Planned Parenthood of Orange and San Bernardino Counties has an exciting full-time opportunity for a Director of Revenue Cycle Management. In this position you will be responsible for all aspects of revenue cycle including intake or registration procedures of patient financial information, eligibility verification procedures, billing and managing accounts receivable through the collection or adjustment process. Generates and reviews revenue cycle policies and procedures to ensure compliance with all compliance with all applicable laws, regulations and standards. Oversees revenue cycle related systems including eligibility and authorizations systems, patient management applications related to revenue cycle data, billing and patient accounting.
Oversee the production and review of an accurate aging on a monthly basis, includes verifying the accuracy of patient accounting reporting. Ensures that all billing information is maintained and produced accurately and timely to maximize reimbursement. Stays current on all updates / changes in billing codes and other requirements along with requirements for electronic billing to ensure that all batches go thru without errors.
Carries out supervisory responsibilities in accordance with the Organization’s policies and applicable laws.
Responsibilities include interviewing, hiring and training employees; planning, assigning, and directing work; reward and recognition; performance management of employees; addressing complaints and resolving problems.
Other Duties and Responsibilities:
Manages and staffs the billing and collection function at PPOSBC.
Implements multiple contracts with Billing, both State and commercial insurance carriers.
Provides guidance and policy and procedures for scheduling and front desk personnel related to patient financial information including eligibility, authorization, co-pays and deductibles, charging, billing and adjustments.
Responsible for overseeing both the electronic and manual billing processes.
Remains knowledgeable on California billing regulations for both Cal Optima in Orange and IEHP and Molina Health Plans in SB County.
Ensures that billing follow-up procedures are taking place so that AR >120 days consists of less than 1 percent of total AR and no accounts over 150 days.
Establishes lines of communication with center managers to ensure accuracy and confidentiality of patient accounting records. Coordinates with personnel in clinics and administration to exchange information and update internal controls.
Assigns responsibility for investigation, follow-up and collection of patient accounts.
Completes month-end reporting of accounts receivable reports to ascertain status of collections and balances outstanding and to evaluate effectiveness of current collection policies and procedures. Reports findings to VP Finance monthly and as requested.
Audits delinquent accounts considered to be uncollectible to ensure maximum efforts have been taken before assigning bad debt status to account.
Responsible for reading and updating State and Federal procedures and codes necessary, including CPT4 and ICD-9 diagnosis codes including the migration to ICD-10..
Compiles and analyzes statistical data on patient accounts for review by senior management and clinic managers to assist in monitoring key productivity indicators.
Manage all revenue cycle related systems.
Responsible for implementing updates of patient charges, sliding scales and billing forms
Monitors billers/collectors activities to ensure maximum productivity and prepare periodic and annual evaluation of revenue cycle staff through documentation of productivity, accomplishments and error rates.
Performs month-end closing for patient revenue accounts.
Other duties as assigned by VP of Finance.
OTHER SKILLS and ABILITIES:
Database management, spreadsheet and word processing programs.
Patience, diplomacy and tact.
Ability to define problems, collects data, establish facts, and draw valid conclusions.
Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Work closely with CIO and Director of IT and IT Staff on system issues.
Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Outstanding organizational and time management skills are essential.
Must be able to handle varied tasks simultaneously and meet department deadlines/goals.
Possess strong communication skills, verbal and written.
Demonstrated ability to define problems, collect data, develop options, and make recommendations for most effective billing department strategies.
Demonstrated ability to set and reach goals.
Bachelor degree required in business, health management or related field experience
5+ years of related billing experience.
3+year of billing department managerial experience.
Knowledge of scheduling, registration and checkout processes and procedures.
Electronic billing or Electronic Medical Record ‘EMR’ experience a must.
Medi-Cal, FPACT and PE billing experience preferred.
Strong commitment to quality healthcare and excellent customer service.
Strong managerial and mentoring experience.
Knowledgeable in outpatient health care services.
Excellent written and verbal communication skills.
Ability to demonstrate mature judgment, initiative and critical thinking.
Ability to relate to diverse communities.
Accuracy and attention to detail essential.
Knowledge of CPT4 and ICD coding a must.
Knowledge of Commercial, MediCal and MediCal Managed Care billing guidelines.
Maintain professional demeanor.
Availability to work flexible hours.
Requires valid CA driver’s license and a reliable means of transportation.
Additional Salary Information: •Attractive benefits package including medical, dental, and vision coverage for you and eligible dependents, life insurance, and long term disability
•Generous vacation, sick, and holiday benefits
•Generous 401(k) matching contributions up to 8%
About Planned Parenthood Orange and San Bernardino County
• A nonprofit organization since 1965, we’ve been building healthy communities with the most sophisticated instrument in medicine: accurate information that can help people make the best decisions about their health.
• We provide essential reproductive services to more than 160,000 local women and men, regardless of their personal circumstances or ability to pay.
• Recently, with Melody Women’s Health, we’ve expanded our services to offer primary care to women.