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Responsible for directing and coordinating the overall functions of revenue cycle activity, ensuring maximization of cash flow while improving patient, physician and customer relations. This includes accountability for front and back end functions, daily reconciliation, resolution of billing inquiries, and patient/caregiver education on the billing process. May function as liaison between patient and other Mount Sinai departments (Hospital or FPA) in management of patient billing inquiries.
Essential Duties and Responsibilities
1. Plans and directs registration, patient insurance verification, billing/collections and data processing activities to ensure accurate claims billing and efficient account collection.
2. Reviews current status of patient accounts to identify and resolve billing and processing problems in a timely manner.
3. Functions as problem-solver for patients with billing challenges. Audits problem accounts and takes appropriate action to represent both patient and the Health System to achieve amicable outcome.
4. May meet with new patients or caregivers in assigned department(s) to orient them to billing processes and expectations.
5. Maintains contact with internal and external departments to obtain and analyze additional patient information to document and support billing and processing of claims.
6. Develops and implements new procedures to improve the quality and quantity of work processed. Ensures policies and SOPs are communicated and administered consistently.
7. Reviews distributed reports on all aspects of front end revenue cycle activity and efficiency and takes action to improve performance. Works with front end staff (e.g., registrars, schedulers, etc.), dept. supervisors and managers, as well as physicians and other providers, on actions that contribute to positive performance. Understands underlying detail of reports and can articulate explanation of department results.
8. Develops and oversees business systems and works with Information Technology to ensure timely and accurate implementation.
9. Monitors daily operating activity of assigned department(s) and makes suggestions necessary for improved work flow and efficiency.
10. Develops and prepares operational and financial reports and analyses, noting progress as well as adverse trends. Makes appropriate recommendations or conclusions.
11. Disseminates actionable information and knowledge to site and dept leadership to support front end revenue cycle activities, resulting in improved efficiency in claims submission and payment for all services rendered. Contributes to continued positive financial performance and growth of the service line.
12. Maintains knowledge and complies with established policies and procedures including government, insurance and third-party payor regulations.
13. Attends administrative meetings and participates on committees as requested. Conducts special projects and studies, as directed.
14. Participates in professional development activities and maintains professional affiliations.
15. Maintains confidentiality as regards patient account status.
16. Acts as liaison with all levels of administration and faculty in coordination of operational activities to accomplish directives and to facilitate resolution of issues.
17. Assists in the planning of short and long-range goals for the department, unit or division. Prepares and evaluates proposals to implement new programs and expand existing ones.
18. Other relevant duties as assigned.
Baccalaureate degree in business administration or related field.
Masters Degree in business or related field preferred.
2-5 years health care operations, including revenue cycle and insurance verification responsibility
Licensing and Certification Requirements (if applicable)
General Skills and Competencies
1. Skill in establishing and maintaining effective working relationships with other employees, patients, organizations and the public.
2. Skill in developing, implementing and administering data analyses and regular reporting.
3. Ability to process patient and public inquiries and respond with poise and efficiency.
4. Ability to recognize, evaluate, and solve problems and correct errors.
5. Ability to conceptualize work flow, develop plans and implement appropriate actions.
6. Ability to maintain confidentiality of sensitive information.
General office environment