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Patient Accounts and Overprovisions Manager in Los Angeles, CA at TeamHealth

Date Posted: 5/24/2019

Job Snapshot

Job Description

JOB DESCRIPTION OVERVIEW:

The Patient Accounts/Overprovisions Manager manages our Patient Accounts and Overprovisions Departments. The Manager is responsible for ensuring that all payments are processed timely and ensure that the month close is completed timely and accurately. In addition to reviewing and analyzing the credit balances for the Overprovisions Department by identifying trends and resolving them to minimize and reduce credit balances. A successful Manager in this role will need to have a strong command of Medicare, Medicaid and other payer guidelines; will be comfortable communicating with payers; possess strong mathematical ability, will have experience managing direct reports who assist in the analysis and reporting process. This position is responsible for approving and releasing refund checks and working directly with the accounting department to reconcile monthly refunds processed. This position is responsible for developing and implementing departmental policies and procedures, productivity standards and measures, monitoring quality, and setting goals and objectives to ensure effective and compliant workflow processes. Also works with business office staff and management to identify issues or trends with regards to billing/appeals.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Manages and supervises the Patient Account Representatives in the functions of posting payments, CCS reconciliation, ETM claim edits/rejections.
  • Manages issues and trends with ERA remit files following HCFS and internal policies.
  • Actively, looks to increase ERA percentage for BC and identifies new payers to convert from paper to ERA or EFT remits.
  • Ensures that all time frames related to posting payments are strictly enforce and items never fall out of Team Health policy.
  • Ensures that all CCS reconciliation is completed prior to close unless there is an identified issue that cannot be avoided.
  • Organizes Monthly BC Close Schedule and ensures that close is managed well and that all deposits are posted and ensures that we do not close short.
  • Assist Patient Accounts/Overprovisions Manager with the MOR.
  • Provides weekly updates to the Patient Accounts/Overprovisions Manager on all department metrics.
  • Assists Patient Accounts/Overprovisions Manager with performance evaluations, rounding and initiates appropriate disciplinary action when required.
  • Plans, organizes, directs, and monitors the assigned area(s).
  • Actively participates in the training/retraining of employees, especially working with new hires in the initial onboarding process.
  • Scheduling the work hours of employees and maintaining accurate timekeeping records.
  • Actively participates in management meetings and provides accurate information.
  • Conducts staff meetings/email communications to inform of changes in policies and procedures and to provide in-service training.
  • Assigning workflow and/or job duties to ensure effective, timely completion of departmental goals.
  • Maintaining accurate production and quality records.
  • Handling complaints and grievances made by employees with the assistance of Human Resources and Director.
  • Controlling inventory, supplies, and materials necessary for the function of the department.
  • Assuring compliance with applicable laws and regulations.
  • Defines and implements a program for quality assurance for assigned areas.
  • Ensures production and quality audits are performed and reported timely and accurately, including notices to staff
  • Monitors key performance indicators and metrics for the department providing corrective action as indicated.
  • Actively participates in the leadership of the department and motivating staff.
  • Completes employee performance appraisals and administers disciplinary action where appropriate.
  • Maintains accurate records of disciplinary actions, developmental conversations, and employee training sessions for their area.
  • Manages staff and procedures ensuring systems operate efficiently and maintains effective personnel relations.
  • Evaluates and refines systems to provide the most efficient, cost effective, and workable flow of reimbursement and accounts receivable management practices.
  • Strives to improve internal relationships between internal departments.
  • Develops long-range and short-range goals and objectives.
  • Prepares and monitors annual budgets.
  • Proactively keeps the Director/Vice President updated on the status of workload and any potential problems that may arise.
  • Performs any and all of the duties assigned by the Director/Vice President.
  • Assists in special projects as requested by the Director/Vice President.
  • Develops and maintains policies and procedures.
  • Assuring the safety of employees
  • Exhibits strong interpersonal relationship building, employee coaching and conflict management skills.
  • Manages expectations and ensures each employee is accountable for performance, including additional training and action plans to address low performance.
  • Holds his/herself accountable for departmental performance.
  • Understands that performance of department is directly tied to Manager/Manager ability to lead and problem-solve.
  • Proactive problem-solver.
  • Plays an active role in setting up meetings, collaborating with peers and other action needed to resolve departmental challenges.
  • Superior delegation skills; does not try to do it all themselves.
  • Accomplishes tasks through people, understanding how to give clear direction/instruction, due dates, and effectively monitors completion of assignments.
  • Superior technical skills (IDX, Analyzer, Excel and basic project management skills). Ability to effectively manage departmental budget.
  • Knowledge of end-to-end revenue cycle (encounter life cycle).
  • Understands how his/her function contributes to overall revenue cycle performance.
  • Superior analytical skills - ability to develop successful action plans for his/her dept; performs root cause analyses using data and implements departmental process improvements.
  • Professional demeanor, ability to practice a high level of confidentiality; ability to manage conflict and emotions; collaborates and searches for win-win solutions.
  • Meets deadlines and delivers on commitments.
  • Identifies potential issues well in advance.
  • Avoids "fire-drills". Escalates high-impact issues to his/her direct Manager immediately.
  • Identifies and escalates issues impacting day-to-day department productivity & performance (e.g. computer issues and other recurring problems).
  • Ability to develop and execute successful training plans; identifies and provides added training when employees are not performing to expectation.
  • Ability to initiate and lead cross-functional meetings effectively and efficiently.
  • Key knowledge resource for Directors & VP. Provides key analyses and metrics for overall A/R; provides key data to support Director/VP decision-making.
  • Ability to manage large-scale projects.
  • Effective project management skills including reporting, coordinating, status updates, and meeting project time lines
  • Actively contributes to a "high performance culture" for TeamHealth as a whole by discussing trends and offering ideas for improvement.
  • May perform special assignments and other related tasks as assigned.

 

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • College education or 4-5 years of equivalent experience in a medical billing setting, with an emphasis on reconciliation and payment posting preferred.
  • BS or BA preferred or equivalent of management/supervisory experience in physician billing related field.
  • Accounts receivable and payer analysis; working knowledge of the revenue cycle process: eligibility, denials, appeals and collections;
  • Solid experience with automated payments tools(ERA);
  • Highly organized, effectively manages competing priorities; superb written, oral, and negotiation skills;
  • Familiarity with the revenue cycle process.
  • Understanding of physician billing guidelines for commercial and government payers in multiple states.
  • Excellent written and verbal communication and interpersonal skills.
  • Proven analytical skills and ability to work in a structured, fast-paces environment.
  • Proficiency in working with systems, GE experience is desirable.
  • Must be organized, detail oriented, and meticulous with all tasks.
  • Astute problem solving skills and ability to interrelate and convey information professionally.
  • Medical billing experience with knowledge of the GE system, Microsoft Excel, Microsoft Outlook, and Microsoft Word.
  • Dependable, always conforms to standards for attendance.

PHYSICAL / ENVIRONMENTAL DEMANDS:

  • Set in a pleasant, high-volume, fast-paced office environment.
  • Ability to meet closing deadlines, and production standards is required.
  • Also, may require physical and/or mental stamina to work additional hours beyond a regular schedule and/or more than five days per week.
  • Significant workload that may require after hours work and/or additional hours be mandated by Management.
  • Regular and reliable attendance is necessary.
  • Prolonged work on a PC/computer.
  • Physical requirements include but are not limited to sitting for extended periods of time, walking, and bending.
  • Periodic travel may be required for meetings and trainings.
  • This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions.

DISCLAIMER:

Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.

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