Responsible for overall functions of the Business office, supervising staff, monitoring productivity and reports to insure timely and accurate reimbursement.

Job Duties:

• Provides oversight and accountability to the Business Office, Registration, Data Processing, Financial Counseling, Denials Management and Precertification department.
• Assists the Revenue Cycle Director
• Reviews electronic claims workflow for current and pending claims
• Reviews denial management for discrepancies and inefficiencies
• Monitors reports for accuracy and timeliness of billed claims and follow-up
• Monitors and reviews patient outstanding balances, collections and bad-debts
• Reviews remittance advices; determines problems causing rejections and denials
• Ensures that the pre-cert department is obtaining prior authorizations or approvals in a timely manner
• Communicates with third party payers in regards to claims processing difficulties or new processing procedures
• Maintains extensive knowledge of revenue cycle and regulatory requirements associated with governmental, managed care, and commercial payers.
• Maintains an effective and efficient workload for each hospital biller

Education:

• High School Diploma or Equivalent
• Bachelor’s Degree in related field is preferred – experience in lieu of education may be substituted

Training/Experience:

• 2 years supervisory experiences required
• 3 years Billing/AR – Denial Management with hospital and/or professional claims which demonstrates attainment of the required requisite job knowledge and abilities.

Skills/Qualifications:

• Proficient in Microsoft Office products, specifically Excel
• Proven leadership skills and ability to gain cooperation and support from a diverse body of individuals
• Highly dependable in both production and attendance
• Ability to effectively prioritize and execute tasks while under pressure; make decisions based on available information and within the scope of authority of the position; excellent customer service skills, including professional telephone interactions.
• Exceptional organization, problem solving, and time management skills with an attention to detail
• Excellent verbal and written business communication skills sufficient to clearly document issues and effectively communicate.
• Promote the mission, vision, and values of Taylor Regional Hospital.
• Maintain confidentiality of all patient, medical, financial, and legal information.
• Represent the organization in a positive amp; professional manner.
• Ability to handle difficult situations involving patients, physicians, staff and others in a positive and professional manner.
• Comply with all organization policies and standards
• Consistently demonstrate the value of team concept.
• Understands and abides by OSHA, HIPAA and CLIA standards
• Understanding of HIPAA regulations and proven ability to ensure confidentiality with respect to sensitive information