Maniilaq Association

12/19

Title:  Patient Financial Services Director                                                                        Range:  19

Program:  Patient Financial Services                                                                              Status:  Exempt

Housing Priority: 4                                                                                                       Covered:  Yes

POSITION SUMMARY

Plans, manages and supervises Patient Financial Services (PFS) staff including Patient Registration, Alternate Resources and the third-party billing outsourced contracts.  Works collaboratively with fellow Revenue Cycle Team members (CFO, Director of Health Information, and relevant department heads) including but not limited to determining annual third-party revenue targets, attaining identified targets, and preparing revenue cycle progress reports for the Board of Directors. Ensures that the goals and objectives of PFS are consistent with Maniilaq Association policies and any applicable Federal and/or State regulations.  This position reports to the Vice President of Health Services.

PRINCIPAL DUTIES AND RESPONSIBILITIES

1.       Participates in development and implementation of PFS program goals and objectives.

2.       Establishes, audits and evaluates outsourced billing, posting and collection operations for all patient accounts for Hospital, Dental, Pharmacy, and Long Term Care services.

3.       Troubleshoots and resolves registration, billing and denial issues, which negatively impact clean claims on initial billing.

4.       Initiates identified revenue cycle improvements.

5.       Maintains a current and comprehensive understanding of insurance, Medicare, Medicaid, federal and state laws, rules, and regulations in regards to the billing and collection for services.

6.       Assures PFS compliance with all internal, state and/or federal codes, rules, regulations and standards regarding the billing and collections for services provided by Maniilaq Health Services providers. Assures PFS compliance with OIG Medicare issues.

7.       Regularly reviews patient eligibility database Medicaid, Medicare, insurance companies and other alternate health resources.

8.       Communicates appropriately to patients, health care providers, and co-workers. Effectively communicates with other Maniilaq programs, third party payers, contractors and software vendors in order to ensure a functional program.

9.       Assures completion of necessary applications and obtains approvals for POS, Medicare Discount Drug Card Program and other programs, which generate reimbursements.

10.   Assists patients with billing and accounts problems not resolvable through the initial channels.

11.   Compiles, maintains and submits PFS reports and data within required deadlines. Responsible for generating, compiling and submitting program end of month reports last business day each month, and other necessary reports within deadline timeframes.

12.   Maintains a cost-effective program that ensures the highest possible cash flow for Maniilaq Association, while minimizing delinquent accounts.

13.   Maintains knowledge of all patients' rights and confidentiality requirements regarding patient information and adheres strictly to all regulations pertaining to such.

14.   Supervises Patient Registration, Alternate Resources and other PFS employees.

15.   Updates and maintains Charge Master.

16.   Supervises Patient Travel staff and program.

17.   Other duties as assigned.

MINIMUM REQUIREMENTS

The capabilities normally equated with completion of a bachelor's degree in Finance or equivalent work experience in health care administration/ medical business office. Knowledge and experience with Medicaid, Medicare and private insurances. Knowledge and experience with billing and accounts receivable systems.  Familiarity with IDC, CPT, HCPC, and state coding rules, regulations and laws are required. Excellent communication skills required. Experience training and leading staff.  Excellent computer skills, electronic health record experience. Minimum of two years supervisory experience.

DISCLAIMER

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job.  They are not intended to be considered an exhaustive list of all responsibilities, duties and skills required of personnel in this job, and the employer reserves the right to revise or change this description.  This description does not constitute a written or implied contract of employment.  To perform this job successfully, an individual must be able to satisfactorily perform each of the above essential duties and meet physical demands.  Reasonable accommodations may be made to enable individuals with disabilities to meet those conditions.