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US-TN-Memphis
2 months ago

Director, Billing

Provides operational leadership in the planning, directing and administration of the multi-specialty billing department designated BMG/BMG Foundations/BMHCC Entities. Responsibilities include but are not limited to: implementation of business office policies and standard operating procedures, management of billing and collections processes, compliance with regulatory guidelines, standardization of business practices, identification of process management and related efficiencies, implementation of performance improvement plans as appropriate, human resources management and financial oversight for billing operations.

 

Essential functions may include but not limited to claims, follow-up, coding, charge capture, credentialing, payment posting, correspondence, customer service, registration, and HIM.

  1. Provides operational and strategic leadership to a high-profile group focused on maintaining and improving revenue realization results by controlling patient collections and third-party payer revenue.
  2. Ensures the maximum performance of revenue management across multiple entities, including accurate and timely charging, processing of billing and open patient accounts, payment posting, denials management and appeals, and customer service
  3. Develops departmental standard operating procedures.
  4. Knowledge of third party payer review, reimbursement systems, and utilization monitoring requirements.
  5. Proactively manages the billing process, maintaining positive and strong internal client relationships and advocating for the health system with third-party payers.
  6. Routinely reports on the performance of the accounts receivable, including key performance indicators, benchmarks and metrics.
  7. Provides direction and coordination for the development and implementation of performance improvement and quality improvement for the physician revenue cycle.
  8. Develops a thorough understanding of systems, processes and payer specific reimbursement mechanisms and billing requirements, contributing in the proactive identification of opportunities for revenue cycle improvement and enhancement.
  9. Provides hospital and practice management with interpretation of standard operational, billing and budget data on a monthly basis.
  10. Participates in the development of the enterprise-wide revenue cycle strategy that aligns with the organization’s core mission and supports the organizational strategic plan, goals, and objectives.
  11. Provides budgetary oversight working within prescribed financial parameters.
  12. Oversee and manage the performance and development of all billing managers, billing supervisors and billing leads.
  13. Has knowledge and potential oversight to hospital revenue cycle, including areas such as registration, coding, billing and financial counseling functions.
  14. Performs other duties as assigned or directed to meet diverse business needs and service standards.
Position Code
00069074
Status
Regular Full-Time
Department
MG CBO Jackson PB
US-TN-MEMPHIS
2 months ago
  • Identify contractual variances between actual and expected reimbursement from contracted payors.
  • Support the execution of strategic initiatives, process re-design, root cause analysis, metric/report development and special projects as it relates to denials management.
  • Proactively formulate a thorough analysis and provide recommendations to Management to obtain appropriate reimbursement according to contract.
  • Regularly monitor contract terms and payer payment patterns to ensure optimal reimbursement.
  • Proactively analyzes payment patterns to get ahead of variances.
  • Communicate with payers to establish methodologies for payments for unlisted or newer procedures.
  • Reviews accounts, takes appropriate action, and documents per departmental standards.
  • Determine if the insurance company paid claims correctly, posting an adjustment if paid correctly and follow up with the appropriate payer to determine the correct payment amount in order to complete appropriate actions to resolve the claim.
  • Work with management and payer to streamline process flow for accurate reimbursement.
  • Follow and understand revenue cycle fundamentals.

 

Perform other duties as assigned.

 

RBO

Analyst

Revenue

Recovery

Jackson MS

Jackson

50089008

 

 

Position Code
50089008
Status
Regular Full-Time
Department
RBO-Jackson
US-TN-MEMPHIS
2 months ago

 Primary Responsibilities • Process correspondence in accordance with established departmental processes. • Review daily mail and disperse correspondence to appropriate parties within the established departmental guidelines. • Processes correspondence within ONBASE by document type/group. • Meet and exceed all performance standards established by Management. • Perform other duties as assigned.

 

 

 

Jackson MS

RBO

50080172

Specialist

Correspondence

Position Code
50080172
Status
Regular Full-Time
Department
RBO-Jackson
US-TN-MEMPHIS
2 months ago

 Working knowledge of 10 key, typing and computers. • Preferred: Knowledge of health insurance billing guidelines.  Ability to type/key accurately. Effective verbal, written, and customer service skills.   Primary Responsibilities • Meet and exceed all performance standards established by Management. • Work all work queues and/or assignments daily. • Communicate effectively with third party payers, physicians, clinical departments, or patients while working to investigate outstanding or denied accounts. • Stay abreast of commercial and/or government insurance billing guidelines and regulations.  Seek and maintain knowledge by researching applicable electronic bulletins, reference manuals, or by consulting with insurance representatives. • Process written correspondence received from third party payers and patient related entities in an accurate and timely manner. • Perform other duties as assigned.

 

Jackson MS

50089004

RBO

Specialist

Accounts Receivable

Follow Up

Position Code
50089004
Status
Regular Full-Time
Department
RBO-Jackson
US-TN-MEMPHIS
2 months ago
Primary Responsibilities
·          Meet and exceed all performance standards established by Management.
·          Work all work queues and/or assignments daily.
·          Review patient medical records for charge capture and resolution of charge department billing edits. Verify billing data for accuracy and completeness, following applicable regulatory requirements and payer specific guidelines. Apply charges for nursing department procedures upon verification of documentation in patient medical record.
·          Perform charge audits by verifying billing data as compared to documentation and making corrections in Epic for correct billing of services identified by Management as areas of possible revenue leakage.
·          Identify charging, coding, or clinical documentation issues and work with appropriate leadership and clinical departments to resolve issues.
·          Serve as a resource and liaison for clinical charging and financial areas as related to appropriate coding and charge capture compliance.
·          Stay abreast of third party regulatory, coding, and billing compliance directives by monitoring disseminated updates, external educational sessions, and/or research obtained.

·          Perform other duties as assigned.

 

Jackson MS

 

 

Jackson

Analyst

Revenue

Integrity

20649001

RBO

Position Code
20649001
Status
Regular Full-Time
Department
RBO-Jackson
US-TN-MEMPHIS
2 months ago
Primary Responsibilities
·          Identify, document and communicate best practices to simplify and standardize the cash and clearing reconciliation process. 
·          Serve as point of contact for complex and escalated issues.
·          Provide training to staff on cash and clearing account reconciliations.
·          Complete additional special projects and reports as needed.
·         Participate in regular calls with facility/finance staff.

·         Perform other duties as assigned.

 

 

RBO

50080171

 

Jackson

Analyst

Reconciliation

Payment

Position Code
50080171
Status
Regular Full-Time
Department
RBO-Jackson
US-TN-MEMPHIS
2 months ago
Primary Responsibilities 
·          Serve as a primary customer service contact with patients and guarantors. 
·          Handle telephone and written communication with patients, insurance companies, physician offices, attorney offices and other Baptist facilities.
·          Handle walk-in customer contacts and research customer concerns and resolve issues.
·          Act as a problem solver and customer advocate. 
·          Proactively identify and resolve patient billing complaints.
·          Meet and exceed all performance standards established by Management.
·          Work all work queues and/or assignments daily.

·          Perform other duties as assigned.

 

Jackson MS

RBO

50089008

Specialist

Customer Service

Position Code
50089008
Status
Regular Full-Time
Department
RBO-Jackson

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