Director

This position is responsible for forecasting and pacing towards monthly/yearly cash goals.  With some oversight from the VP Revenue Cycle, this role should determine on a quarterly basis fundamental metrics in predicting hospital sustainability such as Cash Factor and Average Days to Payment.  The Director should prepare monthly reports detailing cash trending and alert the VP Revenue Cycle of any unusual trends both positive and negative.  The role should oversee processes to ensure each day all cash and adjustments are posted timely and efficiently.  In addition, this position is charged with defining a robust Vendor reconciliation process for invoice & inventory management of all Patient  Accounting vendors.  The Director will provide instruction to the Revenue Cycle Analyst to ensure this process is implemented successfully and maintained on a bi-weekly – monthly basis.  In addition, the role will be charged with managing the file maintenance process within Meditech and the new Allscripts SFM platform as well as ancillary systems including but not limited to ePremis and Tableau.  The Director will monitor remittance 837 file export and 835 remittance file import process and identify and discrepancies with the ePremis clearinghouse system.  Other system items that will fall under the scope of this role will include production of the SPARCS file, annual upload of new/updated DRG/ICD-10 rates, and production of Month End Reporting and development of bad debt reporting for cost reporting purposes (Medicare Bad Debt listing).  In addition, this position will conduct consistent Quality and Productivity audits of the Cash Posting team and Revenue Cycle Analyst(s). 

* Oversees copying of checks and EOB’S in order to follow up on accounts.

* Oversee posting daily cash receipts from Lockbox and adjustments. Reconcile all cash to the Lockbox. Reconcile and unapplied cash on a quarterly basis.

*  Ensure all daily rejected cash batches from Allscripts SFM are worked and posted.

*  Plans and directs patient insurance, billing, collections, and data processing functions to ensure accurate patient billing and efficient account collection.

*  Develops, implements, and maintains a departmental dashboard that communicates critical metrics to management.

*  Manages the Patient Accounts department within the established budget, including annual planning and monthly status reports.

*  Reviews current status of Patient Accounts to identify and resolve billing and processing problems in a timely manner.

*   Develops, implements, and maintains a variance identification and collection process for third party payers.

*   Establishes and implements a system for the collection of delinquent accounts ensuring third-party payers are contacted.

*   Supports external Audits such as HMS, 340B, Price Transparency, Charity, HCRA, and Bad Debt.

*  Update the Hospital contract management system, including MS-DRG, APR-DRG, OPPS, APG, APC, and ETC.

*  Supports the hospital financial department with 990, Medicare Cost Report, and GL.

*  Ensure all vendor payments are posted.  Adjusts bad debt trial balance and/or adjust accounts and compares to agency (vendor) files.

*  Ensure all payments and adjustments are applied to the correct patient’s accounts based on the 835 Remittance and Ceresoft information. Retrieve all remittance files from different types of sources.

*  Monitor and identify changes in PIP, UPL, DPT, VAPAP, HWB payments as well as any rate changes leading positive negative reimbursement impact.

*  Oversee all areas of the department and support as needed.

*  Assist in month end close activities. 

* Ensures the Hospital complies with all the state and federal rules and regulations and reports any suspected compliance issues to the VP Revenue Cycle.

* Review credit reports Monthly and assist in resolving accounts and adjusting balances accordingly and maintaining a low Financial liability.

* Other duties which may be related or assigned in addition to those expressly indicated in this written job description.

* Timely billing of all claims and adjustments of all claims on the AR and Maintain AR days goals.

* Review claim denial and provide root cause analysis to rectify the issue.

* Transfer inpatient and outpatient self-pay accounts to collection agencies within the appropriate 501R Guidelines.

*  Maintain accurate files and records, trial balance and other account information as necessary.

* Refer accounts to collections in a timely manner where claims can still be billed or appealed. 

*  Ensures the team contacts patients regarding outstanding bills.

* Review and oversee the production and delivery of Monthly Vendor Scorecards to vendors.

* Adjust trial balance and/or accounts and prepare summaries to indicate present status of accounts receivable.

* Troubleshoot questionable charges, coding errors, discharge status, etc. and adjust bill as applicable to expedite processing.

* Monitor File Import failures in Meditech, Allscripts SFM, and TRAC system.

* Works with Revenue Cycle Analyst to leverage data to create models that depict trends and projects future cash/operational performance.

* Monitors the creation of statistical methods to analyze and generate recurring ad-hoc revenue cycle reports.

* Direct the day to day system maintenance, which includes checking system, mid-night run, system file transfers to vendors, comment interface, 835 & 837 file delivery, running scripts to maintain system edits and creating bridge routine.

* Keep and verify record of accounts sent out to various agencies. 

* Perform all other duties required.

Position Requirements:

* This position requires a minimum formal education of Bachelor's Degree and a minimum of 3 years job-related experience.

*  Desired (not required) criteria include:  Patient Accounting systems technology preferred (3-4 years).  Previous leadership experience preferred (1-2 years). Strong knowledge of computer programming languages such as SQL/SAS preferred.

* Previous experience at the intermediate to advanced level with windows based software applications (Microsoft Word, Excel, PowerPoint, Outlook), encoder software and e-mail applications.