Director, Patient Accounting - Physician Billing - Hackensack Meridian Health

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The Director, Patient Accounting - Physician Billing directly manages, through proper planning and delegation, the Departments of Third Party Follow Up, and the Patient Accounting functions for the Physician Enterprise across the Hackensack Meridian Health (HMH) network. This includes managers, supervisors, and staff across the Enterprise Reporting directly to the Executive Vice President of Revenue Operations. Responsible for developing and implementing strategies to ensure corporate and divisional Patient Accounting goals and objectives are achieved. Departments reporting to this position include all initial Third Party billing for primary and secondary claims; Third Party Follow-up for all payers and claims including third-party out-sourced claims, and managing vendor relationships for outsourced billing, follow-up, bad debt, and early-out self-pay. Also responsible for coordinating front-end quality items such as pre-service clearance, scheduling, registration, authorization, and insurance verification, even for areas not under direct supervision. Provides leadership and strategic direction, oversight, coordination, and standardization of the Patient Accounting department. Works closely with Health Information Management (HIM), clinical, and Information Technology (IT)/Digital Technology Services (DTS) departments to ensure accurate and timely charge capture and maximizing net cash collected by the Physician Enterprise of HMH.

A day in the life of a Director, Patient Accounting - Physician Billing at Hackensack Meridian Health includes:

• Work closely with the EVP, Revenue Operations to ensure Physician Enterprise goals and objectives are achieved.
• Monitors system metrics, including dashboards and accounts receivable reports, and conducts analytical reviews to determine where additional emphasis needs to be placed to ensure the goal of timely and proper account adjudication is accomplished.
• Manages the accounts receivable, follow-up, reconciliation, and customer service functions for Professional Enterprise.
• Work closely day-to-day with practice directors, clinical chairs, and Corporate Compliance Leaders regarding financial system issues, third party billing guidelines, federal regulatory requirements, state mandates, and compliance issues.
• Work closely with Information Technology directors and others in DTS to ensure technology needs are met and appropriate for Patient Accounting and other departments with a negative impact on the facility revenue.
• Overall responsibilities include directing, leading, and monitoring day-to-day activities and performance of all Patient Accounting functions and serving as the subject matter expert for PB modules in EPIC to support reimbursement measures for the Physician Enterprise.
• Develop and implement clear and concise policies and procedures for end users in Patient Accounting and, when appropriate, multiple disciplines. The latter includes Patient Access, Professional/physician Registrations, Patient Accounting and Health Information.
• Attend and organize any meetings with practice Directors, Practice Managers, and clinical leadership to ensure the exchange of information required for the efficient operation of the patient accounting department.
• Work with practices from all Regions as it related to workflow development for purposes of alignment of processes
• Manage technical and medical denials by providing timely feedback to appropriate practice leaders. Analyze underlying reasons for denials so they can be resolved and prevented.
• Responsible for providing DTS with regulatory data that must be programmed to ensure claim adjudication accuracy.
• Identifies opportunities for more efficient utilization of staff resources.
• Responsible for overall effectiveness and productivity of operations relating to functions and staff within the patient accounting departments. Maintain appropriate staffing levels to accommodate optimal workload for the departments.
• Interacts with key personnel at payer organizations, federal and state intermediaries, as well as various professional/practice associations to keep abreast of third party guidelines and rules, state mandates, and federal regulatory requirements.
• Determines outsourcing needs and selects external vendors required for Patient Accounting functions.
• Ensures effective corporate compliance plans are developed and implemented for each department reporting to the position.
• Encourages a team environment with active supervisor and staff participation in relevant discussions regarding the performance of the patient accounting department, as well as maintaining open communication and accessibility for the staff, supervisors, and other management.
• Establishes clearly defined productivity targets and goals for the supervisors and staff and reports performance feedback.
• Maintain active participation in all patient and employee satisfaction initiatives.
• Reports to EVP, Revenue Operations significant Patient Accounting compliance, system, and other issues that have a negative impact on billing and reimbursement.
• Works with the EVP, Revenue Operations to provide timely feedback to Finance Leaders regarding Account Receivables for the Physician Division. This includes aged receivables, bad debt reserves, and charity care. Prepares all account receivables analyses for inclusion in monthly financial packages.
• Maintains and, when appropriate, implements federal regulatory, state-mandated, and third party guidelines relating to Billing, Registrations, and Health Information. Ensures clinical areas take appropriate actions when there are financial implications.
• Assist leadership in other departments in monitoring and ensuring accurate charge capture for services performed.
• Other duties and/or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Education, Knowledge, Skills and Abilities Required:

• Bachelor's degree in Business, Healthcare Administration or Finance.
• Minimum of 10 years of management work experience in healthcare receivables or health insurance claims processing with a minimum of 5 years of experience as Manager or above responsibilities.
• Extensive knowledge of Federal and State regulations and mandates relating to hospital billing and reimbursement.
• Strong leadership skills.
• Good written and verbal communication skills.
• Strong financial management and leadership skills.
• Good project management skills.
• Excellent knowledge of information technology and management information systems and how it can be used to improve operations.
• Good interpersonal and analytical skills.
• Fluent with computer applications.

Education, Knowledge, Skills and Abilities Preferred:

• Master's degree.
• Member of a nationally recognized professional organization, such as the Healthcare Financial Management Association (HFMA) which would be a plus. 

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!