Essential Duties and Responsibilities
- Organize, direct, coordinate and evaluate the following: clinic patient scheduling, registration, cashiering, refunds to patients and third parties, billing/collection activities, cash application and provider insurance credentialing.
- Work in conjunction with University Administration, Clinic Administration and various academic programs to reach and maintain financial and accounts receivable goals, establish policies and procedures, monitor HIPAA and HiTech compliance, and develop and maintain excellent customer service.
- Interview, hire, train, manage, develop and evaluate patient account staff members.
- Ensure that all Federal, State and other third party billing, collecting and follow-up requirements and regulations are achieved.
- Manage and coordinate accounts receivable functions/reporting to ensure efficiency and maximize reimbursement. Analyze processes to identify payer issues, monitor results and progress, implement plans for improvement and keep bad debt to a minimum.
- Participate in various University and clinic audits as it relates to finance, billing, and coding.
- Participate as a member on various clinic committees.
- Participate as a member of HFMA and MGMA.
- Oversee the application, approval, and administration of the MWU clinic assistance program.
- Prepare, implement, and monitor patient account budgets for MWU clinics.
- Assist in research, development, and implementation of new services and programs.
- Ensure compliance with payer contracting agreements.
- Communicate and educate clinical care staff on billing, coding and documentation changes.
- Assist patients with concerns and complaints regarding scheduling/billing.
- Promote, develop, and maintain excellent customer service with patients.
- Manage and direct credentialing activities for MWU clinic providers in conjunction with the credentialing agency.
- Develop strong and effective relationships with vendors and contracted partnerships in order to exchange information and resolve issues of financial impact.
- Review month-end reporting to develop, implement and monitor benchmarking/metrics for patient accounts.
- Develop/revise policies and procedures for the finance department, as needed.
- Implement changes directed by regulatory agencies.
- Other duties may be assigned.
The position is responsible for the supervision of the Patient Account Representatives, Patient Account Specialists and the Insurance Verification Specialist.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
A Bachelor’s degree in finance or related field is required. 5-7 years of revenue cycle experience working in an integrated clinic environment is required, preferable with an academic institution. 5-7 years of previous management experience. Knowledge of Federal and State guidelines, managed care contracting, payer filing and appeal limits, and credit and collection policies is also required. A high level of interpersonal skills, problem solving and strong analytic abilities is necessary to be successful in this position. Thorough knowledge of Current Procedure Terminology (CPT), ICD9/ICD10, HCPCS codes and the CMS 1500 claim form.
Computer proficiency in MS Office (Word, Excel, Outlook). Experience with Medical Practice Management systems, EHR, payer websites, clearinghouses.
High skills: Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information to top management, and boards of directors
High skills: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.
Intermediate skills: Ability to calculate figures and amounts such as discounts, interests, commissions and proportions, percentages, area, circumference and volume. Ability to apply concepts of basic algebra and geometry.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to talk, hear, stand, walk, reach with hands and arms, use hands to handle and feel. The employee must occasionally lift and /or move up to 25 pounds.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
Midwestern University is an Equal Opportunity/Affirmative Action employer that does not discriminate against an employee or applicant based upon race; color; religion; creed; national origin or ancestry; ethnicity; sex (including pregnancy); gender (including gender expressions, gender identity; and sexual orientation); marital status; age; disability; citizenship; past, current, or prospective service in the uniformed services; genetic information; or any other protected class, in accord with all federal, state and local laws, including 41 C.F.R. 60-1.4(a), 250.5(a), 300.5(a) and 741.5(a). Midwestern University complies with the Smoke-Free Arizona Act (A.R.S. 36-601.01) and the Smoke Free Illinois Act (410 ILCS 82/). Midwestern University complies with the Illinois Equal Pay Act of 2003 and Arizona Equal Pay Acts.
Bachelors or better in Finance or related field.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)