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- Directs and supervises clinical and administrative staff to maintain quality care; and ensure staff productivity.
- Prepares written and online evaluations of staff’s job performance.
- Oversees the operations of Psychiatry’s Ambulatory Care to include POS, ACT, & MCT.
- Conducts and organizes materials and staff for audits.
- Provides overall management and supervision, and maintains attendance records and submits time sheets for staff of 90 plus.
- Maintains statistical and billing data related to operations of Teaching Practice.
- Responsible for the generation and submission of all claims for two group practices.
- Supervise the application of all EMR and scheduling systems such as IDX/eIDX, Queries Omnipro, Emevs, Tier, BCBS, and ARI systems for review of patient billing status.
- Acts as resource person for resolution of complex billing situations that are received by the patients for services rendered in the outpatient behavioral health clinic.
- Resolves simple to moderate edits from the electronic billing system (MD Online) to facilitate the accurate and timely payment of claims.
- Interaction with various departments to solve patient billing issues.
- Follows-up with various departments about present and new billing procedures concerning outpatient behavioral health.
- Coordinates the set-up and training of various departments for billing through the hospital’s professional billing department (MDe).
- Able to extract, manipulate, analyze and interpret data from other billing systems.
- Assists with the implementation of procedures to facilitate billing in a timely manner.
- Able to develop financial collections reports of billing reimbursements as requested.
- Prepares and records collections to be deposited into appropriate account.
- Monitors, reviews, and communicates billing procedures with support staff.
- Apprises physicians and management of new and revised coding guidelines from Medicare, Medicaid, and third party payers.
Under supervision and Direction of Clinic Medical Director, develops policy, procedure and supervises and directs all aspects of Clinic Operations including data management, billing, RVU management, patient relations, QI Initiatives, Patient Satisfaction, and non-clinical staffing functions.
Co-Chairs Divisional QI Committee and UR Subcommittee.
Develops strategic plans and integration planning under direction of Chairman and Senior Director.
Participates in the department’s performance improvement activities.
Maintains patient/employee confidentiality in the management of information.
Observes the Health Care System’s compliance policies.
Coordinates construction projects and purchases with follow-up.
Assists Medical Director in ensuring that the Outpatient Department operates in compliance with governmental, medical center and departmental policy.
Instructs and counsels Attendings, Residents, Psychologists, Social Workers, Interns and Students in departmental and regulatory agency policy, and assists on on-going basis.
Ensures on-going maintenance of facility and addresses deficiencies on interdisciplinary rounds.
Demonstrates competence in utilization of selected hospital information applications.
Participates on CQI and on re-engineering teams.
Maintain the accuracy of the Discharge Planning Manual (departmental and hospital wide) through ongoing reviews and edits/additions.
Participate in Quality Improvement (QI) surveys and studies; assess results; monitor corrective action to ensure continued compliance with standards and procedure.
Supervises all aspects of revenue cycle activities, ensuring compliance with organization’s patient registration, insurance eligibility verification, denial processing, and general reimbursements for clinic, contracts, and FPA operations.
Maintains schedules for clinical and non-clinical staff.
Liaisons with PACC VP and Administrative staff to ensure compliance with OPD regulations.
Attends various meetings and seminars with Manager for Medicare, Medicaid, and OMH updates.
Participates in the development of other staff members.
Meets regulatory, licensure and annual health assessment requirements.
Identifies learning strengths and needs.
Utilizes learning resources.
Coordinates educational classes for staff.
Counsels all staff, clinical and clerical in departmental procedures.
Develop and manage data for QI studies related to patient care in order to improve quality of service delivery and target areas of educational need for staff.
Plan, organize, develop, and assess departmental in-service training programs to improve quality of staff education.
Attends insurance seminars.
Maintains professional skills through attendance at educational activities (i.e., front line, etc.)
Communicates workflow problems regarding billing systems.
Demonstrates a professional, courteous, and respectful attitude in dealing with patients, families and significant others.
Displays courtesy, tact and patience during interactions with all members of the hospital staff and extended community.
Represents the department at meetings and on committees and establishes positive working relationships with other departments within the medical center.
Represents the department at meetings with outside agencies and establishes positive working relationships.
Demonstrates the ability to act independently, and offers suggestions and new ideas for improving performance and operations.
Performs all other tasks assigned, and voluntarily takes on additional responsibilities.
May be required to perform other duties as assigned or perform other duties when necessary.
- Master's Degree in related psychosocial field required
- 4 years of Administrative experience in mental health setting required
- Knowledge of CPT-4 and ICD-10 guidelines, as well as Medicaid and Medicaid coding policies and coverage procedures.
- Managerial experience
- Knowledge of hospital systems
- LCSW, LCAT or OTR/L