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Supervises and coordinates activities and employees related to all patient financial services and processing including: billing, insurance follow-up, self-pay collections, customer service of patients within University Health Associates to ensure the financial viability of the clinical and business enterprise. Will ensure that all administrative and departmental policies and procedures are adhered to by staff. Provides adequate staffing in all areas of the department. Demonstrates the ability to assertively pursue necessary information and to function independently to secure resolution on staff and patient/billing issues. Projects a mature problem-solving attitude while dealing with interpersonal conflict, dissatisfied patients and time demands. Maintains knowledge of revenue cycle operations, third party reimbursement, local/state/federal regulations, Fair Debt Collections Act, and medical terminology. Knowledge will include at minimum, all aspect of payer relations, claims adjudication, contractual claims processing and general reimbursement procedures. Uses excellent customer service, telephone etiquette, written and oral communication skills. Provides coaching and counseling to staff based upon performance management principals. Provides professional, courteous service to patients, customers and families.

MINIMUM QUALIFICATIONS :

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High school graduate or equivalent.

PREFERRED QUALIFICATIONS :

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. AA, BA or BS preferred

EXPERIENCE:

1. Two to three years’ experience in a healthcare setting preferred

2. Supervisory experience preferred

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Coordinate and supervise posting, billing, collection and audit operations for accounts that will be paid by third parties to ensure accurate, timely billing and follow-up for payment.

2. Maintain appropriate internal control safeguards over accounts receivable records and collection of cash i.e., payments, adjustments, write offs.

3. Establish and implement controls for appropriate submission, billing and payment cycles to ensure integrity of accounts receivable and patient information.

4. Implement appropriate procedures for follow-up of third party billing and collection on overdue accounts to meet those department goals.

5. Design and/or prepare appropriate reports to monitor if departmental operations are timely and efficient in billing, insurance follow-up and collection of accounts receivables to ensure the financial viability of the Hospital.

6. Monitor and review aged trial balance of open accounts. Initiate appropriate actions as needed to follow-up.

7. Negotiate special discount arrangements, using sound financial practices, within the guidelines of State and Federal regulations.

8. Completes 90 day and annual evaluations for employees.

9. Able to implement verbal counseling and/or Corrective Action per WVUH Policy.

10. Maintains current knowledge of third party payor and managed care requirements.

11. Gathers statistics, completes reports and performs other duties as scheduled or requested.

12. Communicates status of daily operations to Manager or Director.

13. Organizes and executes daily tasks in appropriate priority to achieve optimal productivity, accountability and efficiency.

14. Maintains functional knowledge of operational areas and is able to step into staffing as needed.

15. Handles patient/family or staff complaints, investigates complaint and makes recommendations on appropriate resolution.

16. Has a working knowledge of current UHA contracts with third-party payors.

17. Collects co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the billing systems.

18. Complies with Notices of Privacy Practices, (HIPAA) .

19. Maintains current knowledge of major payor payment provisions.

PHYSICAL REQUIREMENTS: 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.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping and feeling are necessary body movements utilized in performing duties throughout the work shift

2. Must be able to sit for extended periods of time

3. Must have reading and comprehension ability

4. Must be able to read and write legible in English

5. Visual acuity must be within normal range

6. Must be able to communicate effectively

7. Must be able to exert in excess of 50 pounds of force occasionally to move patients or objects

8. Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment

WORKING ENVIRONMENT: 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.

1. Office type environment

2. Patient care environment

SKILLS AND ABILITIES:

1. Excellent oral and written communication skills.

2. Working knowledge of computers.

3. Knowledge of medical terminology preferred.

4. Knowledge of third party payors preferred.

5. Knowledge of business math preferred

6. Knowledge of collection procedures preferred.

7. Knowledge of ICD-9 and CPT coding preferred.

8. Excellent customer service and telephone etiquette.

9. Ability to use tact and diplomacy in dealing with others.

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Exempt)

Company:

WVUH West Virginia University Hospitals

Cost Center:

544 UHA Patient Financial Services

Address:

Morgantown WV

Core

West Virginia