Posted: Tuesday, September 12, 2017 10:11 AM
Employment Status:AF : Active : Regular : Full Time
Job Summary 13;
Supervises a team or twelve (12) Collectors and Collections Analyst in the day:to:day operations of the Patient Financial Services Department. This position provides strategic insight and recommendations on maximizing cash collections to Collections Manager and is responsible for reduction of A/R days though oversight of work assignments. Develop relationships with payor representatives to help speed resolution to adjudication problems. Follow up with third party payors includes addressing payment delays, under payments and contract set ups. Conduct audits of collections staff to improve efficiency and ensure compliance with organization and governmental regulations. Monitors quality and productivity performance measures.
Job Responsibilities 13;
Supervises operational staff responsible for various patient and third:party insurance collection functions.
:Plans and coordinates various activities and daily workflows associated with insurance follow:up and self:pay collections.
:Manage staff work assignments including oversight of work ques and distribution of standard department reports to ensure hospital accounts are worked.
:Handle inquiries from staff, complete daily administrative forms submitted for approval as part of account resolution. Forms that require extensive review include: contractual adjustments, Charge Master Description (CDM), Contract Management Requests, Medical Records and appeals.
:Review denial and underpayment trends in collaboration with manager and follow:up staff to develop improvement initiatives.
:Assist with working difficult accounts escalated by staff and/management for resolution.
:Communicate with payers, external agencies to resolve issues and foster working relationships. Document payor minutes, distribute to staff, conducts in:services and training as needed. Monitors staff production and QA scores. Measure performance; address improvement opportunities with staff.
:Assist with preparing worksheets to submit for A/R settlements, prepare resource documents for litigation.
Collaborate with Patient Access, Revenue Cycle, Case Management/Utilization Review, HIM, Audit and Compliance, Specialty Centers, external collection agencies and other areas of PFS to ensure that revenue cycle flows efficiently and effectively.
:Identify and communicate increased revenue opportunities to Collections staff, based on analysis of existing billing, coding and reimbursement practices.
:Identify root cause of reimbursement barriers with various entities of CHOP to resolve issues.
:Work with internal and/or external auditors to ensure compliance with organizational and governmental policies and procedures.
:Audit methods and procedures of accounts receivable functions to improve efficiency.
Perform trending and analysis of Accounts Receivables.
:Conduct root cause analysis of denials from third party insurances; trends findings and works with other areas to create and implement necessary process enhancements.
:Complete biweekly analysis of Aged Trial Balance Reports to measure progress towards goals, identifies and resolves cash shortfalls, and directs staff in resolution of high dollar and aged accounts.
:Provide financial analysis on issues resulting from non:compliance with managed care contracts. Address reimbursement issues with third:party contracted payors. Advise contracting team on desirable contract terms and/or changes. Refer non:compliance to internal and external legal counsel, as appropriate. 13;
Job Responsibilities (Continued) 13;
Establish written policies and procedures governing operational workflow.
:Maintain sound working knowledge of current industry concepts and practices.
:Develop written policies and procedures based on best practices within the industry.
:Periodically review policies to ensure applicability to and comp
• Location: South Jersey
• Post ID: 44543122 southjersey