Ops Coordinator Patient Accounting
Ops Coordinator Patient Accounting
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1 Vacancy
Job Description
The Operations Coordinator Patient Accounting reflects the mission vision and values of NM adheres to the organizations 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 & Followup 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 followup 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 followup correspondence to third party payers regarding outstanding accounts receivables (i.e. Statements letters emails 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 followup 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 followup 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 FollowUp. 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 followup 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 followup 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 escalate resource issues to Patient Accounting Manager in response.
- Recommend set up and enforce crosstraining 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 indepth 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 selfpay 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:
- Bachelors 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 selfpay 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 coworkers 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.
- Highlevel problem solving analytical and investigational skills.
- Excellent internal/external customer service skills.
- Excellent communication skills to include oral and written comprehension and expression.
Preferred:
- Bachelors 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.
- Detailoriented good organizational skills and ability to be selfdirected.
- Strong time management skills managing multiple priorities and a heavy workload in a highstress 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.
Additional Information :
Northwestern Medicine is an affirmative action/equal opportunity employer 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.
If we offer you a job we will perform a background check that includes a review of any criminal convictions. A conviction does not disqualify you from employment at Northwestern Medicine. We consider this on a casebycase basis and follow all state and federal guidelines.
Benefits
We offer a wide range of benefits that provide employees with tools and resources to improve their physical emotional and financial wellbeing while providing protection for unexpected life events. Please visit our Benefits section to learn more.
Remote Work :
No
Employment Type :
Fulltime
Employment Type
Full-time
