SUMMARY OF DUTIES: Coordinates the functions
of the Business Office, Revenue Cycle process and oversees all revenue cycle
contractor performance. Ensures maximization of cash flow while improving
patient, physician, and other customer relations. Responsible for oversight of the full scope of business office activities (coding, billing payment posting, prior authorizations and denials) for a 30+ physician multi-specialty group.
REQUIRED: Reports to Chief Financial
EXERCISED: Direct supervision over
assigned Business Office staff. Indirectly supervises contractor staff through
management of vendor performance.
1) Plans and directs registration, patient insurance, billing and
collections and data processing to ensure accurate patient billing and
efficient account collection.
2) Reviews current status of patient accounts to identify and resolve
billing and processing problems in a timely manner.
3) Solves difficult payment and associated business office problems. Audits problem accounts.
4) Maintains contacts with clinical and other departments to obtain and
analyze additional patient information to document and process billings.
5) Develops and implements new procedures to improve the quality and
quantity of work processed. Ensures
policies are communicated and administered consistently.
6) Monitors daily operating activity of department and makes necessary
adjustments in work assignments.
7) Responsible for hiring, training and development of staff including
evaluation and counseling responsibilities.
8) Works closely with the
physicians, insurance provider relations representatives, and PHO
representatives to assure the physicians and facilities. Ensures providers are
credentialed and are following revenue cycle requirements in compliance with
state, federal and insurance guidelines.
9) Monitors physicians' credentials such as licenses, CME's and appropriate hospital privileges to assure that all are kept current. Notifies Credentialing Department to correct any deficiencies noted.
10) Initiates and answers
pertinent correspondence. Prepares and
11) Maintains knowledge of
and complies with established policies and procedures including government,
insurance and third-party payer regulations.
12) Attends administrative
meetings and participates in committees as requested. Conducts special projects and studies as