SCOPE / GENERAL PURPOSE OF JOB:
Responsible for supervising the daily processes of the Cash Application department in accordance with RC Billing standards and Reimbursement policy and procedures. Directly supervises cash application staff to ensure timely posting of receipts, adjustments and zero pays, oversees the balancing of the weekly and monthly reports and ensures their accuracy prior to dissemination to clients and/or advising management that a database is ready for month end close; assists management with problem resolution, process improvements, documentation of process improvements, staff training while ensuring adherence to RC Billing Reimbursement policy and procedures and that benchmarks are obtained per client. Ensures client satisfaction.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Supervises the daily operations of the cash application department to ensure accuracy and timeliness.
- Completes all training of new staff members for the Cash Applications department.
- Thorough understanding of all clients to ensure that there is staff coverage should someone be out.
- Understanding that there is no PTO approved during month end closing processes.
- Demonstrates thorough understanding of all aspects of interpreting insurance reimbursements and processes of posting within the billing system ensuring compliance with the RC Billing policy and procedures.
- Ensures daily accurate and timely (within 2 business days of receipt) line item posting of all receipts received from payors to include the appropriate contractual adjustments, zero pays, adjustments, filing of secondary’s, accurate release to patient responsibility, etc…
- Ensures daily accurate and timely (within 2 business days of receipt) line item posting of denials/zero payments received from the payors, to include posting the appropriate denial reason code.
- Ensures daily and timely (within 2 business days of receipt) accurate line item posting of approved adjustments received from AR, to include applicable levels of management approval and client approval when required.
- Ensures timely daily resolution of any unidentified receipts (unable to identify the patient account/line item to accurately post)
- Ensures timely recognition of client ERA issues and/or delays and works directly with RC Billing Support and EDI Depts. for immediate resolution.
- Ensures that a Daily Receipt Log for each client is maintained daily, balanced and accurate for weekly reporting to each client.
- Ensures that clients receive accurate and timely weekly reports.
- In conjunction with the Cash Application Manager directly oversees month-end system closes; ensures that Cash Application Dept. meets cutoff deadlines.
- Works directly with client banking and client to ensure timely receipt of lockbox and/or seeks resolution to any issues relating to a client’s deposit.
- Assist the Cash Application Manager with establishing and setting up new lockbox services.
- Implements and ensures compliance and confidentiality of the RC Billing Reimbursement Policies and Procedures to maximize efficiency. Ensures compliance with appropriate industry regulations and State and Federal regulations.
- Assist the Cash Application Manager with quarterly QA’s for the Cash Application staff.
- Assist the Cash Application Manager with the annual SSAE-18 audit.
- Maintains working day to day knowledge of all practice management system(s) to include Clearinghouse software.
- Immediately reports any issues identified to the Cash Application Manager, Director of Operations. (President when applicable).
- Maintains working knowledge of applicable laws and regulations as they relate to assigned responsibilities.
- Maintains working knowledge of Medical and Radiation Oncology billing guidelines.
- Maintains confidentiality of all information related to patients, clients, finances and cost effective health care delivery issues.
- Strives to achieve and maintain company Days Sales Outstanding, Account Receivable Aging standards and Collection Percentages per client.
EDUCATION AND/OR EXPERIENCE:
- High school diploma or equivalent, Bachelor’s degree preferred.
- Minimum four (4) years medical office management experience.
- Knowledge of organization policies and procedures.
- Knowledge of health care administration principals.
- Knowledge of business office procedures.
- Previous supervisory experience required.
- Knowledge of insurance agency operating procedures and practices.
- Skill in exercising initiative, judgment, discretion and decision-making to achieve business unit objectives. Skill in identifying and resolving problems.
- Ability to communicate effectively regarding fiscal policies.
- Ability to establish and maintain effective working relationships with all employees and clients.
- Knowledge of CPT-4 and ICD-9/ICD-10 coding.
- Knowledge of Allscripts, Allscripts Pro PM, Misys/Tiger and Practice EDI Insight preferred.
- Ability to communicate effectively orally and in writing.
CERTIFICATIONS / LICENSURES / CREDENTIALS: None
SUPERVISORY RESPONSIBILITIES: Yes, without hiring or firing responsibilities.
The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position requires full range of body motion including manual and finger dexterity and eye-hand coordination. The position additionally requires standing/sitting for extensive periods of time. Occasional lifting and carrying items weighing up to forty (40) pounds may be required. Requires corrected vision and hearing to normal range.
The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment involving frequent interaction with staff, clients and the general public.