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Manager Patient Financial Services
Fairfax, VA
Job Description
As a Manager of Patient Financial Services, you will be responsible for the timely and accurate processing of claims by assigned supervisors and staff monitored through productivity measurement, quality review and feedback. To help achieve our mission, you will ensure that all claims meet clearinghouse and/or payer processing criteria, are followed up on in accordance with departmental/contractual requirements and that payments/adjustments are handled properly. Your ability to supervise the operational and financial functions of the Patient Accounting department is expected. Providing the Director of Patient Financial Services with issues and potential resolutions regarding problems with the claims submission and payment process is of vital importance. Ensuring regulatory compliance enforcement with policies and procedures is required.
Job Responsibilities
Additional Requirements
As a recipient of federal financial assistance, Inova Health System (“Inova”) does not exclude, deny benefits to, or otherwise discriminate against any person on the basis of race, color, national origin, sex, sexual orientation, disability, or age in admission to, participation in, or receipt of the services or benefits under any of its programs or activities, whether carried out by Inova directly or through a contractor or any other entity with which Inova arranges to carry out its programs and activities.
This policy is in accordance with the provisions of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, Section 1557 of the Affordable Care Act, and regulations of the U.S. Department of Health and Human Services issued pursuant to these statutes at 45 C.F.R. Parts 80, 84, 91 and 92, respectively.
Job Responsibilities
- Creates and enforces work standards, quality measures and process improvements that are consistent with the organization's goals and objectives. Ensures regulatory compliance with Medicare and state authorities, Generally Accepted Accounting Principles and any external governing authority.
- Assures claims are reviewed, corrections are identified/made or resolutions are initiated while ensuring all follow-up claims/actions are submitted via the appropriate medium and with all required attachments.
- Maintains knowledge of government regulations, payer requirements, UB-04 standards, information system functionality (i.e. Hospital, clearinghouse, payer), hospital policies/procedures and departmental SRGs.
- Evaluates the impact of new or upgrades to existing systems/tools while performing testing of system changes, providing technical/operational support during implementation and evaluating the success of new systems/tools.
- Ensures timely/accurate billing, collection, posting, servicing and/or auditing of the $1.5 billion receivable stream.
- Ensures follow-up is completed utilizing TRAC work lists, QMS or other systems/reports according to department policy/procedure, SRG or industry best practice standards.
- Demonstrates a working knowledge of CareMedic systems, DSS electronic billing systems, Syntellect IVR systems, HealthQuest 2000, QMS and Premis electronic billing systems.
- Provides feedback and training to supervisors and staff. Provides resolution for pended (WIP backlog) claims within allowable timeframes (as defined for appropriate deficiency) and/or ensures billed claims receive timely and appropriate follow up based on established protocol or SRG.
Additional Requirements
Education:
Bachelor's degree four-year degree or four years of additional experience, (at least two need to be in management / consulting), Bachelor's degree in finance or accounting.
Experience:
Four Years of Patient Accounting, three years of experience in Patient Accounts Management/Supervision or Consulting. Four - five years of management experience in a large hospital system.
Certification:
CCAT, CPAT, CCAT, CPAT or degree and experience in lieu of certification. CCAT, CPAT, CPAM, CPMA or Degree and two years of experience in lieu of certification.
Skill:
Microsoft Office, working knowledge of Microsoft Word and Excel.
As a recipient of federal financial assistance, Inova Health System (“Inova”) does not exclude, deny benefits to, or otherwise discriminate against any person on the basis of race, color, national origin, sex, sexual orientation, disability, or age in admission to, participation in, or receipt of the services or benefits under any of its programs or activities, whether carried out by Inova directly or through a contractor or any other entity with which Inova arranges to carry out its programs and activities.
This policy is in accordance with the provisions of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, Section 1557 of the Affordable Care Act, and regulations of the U.S. Department of Health and Human Services issued pursuant to these statutes at 45 C.F.R. Parts 80, 84, 91 and 92, respectively.
Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
4+ years
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