Manager Patient Financial Services

About this role

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Work Day(s) Monday, Tuesday, Wednesday

Shift Start Time 8:00 AM

Shift End Time

4:30 PM

Worker Sub-Type

Regular

Children’s is one of the nation’s leading children’s hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We’re committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children’s.

Job Description

Oversees and resolves accounts receivable activity assigned to the team. Monitors and manages area, including claims billing and collection activities. Responsible for proactively identifying and addressing account aging, payer trends in relation to zero payment, payment variance, billing, and denials, and takes action to address both accounts receivable and individual account issues. Works closely with IS&T, Contract Analytics, Patient Access, Coding, HIS, Reimbursement, Finance, Managed Care, and other departments. May collaborate with Vice President of Revenue Cycle and Directors within the Revenue Cycle team. Works closely with system and Revenue Cycle leaders to develop and implement quality measures related to billing compliance and collection activities. Sets and manages productivity and other performance indicators, providing feedback to staff related to performance throughout the year. Proactively monitors regulatory requirements and works to ensure compliance. Communicates any changes identified that may impact customer service, patient throughput, patient billing, and collections. Produces reporting and provides analytic analysis of data relevant to claims and billing to drive swift resolution of accounts receivable. Serves as primary Revenue Cycle contact for insurance payors.

Experience • 5 years of experience in provider accounts receivable management

• 2 years of experience in a supervisory or management role

• Demonstrated change management experience

Preferred Qualifications • Master’s degree

• Experience leading teams during system implementations and upgrades

• Knowledge of coding, reimbursement, and clinical documentation

• Experience working with finance, reimbursement, managed care contracting, and revenue cycle leaders to present key performance indicators with accounts receivable analysis and recommendations for improved reimbursement

• Demonstrated strong technical skills including experience with Microsoft Access and the ability to craft and manipulate SQL queries

Education • Bachelor’s degree in Business, Health Administration, Mathematics, Statistics, Computer Science, or related field, or equivalent years of experience in supervisory role

Certification Summary • No professional certifications required

Knowledge, Skills, and Abilities • Detailed knowledge of accounts receivable key performance metrics—including accounts receivable days, account aging, collection and denial rates, cost to collect—and demonstrated success in managing to those metrics

• Possesses and demonstrates excellent communication, organizational, and interpersonal skills

• Proven aptitude for problem-solving and critical thinking

• Knowledge of key Children's Healthcare of Atlanta patient accounting or comparable applications: Epic Resolute, nThrive, EncoderPro, QlikView

• Demonstrated understanding of provider finance, reimbursement, managed care contracting, and revenue cycle processes and indicators

• Ability to function in a dynamic environment subject to impromptu changes in schedules and priorities

• Ability to communicate well and present findings verbally via presentations, spreadsheets, and written documents

• Ability to multitask and work both independently and within teams

• Demonstrated ability to develop and manage budgets and other financial skills

• Advanced proficiency working in Microsoft Excel, Word, and PowerPoint

Job Responsibilities • Has primary responsibility for the oversight of accounts receivable assigned, including all billing and collection activities, as well as ensuring quality and collection goals are met.

• Has primary responsibility for denial management for accounts receivable assigned, with working knowledge of the appeal process, including reconsideration, arbitration, and administrative law hearing process.

• Has detailed knowledge of payer policies, with strong understanding and interpretation of Children’s contract as it relates to billing requirements, payment rates, and appeals.

• Maintains working knowledge of industry standards and federal and local regulatory requirements for billing and collection activities.

• Develops professional relationships with stakeholders within Children’s as well as payers to foster collaboration and partnerships for improved collection efforts.

• Approves balance adjustments as outlined in department’s policies.

• Partners with Coding department to understand requirements and ensure claims resolution.

• Participates in internal and external audits as needed to ensure regulatory compliance.

• Identifies trends, issues, and concerns related to claims, and collaborates with revenue cycle and other leaders across the organization for resolution.

• Works to achieve compliance with all governmental, payer, and regulatory agencies’ requirements by routinely analyzing standards, regulatory rules, and Children’s policies, and develops and implements activities and policies/procedures designed to meet requirements of these agencies. Directs formulation of responses to governmental, payer, and regulatory audits and requests.

• Manages the orientation, competency assessment, and mandatory education for Patient Accounting staff. Ensures the development of educational pr

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