CLINIC: Pullman Regional Hospital Clinic Network - Central Billing Office
This position is responsible for the day to day billing and revenue cycle processes with special attention to billing outcomes and coding performance. This includes working with departmental leadership and providers to assure optimum billing performance.
Planning and Prioritizing
Ensures that personnel policies are followed and consistency is attained through meetings with management and staff.
Reviews accounts on aged trial balance with all accounts over 90 days as a priority.
Monitors accounts receivable metrics to ensure benchmarks are met.
Establishes annual and department goals and objectives; establishes priorities, defines resource limitations, participates directly in various projects, monitor projects and results.
Monitors staff schedules to ensure coverage and use of overtime.
Work with contracted insurance companies to resolve system wide billing/payment issues.
Uses staff meetings, customer comments and employee input to research and identify intra and inter departmental processes and system components that enable clinic-wide solutions and objectives to be met.
Conducts audits when necessary.
Gathers pertinent information necessary to provide patient with accurate cost for procedures.
Interviews and hires personnel for the business office.
Ensures that charity care guidelines and policies are followed prior to approving such applications.
Communicates appropriately with patients, coworkers, physician offices as well as members of ancillary clinics throughout the network and any other individual necessary to perform essential job functions.
Follows clinic network protocols with regards to patient complaints.
Prepares monthly reports for ancillary clinics for review of accounts.
Provides initial job training and information to new employees as a preceptor.
Evaluates and assesses the staff’s ability to fulfill specified responsibilities.
Maintains Central Billing Office policies and procedures manual. Keeps up-to-date with current State and Federal regulations.
Possesses knowledge of current insurance contracts and reimbursement rates.
Assists team members with questions, concerns and problems that arise.
Assists when necessary in a biller, coder, and financial counselor role in the absence of employee.
Conducts monthly staff meetings and participates in monthly clinic management meetings.
Ensures that billing is performed in an accurate and expeditious manner for a prompt reimbursement.
Assists with establishment of policies and procedures for patient registration in a compassionate, confidential and appropriate manner.
Ensures that patients are treated according to Pullman Regional Hospital Clinic Network’s customer service policy.
Responds to patient complaints.
Participates in committees or task forces as requested or required.
Evaluates system processes to produce clean accurate billings, for both clinic and physicians, and clean accurate statements.
Attends ongoing educational activities as necessary to acquire and maintain competency in billing, compliance and management by attending conferences, seminars and reading appropriate material.
Ensures productivity by staff as well as quality of work and streamlines billing processes with ancillary departments.
Creating a Safe Work Environment
Identifies safety concerns and actively seeks to resolve these issues.
Assumes the willingness to be accountable for the well-being of the larger organization by operating in service, rather than in control, of those around us.
Consistently communicates and collaborates with colleagues about decisions which involve legal and ethical issues.
Bachelor’s degree preferred in business administration, health care administration or related field or a minimum of five years’ experience as a manager in a revenue cycle/business office department.
Advanced skills with Microsoft applications which may include Outlook, Word, Excel, Power Point or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.
Decision Making: Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area.
Problem Solving: Ability to address problems that are highly varied, complex and often non-recurring, requiring staff input, innovative, creative and utilizing Lean techniques to resolve issues.
Communication: Ability to communicate effectively in writing to all levels of staff, management and external customers across functional areas. Ability to verbally communicate complex concepts, addresses sensitive situations, resolve conflict, negotiate and motivate others.
Knowledge: Ability to demonstrate broad and comprehensive knowledge of theories, concepts, practices and policies with the ability to use them in complex and/or unprecedented situations across multiple functional areas.
Teamwork: Ability to act as a team leader for projects or workgroups, creating a collaborative and respectful team environment and improving workflows. Ability to lead operational initiatives to meet the health system’s strategic objectives.
Minimum of seven years’ experience in a medical business office, five years’ as a department manager in a revenue cycle/business office department.
Current knowledge of computerized medical billing systems including electronic claims, follow-up, collections, refunds, processing of underpayments/overpayments.
Knowledge, experience and proficiency with word processing, spreadsheets and database operations.
Internal Number: 2239
About Pullman Regional Hospital Clinic Network
Pullman Regional Hospital Clinic Network is a multi-specialty group consisting of Palouse Heart Center, Palouse Pediatrics, Palouse Psychiatry & Behavioral Health, Palouse Pulmonology & Sleep Medicine and Pullman Family Medicine. PRHCN works closely with Pullman Regional Hospital, the town's full-service critical access hospital. The City of Pullman is located in Eastern Washington's golden Palouse Region and is home to Washington State University. With the motto "high tech, higher education and highest quality of life" you will enjoy the small-town comforts and feel with urban amenities.