Manager Patient Accounting - Hospital Medicare Billing

Company Description

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?

Job Description

The Manager Patient Accounting reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

Manage staff responsible for resolving unidentified payments and credit balances for the organization’s clinical and hospital services through the appropriate application of adjustments and refunds.  The manager is the primary contact for refund services and other cash receipts. The Patient Accounting manager provides accounts receivable management support by ensuring the smooth day to day operation of the department, leveraging systems and the team of Operations Coordinator(s), Team Lead(s) and staff positions towards the achievement of daily, weekly, monthly performance targets. This individual is responsible for recruiting, interviewing, hiring, training, reviewing, promoting, and disciplining Patient Accounting staff members, ensuring they understand NMHC’s vision, Patient’s First philosophy and their individual efforts towards the achievement of this vision.  Fiscal responsibilities include developing the annual operating budget, monitoring and controlling budget expenditures including overtime, temporary support, and operating expenses to avoid negative variances, remediates overages as required to within annual fiscal budget. The Manager is accountable for achieving institutional and departmental goals and objectives, actively supporting NMHC strategic goals and objectives while ensuring full compliance with all policies and procedures.

Responsibilities:

• Directs and coordinates all the activities, functions and responsibilities of the Patient Accounting Department Operations related to optimum third-party accounts receivables management (i.e. Managed Care, Commercial, Medicare, Medicaid, Replacement plans, Workers Compensation, Corporate Accounts, Research, Specialty AR Accounts).
• Leverages all available systems to support optimum AR management such as Epic, Hyland OnBase, PassPort, Cerner, EMR, Recondo, NDAS, TransUnion, Authorize.net, JP Morgan Receivables Edge and payer specific websites.
• Establishes and updates job descriptions, quality assurance criteria, division policies and operational procedures.
• Formulates departmental performance metrics, quality assurance, customer service and employee satisfaction target goals for billing, account follow-up, cash processing and customer service work for any measurable productivity and quality standards which are benchmarked to an industry standard or NMHC internal standard.
• Develops department policies and procedures and coordinates with other departments to develop and maintain policies and procedures affecting the goals and objectives of the team and the entire revenue cycle.
• Review operational reports & complete AR analysis on a daily, weekly, monthly or as necessary basis of key performance indicators (KPIs), making necessary adjustments to staff resources, workflows or prioritization of work in order to reach the department’s stated goals.
• Manage people, processes and projects to implement the overall strategies and achieve the goals of the Patient Accounting department.
• Leads and/or represents Patient Accounting in meetings with departments and hospital committees such as FOSC, EWI/FSR, EDI Work Group, Free Care Committee, Level of Care Write-offs & Appeals, monthly pre-close meeting, Managed Care Issues meeting, monthly vendor meetings, etc.
• Works closely with NMHC’s Information System and Compliance & Corporate Integrity Departments to ensure all revenue cycle systems, workflows and AR processes are secure and compliant per all regulatory guidelines (JCAHO, HIPAA, Patient Privacy, ACA Consumer Protections, etc.).
• Identifies opportunities for and leads/participates in Lean, Six/Sigma and process improvement activities.

Qualifications

Required:

• Bachelor’s degree or equivalent experience.
• Demonstrated management competency & experience.
• Knowledge of hospital and/or physician HIS systems. Strong leader