Compensation: Pay is determined by various factors, including but not limited to job-specific requirements, individual experience, internal pay equity, and organizational needs/budget considerations, all in alignment with our RML's compensation philosophy. Additionally, you may be eligible for a discretionary annual incentive program based on both individual and organizational performance.

Benefits

RML offers competitive compensation and excellent benefits package. Employees can choose from a large selection of benefits that help protect their health, wealth, and well-being. Benefits include:

GENERAL SUMMARY:

Under the supervision of the Supervisor of Patient Financial Services, assumes responsibility for the coordination and direction of the Patient Accounts billing and collection activities for hospital and physicians.  Assists in the design and implementation of improved billing systems to facilitate more efficient patient billing, reduce write-offs and improve hospital cash flow; prepares financial, statistical, and productivity reports which summarize Patient Accounts receivable activity, identifies and analyzes payment variances; completes other billing and collection projects as assigned.

PRINCIPAL DUTIES & RESPONSIBILITIES:

1. Supports the Mission and Vision of RML Specialty Hospital by demonstrating RML’s Core Values of Service, Teamwork, Accountability, Integrity, Respect and Stewardship (STAIRS) in all actions. Promotes a positive patient/customer experience by exemplifying the principles of the Language of Caring in all interactions with patients, families and coworkers.                                       
2. Performs routine and complex billing, reimbursement, and A/R management functions in association with Medicare, Medicaid and Third Party Payers for both UB04’s and 1500’s.  This includes ensuring that all secondary payer claims and Medicare exhaust claims are processed in accordance with departmental policy to achieve maximum payment for RML.                                 
3. Verifies insurance coverage and follow-up with payers to ensure coverage for services provided.                         
4. Ensures accurate contractual adjustments for all payers.  Reports any contract payment discrepancies to management on a timely basis.                                                                               
5. Ensures accurate and timely submissions of claims; proactively analyzes account activity, identifies problems and initiates actions.
6. Negotiates, recommends, and communicates payment expectations or any other reimbursement issue within hospital policies and procedures.
7. Collects and assesses payments and identifies when reimbursement is not in compliance with specific RML contracts.
8. Identifies and works to minimize potential financial risk of patient accounts through financial reports, systems information, or direct contact.                                                                                
9. Identifies and resolves third party and patient credit balances; this includes monitoring the causes of credit balances and reporting back to management.                                                             
10. Challenges and appeals third party denials and rejections; follows through with appropriate resolution, including initiating corrective action.
11. Educates and assists patients and customers in understanding PFS processes and hospital policies, procedures and expectations.                                                                                                  
12. Responds timely to customer service; patient bills, complaints and billing disputes.                                             
13.  Ensures compliance with Federal and State regulations.                                                                                
14. Performs backup for the Admitting Dept. when necessary and timely reviews all financial verifications performed by the Manager of Admitting.                                                                                   
15.  Assists management with projects.                                                                                                                      
16. Performs other duties as assigned.
    
    

JOB REQUIREMENTS & CHARACTERISTICSJ

The above statements are intended to describe the general nature and level of the work being performed by people assigned to this job.  They are not exhaustive lists of all duties, responsibilities, knowledge, skills, abilities, and working conditions associated with it.

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