Medical Business Office Manager, Full Time

Business Office Manager - Patient Financial Services

Northwest Florida Community Hospital (NFCH), in Chipley, FL, is seeking a FT experienced, energetic and dedicated Medical Business Office Manager to provide exceptional care for our patients in support with medical Providers and staff, in our Patient Financial Services Department.

At NFCH, our strength lies in our promise of Your HealthOur Mission, where we get to know our patients and residence, care for them, and ease their way. Working at our organization means that regardless of your role, well walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected.

We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. Join our team of passionate caregivers and make Northwest Florida Community Hospital your new home.

Job Summary:

Provides managerial leadership for hospital business office functions that contribute to the billing and collection of patient service revenue. Responsibilities include best practices and principles related to patient accounting, insurance reimbursement, governmental and other payer source billing, credit and collections and cashiering related to hospital and long-term care services. Knowledge of functions, capabilities and operation of computer-based billing and patient accounts management systems, including but not limited to CPSI (EHR), Quadax or similar (Clearinghouse) and Microsoft applications (Word, Excel, Powerpoint, etc.).

Education:

Associates degree from an accredited college or university required; a bachelors degree in business, finance, accounting, management or closely related discipline is preferred.

Experience:

A minimum of five (5) years management experience in healthcare receivables required. Work record that demonstrates in-depth knowledge of hospital and long-term care billing and reimbursement, knowledge of medical terminology, negotiating skills, and knowledge of healthcare industry financial statistical information.

Licenses, Certifications and/or Registrations:

None.

Specialized Knowledge and Skills:

Principles and practices of patient accounting, insurance reimbursement, governmental and other payer source billing, credit and collections and cashiering related to hospital and long-term care services. Knowledge of functions, capabilities and operation of computer-based registration, billing and patient accounts management systems.

Requires sufficient knowledge in the use of basic computer software. Must use software to develop spreadsheets for analytical purposes.

Supervised by:

CFO, COO and CEO

Supervises (Headcount): 6 - 10

Supervises (Job titles): Patient Financial Services associates

Interrelations/Contacts:

Works with all departments on accounting and/or human resource issues.

Essential Functions of Competent Performance for This Position:

• Demonstrates in-depth knowledge of hospital and professional billing to ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payors. A deep understanding of how a CAH (Critical Access Hospital) operates as it relates to insurance and financial matters.
• Demonstrates up-to-date knowledge related to CMS guidelines, ICD-10 requirements, UB/1500 claim submission data and elements required for clean claim submissions.
• Manages billing operations that cover all aspects of government payers, third party and patients to ensure accurate and timely processes occur.
• Ability to analyze and resolve problems that affect the claim submission process, regardless of whether the problem originates in an area under direct or indirect control.
• Satisfactorily mediate and resolve conflicts regarding billing inquiries from patients and/or third party payors. Implement patient friendly billing guidelines.
• Maintain appropriate internal control safeguards over AR records and collection of cash. Maintain compliance standards for providing accurate information on hospital billing system.
• Has a good understanding of how insurance contracts work between hospitals/health systems and third party payers.
• Has a good understanding of how government payers adjudicate and process claims. A solid understanding of the various payment methodologies from Medicare and Medicaid is critical.
• Promptly audit remittance advices to ensure timely and optimal payment. Communicate deficiencies to applicable department managers to resolve issues related to uncollected revenues.
• Ensure timely collection of AR to maintain consistent cash flows. Maintain days in AR at acceptable level (e.g. 45 day.
• Provide decision support [generate reports] to financially analyze data to identify trends and/or variances with regard to billing and collections. Make procedure changes as necessary.
• Develop billing and collection policies, procedures and standards that promote best practice guidelines that improve productivity and efficiency throughout the revenue cycle process.
• Oversees physician coding function and trains staff to ensure that physician clinics receive appropriate reimbursement and conforms to applicable guidelines and regulations.
• Assures the accuracy and timeliness of the physician coding process. Displays knowledge in ICD-9 and CPT-4 coding.
• Acts as a liaison between patients, patients' relatives, and the healthcare organization; communicates patients' questions, complaints, problems and concerns to appropriate staff members. Explains policies and procedures to patients and refers them to the proper services required.
• Coordinates CDM review and change process; reviews appropriateness of CPT and Revenue codes and determines if care provided corresponds to the charges submitted; serves as resource for department heads regarding annual CPT code changes.
• Demonstrates teamwork; supports, assists, and praises fellow associates whenever possible; feels a sense of ownership and takes pride in the Health System; looks beyond assigned tasks to achieve goals.
• Communicates with staff; conducts regular departmental meetings to inform staff; stays accessible to staff and provides assistance, education and/or training if necessary; keeps Administration informed of departmental issues.
• Implements new and innovative ways to reduce cost or increase productivity; increases working knowledge of CPSI system; improves departmental customer service standards.
• Demonstrates a strong commitment to budget guidelines; participates in the budget process; recommends methods to increase revenue or decrease costs; maintains current CDM (if applicable); complies with billing requirements.
• Participates in Health System activities; takes initiative in Process Improvement; promotes the Health System throughout the community; enforces Health System policies; exhibits leadership qualities.

We are an Equal Opportunity Employer and boast an enjoyable, team oriented working environment that offers a number of benefits to full-time associates including, but not limited to: medical, dental, vision, disability, life, paid time off, and a voluntary match 401(k) retirement savings plan.

*Perks for our team:

401K with employer match

Medical, dental, vision, and life insurance

FREE Services with NFCH Providers

A generous PTO plan

Competitive pay

Health and Wellness Discounts

*Details outlining program specifics are available upon request

Job Type:

Full time - Day Shifts, Monday - Friday.

Eight (8) hours per day, five (5) days per week; additional hours as needed

Pay:

Based on years of experience

Working Conditions:

Normal office environment; fluctuations in workload.

Benefits:

401(k)

401(k) matching

Dental insurance

Employee assistance program

Health insurance

Life insurance

Paid time off

Vision insurance