Manager, Patient Accounts Billing (North) 6/4/2020
Hackensack Meridian Health
JOB DESCRIPTIONAPPLY OVERVIEW
How have you impacted someone s life today* At Hackensack Meridian Health our healthcare teams are focused on changing the lives of our patients by providing the highest level of care each and every day. From our hospitals, rehab centers and occupational health teams to our long-term care centers and at-home care capabilities, our complete spectrum of services will allow you to apply your skills in multiple settings while building your career all within New Jersey s premier healthcare system.
The Manager of Patient Accounts Billing is responsible for all pre-billing and billing functions for all hospitals located in the Northern region of Hackensack Meridian Health (HMH); processes to be performed in compliance with established goals, revenue cycle activities, and regulations. Manages the supervisor and billing team members. Responsible for oversight and administration for the claims scrubber and clearinghouse application, including all related electronic data interchange (EDI) transactions. Performs testing and validation for upgrades, system modifications and regulatory mandated changes. Ensures claims are submitted timely and accurately in compliance with local and federal regulations. Assists Vice President and Director with identifying issues and recommends possible solutions to increase productivity, maximize cash collections, and improve the revenue cycle.
A day in the life of Manager, Patient Accounts Billing (North) at Hackensack Meridian Health includes:
* Manages all daily pre billing and billing activities for the North region including providing guidance and leadership for the supervisor and team members, creates standards of performance in daily work activities; monitors the performance of each team member against these standards.
* Oversees the claims submission processes via the clearinghouse to third party payers in accordance with established polices, state, and federal regulations; this includes responsibility for ensuring all claim files were accepted via payer gateways.
* Responsible for the timely release of all claims from EPIC; follows up with appropriate department leader for issues contributing to delays in claim release.
* Escalates these issues to Director and VP as necessary.
* System Administrator for the billing application/claims scrubber (currently the Assurance Reimbursement Management System); responsible to coordinate training related to any upgrades or enhancements.
* Responsible for ensuring all claim files and payer responses produce and post correctly, including ongoing reconciliation and monitoring of file movement.
* Liaison with Information Technology and the billing vendor support team for any issues or delays that impact timely claim submission to payers and files posting to EPIC.
* Oversees vendors utilized for any specialty billing purposes, including out of state Medicaid, Charity Care & Medicaid, and Worker s Compensation and No Fault claims.
* Provides input and judgment on medical center committees to ensure compliance with internal and external policies, goals, and regulations.
* Participates in Revenue cycle meetings providing input and analysis for claim issues resulting in denials or payment delays.
* Oversee all billing work queues and dashboard categories in EPIC.
* Follow up with team members and departments contributing to any delays.
* Participate in billing/claims testing whenever a new clinical department, service line, or interface is added to ensure revenue safety in EPIC.
* Establishes documented policies and procedures, ensures adherence to such policies and procedures.
* Responsible for the completeness and ongoing updating of the procedures for all areas of responsibility.
* Keeps Senior Management in Finance informed of any billing related issues.
* Billing issue liaison with other departments including Corporate Compliance, Nursing, and Health Information; responsible for resolution of such issues.
* Establishes Global Billing and Days in A/R goals in accordance with department objectives.
* Ensures goals and objectives are achieved.
* Responsible for maintaining time and attendance records for the billing team members.
* Utilize the PeopleSoft and Clairvia system for electronic attendance management and ensure policies are followed by the staff.
* Oversees recruitment and hiring activities; responsible for evaluating, coaching, counseling and termination of staff.
* Maintains current and complete knowledge of applicable Federal and State regulations; maintains thorough knowledge of managed care and third party billing rules, applicable State Department of Health legislature for charity care, information system(s), State or federal legislature regarding collection practices, HIPAA and HCFA rules and regulations and processes connected to the revenue cycle.
* Provides feedback to the Managed Care department regarding contract terms and rates as it relates to billing and collections.
* Interacts with payers on an ongoing basis to resolve account issues and be fully aware of payers changes and policies.
* Utilizes system-generated monitoring reports as tools for measuring staff performance, billing statistics, and identifying areas for performance and quality improvement.
* Brings any billing issue(s) forward during business office management meetings that would impact other departments and/or changes affecting clinical areas.
* Monitors the status of unbilled and rejected claims. Advises staff, management, or other departments as to the proper course of action to be taken for resolution.
* Monitors reports and conducts analytical reviews to determine where additional emphasis needs to be placed to ensure the goal of timely and proper billing is accomplished.
* Establishes clearly defined productivity targets and goals for the billing team members.
* Identifies system issues that impact the Medical Center s billing and notifies Information Technology, the Charge Master Coordinator, Clinical Department Head, and/or the billing system vendor as necessary.
* Brings forward relevant issues to the Revenue Cycle Committee.
* Assists with the timely resolution of each issue in coordination with any of the involved parties.
* Responsible for overall effectiveness and productivity of operations relating to functions and staff, while also maintaining appropriate staffing levels to accommodate optimal workload for the department.
* Identifies claims/scenarios that are appropriate for testing a new system, new software, an enhancement, or an upgrade to an existing system as necessary; responsible for providing feedback and approvals to Information Technology test results.
* Responsibility for document imaging/scanning functions for Patient Financial Services (PFS).
* Responsible for providing Information Technology with regulatory requirements that must be programmed to ensure claim accuracy.
* Recommends changes and/or appropriate enhancements in the charging system (charge-master/revenue codes) that will make the operations of the Billing Department more efficient and to ensure the proper and timely billing of accounts.
* Responsible for the timely scanning of financial documents, refund requests, EOBs, and the related equipment and maintenance needs.
Meridian Health is committed to the principles of equal employment opportunity and affirmative action and will not discriminate in the recruitment or employment practices on the basis of race, color, creed, national origin, ancestry, marital status, gender, age, religion, sexual orientation, gender identity/expression, disability, veteran status and any other category protected by federal or state law.