DHR Health - US : TX : Edinburg - Days
Summary : POSITION SUMMARY :
The normal work routine involves no exposure to blood, body fluids, or tissues (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way. Tasks that involve handling of implements or utensils, use of public or shared bathroom facilities or telephones, and personal contacts such as handshaking are Category III tasks. This position is responsible of overseeing insurance collectors and managing the collection of accounts receivable that are outstanding as shown on the ATB monthly reports. This position requires extensive knowledge of commercial workers compensation and liability third party payor reimbursement. Operates as a member of the Business Office's management team, participates in the policy development and strategic decision making, and implements and enforces operating policies, procedures, and standards.
POSITION EDUCATION / QUALIFICATIONS :
- Minimum of High School Diploma or GED.
- Experience in health related fields is necessary.
- Some college hours in a related field preferred.
- Comprehensive knowledge of healthcare reimbursement
- Strong organizational skills are necessary
- Understanding CPT , HCPCS , and ICD 9 coding
- Good written and verbal communication skills required.
- Ability to read, write and speak English required
- Ability to communicate clearly and concisely with all levels of nursing, administration, and physicians
- Prefer hospital experience
JOB KNOWLEDGE / EXPERIENCE :
One to two ( 1-2 ) years of medical / healthcare business office experience,Two ( 2 ) years supervisory experience required.Excellent customer service skills.Computer skills required with knowledge of Microsoft Office Suite.Good written and verbal communication skills required.Bilingual - English / Spanish.Requires good independent judgment and the ability to work with frequent interruptions.(Specifically Word and Excel)Requires good communication and organizational skills.Requires reasoning ability and good independent judgment.Requires working with frequent interruptions.Must project a professional image.Responsibilities :
POSITION RESPONSIBILITES :
Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practicesManages the day to day operations of the Patient Accounting area of the Business Office (Insurance Benefit Verifications / Self Pay Collections / Customer Service / Refunds an the Reimbursement area(s)) and oversees the Patient Accounting Supervisor handling Financial Counselors and Self Pay collectors :Manages daily activities related to the Patient Accounting area of the Business Office ((Insurance Benefit Verifications / Self Pay Collections / Customer Service / Refunds an the Reimbursement area(s)).Ensures processes are performed efficiently and effectively.Monitors and ensures that productivity reports are completed at 95% or greater at the end of the week.Analyzes trends in reimbursement delays, underpayments and insurance denials. Develops and implements an action plan to resolve issues.Works with the scheduling staff and the benefit verification staff to ensure that appropriate insurance reimbursement is maximized.Analyzes appeal and denial codes to determine underlying causes.Reconciles Cash posting for the department with Accounting and the bankEnsures that all private pay accounts are contacted / followed-up by the Financial Counselor / Self Pay Collectors or transferred to the Third Party eligibility agency or other collection agency.Manages Bad debt review and Charity review.Ensures that credit balances are reviewed and refunded within (30) days of last payment transaction.Oversees that patients are provided good customer service.Ensures that return mail and correspondence is reviewed for appropriate follow up.B. Manages the operations in the Patient Accounting area of the Business Office
Effectively manages and directs the Patient Accounting area of the Business Office ((Insurance Benefit Verifications / Self Pay Collections / Customer Service / Refunds an the Reimbursement area(s)) : To ensure quality. Ensures work assignments and schedules are established.Reviews each staff's productivity and ensures staff meets productivity standards.Completes and submits daily, weekly and monthly reports to the Director.All Self Pay AR (I-plans)Pending Assistance AccountsThird Party Agency ReportsAR reports by facility (DHR, WH, Oncology, Etc)AR reports by specialty (Newborns, Obstetrics)AR by aging reviewAR by dollars reviewPerforms QA on for all areas. Includes trending and analysis of the data, as well as the development and implementation of action plans.Maintains QA statistics and reports.Resolves issues escalated by patients and / or staff.Meets with Supervisor regularly to effectively communicate and resolve issues, set and prioritize goals and improve processes.Works closely with peers to ensure all procedures regarding patient's accounts are completed in a thorough and timely manner.Works closely and professionally with outside agencies on special projects developed by the Administration. (Third Party ; collection agencies, etc)Demonstrates proficiency and initiative at problem solving.Develops and recommends long and short range goals and specific actions to maximize results in the department.Keeps informed of developments affecting product, services or areas of specialization and utilizes this information for the benefit of the hospital.Cooperates and assists staff to foster productive teamwork.Works with staff to improve processes and work flow in the areas of responsibility. (EX. Listen to staff for implementing process improvements.)C. Human Resources / Administrative :
