Ensure file transfer set-up and secure in accordance to Health Insurance Portability and Accountability Act (HIPAA) requirements
Responds to emergencies outside normal work hours
Exhibits behaviors reflective of Memorial’s core values: Compassion, Accountability, Respect, Excellence, and Service
Demonstrates regular and predictable attendance
Attends all mandatory education and in-services (i.e., team training, safety, infection control, etc.); completes mandatory health requirements
Employee performs within the prescribed limits of the hospital’s and department’s Ethics and Compliance program and is responsible to detect, observe and report compliance variances to their immediate supervisor, or upward through the chain of command, the Compliance Officer, or the hospital hotline
Performs other duties as required or assigned
Qualification
Required
Bachelor's Degree with an emphasis on finance, accounting or healthcare administration or equivalent work experience
Four (4) years of core Revenue Cycle experience
Skill in directing the work and activities of staff with the ability to effectively delegate
Skill in providing leadership and in the mentoring of staff
Knowledge of healthcare trends and CMS regulations
Knowledge of and proficient skill in the use of core PC-based Microsoft Excel, Word, PowerPoint and Access functions
Knowledge of and a broad understanding of healthcare operations and key cost and revenue drivers
Knowledge of all aspects of the revenue cycle to include patient access and data input; billing patients and third party payers; follow up collections from patients and third party payers; denial avoidance and management; cash posting and reconciliation; contract management; revenue integrity; and vendor management
Benefits
Medical Insurance
Dental Insurance
Vision Insurance
Life Insurance
Flexible Spending Account
Vacation
Sick Leave
11 Paid Holidays
Personal Day
Ohio Public Employee Retirement System
Deferred Compensation
Tuition Reimbursement
Kidzlink Daycare Center
Employee Recognition
Free Parking
Wellness Center
Competitive Salaries
Community/Family Atmosphere
Company
Memorial Health Ohio
At Memorial Health, we are 1,000+ strong – caring for patients and their families who share our neighborhoods and communities.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Ashley Richmond, MBA
HR Business Partner
Chandler Fields
HR Business Partner
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