Manager Patient Accounting - Denials and Appeals, Full-time, Days

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better? Description

The Patient Accounting manager provides accounts receivable management support by ensuring the smooth day to day operation of the department, leveraging systems and the team of Operations Coordinator(s), Team Lead(s) and staff positions towards the achievement of daily, weekly, monthly performance targets. This individual is responsible for recruiting, interviewing, hiring, training, reviewing, promoting, and disciplining Patient Accounting staff members, ensuring they understand NMHCs vision, Patients First philosophy and their individual efforts towards the achievement of this vision. Fiscal responsibilities include developing the annual operating budget, monitoring and controlling budget expenditures including overtime, temporary support, and operating expenses to avoid negative variances, remediates overages as required to within annual fiscal budget. The Manager is accountable for achieving institutional and departmental goals and objectives, actively supporting NMHC strategic goals and objectives while ensuring full compliance with all policies and procedures. Directs and coordinates all the activities, functions and responsibilities of the Patient Accounting Department Operations related to optimum third party accounts receivables management (i.e. Managed Care, Commercial, Medicare, Medicaid, Replacement plans, Workers Compensation, Corporate Accounts, Research, Specialty AR Accounts). Leverages all available systems to support optimum AR management such as Epic, Hyland OnBase, PassPort, Cerner, EMR, Recondo, NDAS, TransUnion, Authorize.net, JP Morgan Receivables Edge and payer specific websites.

Establishes and updates job descriptions, quality assurance criteria, division policies and operational procedures. Formulates departmental performance metrics, quality assurance, customer service and employee satisfaction target goals for billing, account follow-up, cash processing and customer service work for any measurable productivity and quality standards which are benchmarked to an industry standard or NMHC internal standard. Develops department policies and procedures and coordinate with other departments to develop and maintain policies and procedures affecting the goals and objectives of the team and the entire revenue cycle. Review operational reports & complete AR analysis on a daily, weekly, monthly or as necessary basis of key performance indicators (KPIs), making necessary adjustments to staff resources, work flows or prioritization of work in order to reach the departments stated goals.

Manage people, processes and projects to implement the overall strategies and achieve the goals of the Patient Accounting department. Leads and/or represents Patient Accounting in meetings with departments and hospital committees such as FOSC, EWI/FSR, EDI Work Group, Free Care Committee, Level of Care Write-offs & Appeals, monthly pre-close meeting, Managed Care Issues meeting, monthly vendor meetings, etc. Works closely with NMHCs Information System and Compliance & Corporate Integrity Departments to ensure all revenue cycle systems, work flows and AR processes are secure and compliant per all regulatory guidelines (JCAHO, HIPAA, Patient Privacy, ACA Consumer Protections, etc). Identifies opportunities for and leads/participates in Lean, Six/Sigma and process improvement activities. Manager Patient Accounting Cash Apps System Manage staff responsible for receiving and posting all payments for the organizations clinical and hospital services and resolving unidentified payments through the appropriate distribution of payments and adjustments. The manager is the primary contact for lockbox services and other cash receipts. Manager Patient Accounting Credit Refunds System Manage staff responsible for resolving unidentified payments and credit balances for the organizations clinical and hospital services through the appropriate application of adjustments and refunds. The manager is the primary contact for refund services and other cash receipts. AA/EOE Qualifications

Required:

• Bachelors degree or equivalent required. Demonstrated management competency & experience. Knowledge of hospital and/or physician HIS systems.
• Strong leadership, organization, planning and time management skills required.
• Excellent analytical skills required high proficiency in excel.
• Excellent verbal, written, communications and presentations skills required.
• Excellent interpersonal skills required.
• Customer Service experience.
• Project management skills and ability to effect change is required.
• Exhibit behaviors consistent with standards of performance improvement and NMHC values.

Preferred:

• 5-7 years of increasingly responsible positions within a Patient Financial Services/Patient Accounting. Knowledge of Epic Systems. Knowledge of Epics Single Billing Office (SBO) module.
• Knowledge of Process Improvement methodologies such as LEAN/Six Sigma.
• Knowledge of NMHC systems. Knowledge of NMHC policies and procedures.