Interviews and hires.Supervises all employees with equal standards, efficiently and professionally.Assists with payroll activities for staff. (Timecards, PTO requests, etc.,)Assists with the orientation of new employees.Provides continuous training and communicates process improvement changes to employees.Trains new employees in all aspects of their assigned job and ensures that their training is complete and accurate for their assigned tasks.Coaches and counsels staff as necessary, provides written documentation of coaching and / or counseling sessions as appropriate. Enlists the help of Director or Human Resources depending on severity of issue.Recommends termination of employees as necessary.Maintains appropriate documentation to support such recommendations.Performs employee's performance evaluations in a timely manner.Ensures all personnel policies are followed.Recommends changes in department policies and procedures to the Director.Leads in a way that motivates employees to do their best work in a positive manner.Provides employees with guidance and supervision, but gives them sufficient opportunity to carry out their assignments and make decisions.Creates a positive atmosphere conducive to employee development by personal example and by encouraging and praising initiative, imagination and resourcefulness.Other duties as assigned.Other information :
LINES OF REPSONSIBILITES :
(Chain-of-command)
1. Director → 2. CRO
CUSTOMER SERVICE :
Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including : Commitment, Accountability, Respect, Excellence and Service.
AGE SPECIFIC :
Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his / her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirement relative to his or her age.
AMERICANS WITH DISABILITIES ACT : (ADA) :
A. Essential Duties : Indicated by bold print within performance standards, preceding individual numbered criteria.
The following table provides physical requirements that will be associated with, but not limited to, this position :
Light / moderate lifting up to 20 lbs, from the floor to shoulder height.YesKneelingYesMust be able to assist other employees with lifting more than 20 lbs.YesWalkingYesLight / moderate carrying up to 20 lbs.YesStanding / SquattingYesStraight pullingYesSittingYesPulling hand over handYesPushingYesRepeated bendingYesStooping / BendingYesReaching above shoulderYesClimbing StairsYesSimple graspingYesClimbing LaddersNoDual simultaneous graspingYesDepth Perceptions neededYesAbility to seeYesIdentify ColorsYesOperating office equipmentYesTwistingYesOperating mechanical equipmentYesCrawlingNoAbility to read and writeYesAbility to CountYesAbility to hear verbal communication without aidYesOperating Personal VehicleYesAbility to comprehend written / verbal communicationYesOther : Ability to deal with stressYesOSHA CategoryIIIB. Working Conditions : The individual spends over 95% of his / her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.C. Occupational Exposure : This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.
D. Aptitudes : HIGH 1 2 3 4 5 6 LOW
Intelligence : General learning ability : The ability to "catch on" or understand instructions and underlying principles. Ability to reason and make judgments. 3
Verbal : Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3
Numerical : Ability to perform arithmetic operations quickly and accurately. 2
Spatial : Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to "visualize" objects or two or three dimensions, or to think visually of geometric forms. 2
Form Perception : Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3
Clerical Perception : Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2
Motor Coordination : Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3
Finger Dexterity : Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3
Manual Dexterity : Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3
Eye-Hand-Foot Coordination : Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3
Color Discrimination : Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3
I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform.
If applicable ____________ certification will be completed within _________ time frame of hire / transfer date.
Employee Signature : ________________________________ Date : ____________________
Transfer / Hire Date Effective : ________________________.