Manager Patient Accounts (Commercial & Government)

About The Role

The primary purpose of the Manager Patient Accounts (Commercial & Government) position is to plan, organize, staff and direct the Patient Account Department’s Charity Care Self Pay and Bad Debt operations at University Hospital. The position is also responsible for managing special projects within the Department, with an overall goal of assisting the organization to meet its strategic objectives. Takes charge of the department in the absence of the Assistant Director.

Responsibilities

• Maintains monthly follow-up on unpaid claims and takes appropriate action to correct and re-bill for timely reimbursement.
• Manages and pulls daily facility (UB04) (837-I) and physician (HCFA-CMS 1500) 837-P claims submission and 835 errors, and rejections from the Clearinghouse.
• Performs regular audits of daily billing reports to identify billing errors.
• Works with the billing team and other department staff to address; notify on-site management of problems and troubleshoot as needed.
• Manages the zero, partial, denials (credentialing, COB and any carrier issues) payment reports monthly to identify trends and underpayments; investigates causes and takes appropriate steps toward resolution using professional judgment.
• Develops and Implements quality assurance measurements and standards, including completion of internal and external audits for Medicare, Medicaid, Commercial, Charity Care, Worker Compensation, No Fault, self-pay, refunds, write-offs and bad debt accounts.
• Responsible for yearly external audit or other entity engaged to conduct the yearly audits as it relates to revenue related questions and responds to payer audits requests as needed.
• Directly manages account receivable units to ensure maximum efficiencies and productivity by prioritizing work activities.
• Responsible for weekly/monthly/status and reconciliation report (development/preparation/maintenance/analysis of reports).

Qualifications

• Bachelor’s degree in Business Administration, Finance, Hospital Administration, or a related field required.
• Minimum of five (5) years of experience as a Supervisor or Manager in Patient Accounts, Hospital Billing, or Patient Financial/Business Services required.
• Proficiency in personal computers and supporting software in a Windows-based environment, including Microsoft Word, Excel, PowerPoint, and Outlook.
• Thorough knowledge of Charity Care, UB-04/CMS-1500 billing forms, healthcare claims processing, ICD-10, CPT, and HCPCS coding.
• Strong knowledge of Charity Care, Medicare, Medicaid, commercial insurance, and federal and state regulations and guidelines.
• Knowledge of intranet and internet applications.
• Excellent oral and written communication skills.
• Able to effectively interact with internal and external departments.
• Able to represent the department professionally and effectively at meetings.
• Proficiency in department-specific software applications.
• Able to prioritize projects and manage multiple responsibilities.
• Excellent customer service skills.
• Outstanding interpersonal and leadership skills.
• Able to work effectively in a team-oriented environment.
• Demonstrated knowledge and success working in a unionized environment.
• Additional related experience may be substituted for the required degree on a year-for-year basis.

What We Offer

• Medical & Prescription Drug Coverage
• Dental & Vision Insurance
• Health Savings Account (HSA) & Flexible Spending Account (FSA)
• Short- & Long-Term Disability Insurance
• Pension Plan
• Pet Insurance
• Employee Assistance Program (EAP)
• Professional Development
• Compensation

Pay

The expected salary range for this position is in accordance with the New Jersey Pay Transparency Law; final compensation will be commensurate with experience and qualifications.

About Us

University Hospital is one of the nation’s leading academic medical centers. As the principal teaching affiliate of Rutgers New Jersey Medical School and the only state-certified Level 1 Trauma Center in Northern New Jersey, University Hospital is training the next generation of physicians and advancing science to discovery while taking exceptional care of patients, regardless of their financial situation.