Ops Coord Patient Acctg

Description The Operations Coordinator Patient Accounting reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. Responsibilities Responsible for providing leadership and professional expertise or services by leveraging the knowledge and skills of Patient Accounting Billing & Follow-up staff. Maintain oversight for the following: Timely resolution of all claim edits and management & reporting of candidates for bill. Outbound compliant bill submission, clinical documentation requirements and any other communication required (verbal or written) regarding claims ensuring timely filing of claims and clean, complete and accurate claims. Timely follow-up and collection of third party payer receivables and tracking of third party yields. Denials and Appeals management including root cause analysis to reduce/prevent future denials while working to overturn denials for payment resolution. Compliant follow-up correspondence to third party payers regarding outstanding accounts receivables (i.e. Statements, letters, e-mails, faxes, portal mail, etc.). Operations related to optimum third party accounts receivables (i.e. Managed Care, Commercial, Medicare, Medicaid, Replacement plans, Workers Compensations, Corporate Accounts, Research, Specialty AR Accounts). Ensuring adherence to all regulatory billing requirements reporting any suspected breaches or concerns to the Patient Accounting Manager and Corporate Integrity & Compliance (HIPAA, Patient Privacy, ACA Consumer Protections). Accounts receivable management (reimbursement due for services rendered). Serve as a subject matter expert for efforts to improve revenue cycle operational workflows between the various systems supporting the end to end revenue cycle (Cerner, PRMES, Epic, MethodCare, PassPort, ScriptPro, Recondo, 3M, MedAssets). Effectively organize, schedule, and supervise staff to monitor and ensure all billing and account follow-up accounts are ready for work are completed each day. Assign work to the staff and review output of the staff for accuracy and completeness. Effectively monitor and ensure staff enters account notes in a timely and thorough manner. Assist in the development of goals and objectives for billing and account follow-up staff for any measurable productivity and quality standards which are benchmarked to an industry standard or NMHC internal standard. A Assist in the development and maintenance of department policies and procedures and coordinate with other departments to develop and maintain policies and procedures affecting the goals and objectives of the team. Assist in managing the administrative and operational objectives for billing and account Follow-Up. Generate and monitor reports on a daily, weekly and monthly basis, making necessary adjustments to the schedule in order to reach the departments stated goals. Generate and monitor staff performance reports as directed by the Patient Accounting Manager. Provide frequent updates to the Patient Accounting Manager on staff performance, AR aging, Days in AR, cash collections, accounts backlogs and current process improvement initiatives. Manage people, processes and projects to implement the overall strategies and/or achieve the goals of the Patient Accounting department. Ensure all Patient Accounting billing and follow-up functions are adequately and properly staffed, effectively shifting personnel for maximum efficiency. Conduct regular evaluations of staff adherence to productivity and quality standards and provide direct feedback and counsel to staff members. Provide flexible support for billing and account follow-up activities when staff members are absent or have a growing backlog of work. Work with staff to determine root causes for any growing backlogs; provide necessary education, submit issues to IT, or elevate resource issues to Patient Accounting Manager in response. Recommend, set up, and enforce cross-training schedules to ensure more than one member of the staff can perform each job function. Attend training and seminars as assigned and approved by the Patient Accounting Manager. Act as the second level escalation point for operational issues, customers who request a supervisor or manager, and customers who ask for information that requires in-depth knowledge; recommend corrective services to respond to customer complaints. Assist the Patient Accounting Manager with developing and implementing new and/or updated policies and procedures. Assist the Patient Accounting Manager in recruiting, interviewing, hiring, training, reviewing, promoting, and disciplining Customer Service staff. Assist with administrative supervisory functions such as handling requests for paid time off (PTO), creating and maintaining schedules, managing staff hours and pay, and verifying accuracy of timesheets for payroll. Responsible for education and enhancement of customer service to external and internal customers. Effectively communicate with management, staff, external vendors, attorneys, insurance companies, and internal departments. Conduct testing of system updates related to customer service and self-pay and provide feedback to IT. Assist with monitoring and managing department expenses and budget. Work to continually improve processes; ensure timeliness of interactions with patients to improve patient satisfaction. Qualifications Required: Bachelor’s degree in an applicable field of study, or equivalent work experience. Minimum of five (5) years of progressive work experience with a call center, patient customer service, and/or self-pay collections with supervisory experience. Knowledge of hospital and physician base patient management and automated systems. Able to effectively supervise a team composed of direct and indirect reporting relationships. Ability to perform mathematical calculations. Excellent communication skills when dealing with patients, authorized guarantors, public, co-workers, and professional offices. Advanced knowledge of medical terminology, insurance plan payment practices and billing requirements. Extensive experience and knowledge of PC applications, including Microsoft Office and Excel. Knowledge of and detailed understanding of all negotiated agreements. High-level problem solving, analytical, and investigational skills. Excellent internal/external customer service skills. Excellent communication skills to include oral and written comprehension and expression. Preferred: Bachelor’s degree in an applicable field of study. Knowledge of Epic Systems. Knowledge of Epics Single Billing Office module. Knowledge of Process Improvement methodologies such as LEAN/Six Sigma. Detail-oriented, good organizational skills, and ability to be self-directed. Strong time management skills, managing multiple priorities and a heavy workload in a high-stress atmosphere. Flexibility to perform other tasks as needed in an active work environment with changing work needs. Knowledge of NMHC systems. Knowledge of NMHC policies and procedures. Equal Opportunity Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status. Background Check Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check. Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act. Artificial Intelligence Disclosure Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person. Benefits We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more. Sign-on Bonus Eligibility (if sign-on bonus offered for position): Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family. #J-18808-Ljbffr Northwestern Medicine