- Date: 04/27/2020
- Hospital: Rochelle Community Hospital
- Address: 900 N. Second Street, Rochelle, IL 61068
- Contact Information:
Denise M. Bauer, RN, MBA, SPHR, SHRM-SCP
Director of Human Resources
- Position Summary:
The Patient Financial Services Manager is responsible and accountable for all aspects of the revenue cycle related to patient access, billing and collections. Coordinates departmental activities to ensure compliance with regulatory standards, charge master integrity, and provides support to ensure accurate functionality of automated systems while maximizing collections. Reviews, designs and implements processes surrounding pricing, billing, third party payer relationships, collections and other financial analyses. Relies on extensive experience and judgment to plan and accomplish goals. A wide degree of creativity and latitude is expected.
- Understanding and following Rochelle Community Hospital’s Standard of Excellence document. Displaying respect and dignity to patients, visitors and staff. Upholding hospital mission and vision statements, hospital policies, and maintain a code of confidentiality.
- Directly managing and assisting the Patient Access Coordinator and Patient Accounts Coordinator in jobs assigned to the staff in registration, billing, and collections. Ensuring periodic staff meetings are conducted by coordinators to inform staff of changes in policies and procedures.
- Interviewing perspective new employees with coordinators. Conducting annual performance reviews and assisting coordinators in setting goals for individuals. Ensuring personnel comply with hospital policies, procedures, management systems, and documentation. Participating in disciplinary actions as needed for staff.
- Ensuring all staff in areas of responsibility meet standards set by TJC, CMS, Illinois Medicaid, and other governing bodies. Conducting annual compliance and skills testing for staff employees to ensure their educational and skill level needs have been met.
- Preparing annual budget for Patient Access and PFS. Providing leadership with coordinators to explain budget variances and reporting to the CFO. Preparing and planning for capital equipment needs of responsible areas.
- Accurately and objectively reviewing accounts receivable and developing monitoring tools to report hospital receivables. Measuring performance and integrity of the revenue cycle functions. Determining opportunities for improvements and hospital financial success as it relates to the revenue cycle. Using standard industry metrics, reports to CFO.
- Providing information crucial to successful negotiations of managed care contracts. Reviewing third party contracts and ensuring appropriate terms are being followed.
- Responsible to read, act on, and implement policies related to updates in federal and state billing and collections regulations. Must maintain acceptable level of knowledge as it relates to legal aspects of patient accounting and healthcare collection laws. Demonstrating ability to approach self-development needs, including willingness to attend educational opportunities as necessary to maintain knowledge. Encouraging employees to learn new duties and expand on education related to PFS.
- Evaluating in-house EHR system to ensure system is current and efficient as it relates to revenue cycle. Demonstrating knowledge in all aspects of the EHR as it relates the revenue cycle. Recommending updates and/or enhancements to the EHR. Maintaining advanced knowledge of insurance eligibility tools and claim clearinghouses including HIPAA Transaction Code sets: 270/271 and 837/835.
- Maintaining hospital charge master and ensuring charge master integrity. Establishing controls to ensure system changes are being followed correctly. Providing guidance and collaboration with revenue generating department managers in use of coding (CPT and HCPCS) within the charge master to insure accuracy and compliance. Understanding requirements of the Office of Inspector General (OIG) related to areas of responsibilities. Leading periodic charge master reviews with outside consulting services.
- Responsible to maintain EHR files related to patient revenue cycle specifically, registration, production of both UB and 1500 billing forms, payer logs, provider enrollments, cash postings and payer plan maintenance. Maintain knowledge of CMS Critical Access Hospital (CAH) billing and reimbursement regulations.
- Reading, interpreting, and distributing payer coding and reimbursement information to all departments to ensure regulatory compliance. Working closely with revenue producing department managers to ensure all services rendered are captured and billed appropriately. Acting as a resource to all revenue departments regarding charge master needs.
- Approving requests for overpayments from credit balance accounts. Reviewing financial aid discounts with coordinator. Ensuring quarterly credit balance reports are submitted timely to CMS/MAC.
- Coordinating effectively with HIM Manager for compliance, coding, and timely billing.
- Working closely with the CFO and Finance Manager as it relates to financial reporting and audit needs. Assisting in audits performed by hospital auditors, CMS, and IL Medicaid as needed. Providing auditors with necessary data as requested.
- Serving on hospital committees including but not limited to Corporate Compliance, IT Task Force, Utilization Review, Information Governance, and Dare to Soar. Serves as chair of Revenue Cycle Team.
Seven years’ experience in patient financial services, preferably in a hospital setting. Minimum of five years in leadership. Bachelor’s degree in Finance/Accounting or Management preferred or current certification accreditation from AAHAM or HFMA. Proficient with Excel and Word. Knowledge or experience in Health Information Management and coding is helpful.
Must be able to demonstrate initiative in problem solving, critical thinking skills and project management skills. Able to demonstrate a responsibility for departmental success while balancing financial needs of facility. Excellent written and verbal communication skills and motivational skills. Visual and hearing acuity pertinent to communicate effectively with patients and staff.
Rochelle Community Hospital Association position descriptions are guidelines. They are not intended to identify every task that an employee will be asked to do. They are intended to provide a general outline of the work, responsibilities and qualifications of the position. Employees are expected to provide whatever assistance is needed so that both individual and organizational success can be achieved.