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    Patient Receivables Manager - Los Angeles, United States - St Johns Community Health

    St Johns Community Health
    St Johns Community Health Los Angeles, United States

    2 weeks ago

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    Description

    Job Description

    Job Description

    The Patient Receivables Manager is responsible for ensuring that the financial systems are operational and effective ensure fee-for-service estimates are correct, analyze payer contracts, revenue cycle, operations, and decision support to resolve net revenue issues.

    BENEFITS

    • Free Medical, Dental & Vision
    • 13 Paid Holidays + PTO
    • 403 (B) retirement match
    • Life Insurance, EAP
    • Tuition Reimbursement
    • Flexible Spending Account
    • Continued workforce development & training
    • Succession plans & growth within

    QUALIFICATIONS

    Education and Experience

    • Five (5) years of experience with revenue cycle operations management. With excellent presentation and writing skills. Advanced skills in analysis and MS Office suite. eClinical Works experience is preferred.
    • Required bachelor's degree in business, Finance, Accounting, Healthcare Administration or equivalent.
    • Demonstrated knowledge of all Insurance companies, HMO's, PPO's Government and State programs Medi-Cal and Medicare, and third-party payers.
    • Experience with managing revenue cycle processes including Medicaid and Medi-Cal eligibility, health information management and billing, and charge capture processes.
    • Experience responding to government and financial Audits is a plus.

    ESSENTIAL DUTIES AND RESPONSIBILITIES

    Performs a combination, but not necessarily all, of the following duties:

    • Maintain knowledge of, Medicare, Medi-Cal, HMO, PPO and publicly funded programs Family PACT and grants.
    • Communicate to Director of Patient Receivables and Billing and other colleagues to stay informed of payer and/or regulatory updates and create action plans to accommodate changes as needed.
    • Engage colleagues to facilitate educational and workflow/process opportunities identified by team to improve documentation, billing, and clinical operations.
    • Continually develop processes, policy procedures and controls to drive revenue integrity.
    • Analyze insurance contracts/contract requirements, and fee schedules.
    • Maintain positive external contacts, attending all pertinent meetings and trainings related to billing.
    • Create and expand procedures of Revenue Cycle Department including cross training of Revenue Cycle personnel.
    • Assist with the filing of Medi-Cal Reconciliation, and Medicare Cost Reports and HRSA site visits. This also includes researching discrepancies and reconciling of the prior years' reports.
    • Support staff with training and communication of pertinent information affecting the team and other stakeholders.
    • Collaborate with Clinical Management Team on workflow and ensures that office-oriented directives and policies and procedures are implemented in a timely manner. This role has the primary responsibility of creating all necessary procedure guidelines to instruct the Billing and Clinic Support Staff on all revenue-oriented tasks.
    • Assist with Payer Enrollment planning, direction, control, and evaluation of the Payer Enrollment Department.
    • Attend administrative meetings and participate in committees as requested. Conduct special projects and studies as directed.
    • Assist in maintaining eClinical Works patient accounting and registration system tables for registration, patient accounting, eligibility, charge master's maintenance, billing, claims editing, and account follow-up.
    • The Patient Receivables Manager oversees the day-to-day leadership and management of the collections, accounts receivables, and account resolution management.
    • Display independent judgement by willingness to make timely and accurate decisions based on available information that is sometimes vague or limited in nature.
    • Strong research and auditing skills.
    • Ability to prioritize tasks and projects with limited direction, while understanding and contributing to the success of the organization.
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