Note: The job is a remote job and is open to candidates in USA. Children's Healthcare of Atlanta is a leading children's hospital committed to improving children's health and well-being. The Manager of Patient Financial Services oversees accounts receivable, billing, collection, and denial management activities while ensuring regulatory compliance and effective payer relationships. The role also leads staff, analyzes financial performance, supports revenue cycle initiatives, and coordinates with clinical, finance, technology, and reimbursement teams.
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 programs needed for teams assigned
- Validates that information system implementations and upgrades are completed successfully in conjunction with IS&T, Reimbursement, Managed Care, and other areas/departments as needed
- Responsible for all aspects of managing and leading a team including interviewing, hiring, training, developing, directing work and processes, managing performance, recognizing, and rewarding employees
- Represents department in meetings as needed and takes responsibility for documenting and ensuring actions and follow-up items are addressed timely and in appropriate detail
- Participates as lead resource in internal and external meetings to help explain trends in accounts receivable and collection performance as well as to find and address root causes of issues and concerns identified
- Supports Patient Accounting director in implementing and achieving revenue cycle goals and initiatives
Skills
- 5 years of experience in provider accounts receivable management
- 2 years of experience in a supervisory or management role
- Demonstrated change management experience
- Bachelor's degree in Business, Health Administration, Mathematics, Statistics, Computer Science, or related field, or equivalent years of experience in supervisory role
- 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
- 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
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