Job Information
MD Anderson Cancer Center PBS Manager - Payment Posting & Credits in Houston, Texas
Summary
The primary purpose of the Credit Resolution Manager position in Service Documentation is to oversee the day-to-day operations of the Credit Resolution department.
Key Functions - credit resolution manager
Provide oversight to Credit Resolution and contracted vendors and consistently review processes for efficiency.
Monitor and manage work queues in the patient accounting system to ensure a positive patient experience and compliance with payor refund requirements
Work with insurance carriers and their collection agencies on credit resolution and refunds and monitor/trend these activities. Communicate these trends/issues to managed care and other revenue cycle committees as appropriate.
Review patient accounting system for opportunities to improve performance and efficiency. Develop and update workflows as needed to improve processes and outcomes. Communicate and collaborate with IT on any limitations to add to future development lists, system initiatives, and functionality requests.
Manage the daily reapplication of all patient and insurance payments based on departmental guidelines.
Manage the appropriate handling of returned guarantor and insurance refund checks, including stop payment and reissue of these checks.
Oversee the State of Texas Unclaimed Property Filing and submit as required by statute
Collaborate with Billing to ensure the CMS regulations regarding the quarterly reporting of Medicare credits and monitor the vendors who assist in the account review.
Oversee the reconciliation of the General Ledger for the credit clearing account.
Key Functions - Payment Posting manager
Oversee posting of all payments, adjustments and denials in the patient accounting systems.
Provide direct supervision to the Payment Variance Unit and oversee the daily operations of the Payment Posting department.
Investigate missing payment complaints and reply to requestor as appropriate.
Update Payment Code and Rejection Code within Epic.
Explore opportunities for automation of departmental processes (EDI, ERA, etc.).
Coordinate batch completion and night jobs processing (system update).
Oversee the reconciliation of the all financial reports (Daily Cash Deposit, GL Clearing Account).
Key Functions - credit resolution/Payment Posting manager
Ensure that departmental policies are updated annually and distributed to the staff for compliance.
Oversee and coordinate the monthly performance statistics distributed to the staff.
Monitor quality control process in Payment Posting to ensure an error rate of 1% or less.
Ensure HIPAA compliance within the area.
Ensure documentation control procedures for imaging are followed.
Monitor production standards.
Provide feedback to the supervisors and the Payment Posting & Credits Director regarding workflow, quality, production and work performance issues as necessary.
Report any system problems or staffing issues to manager or Payment Posting Director when identified.
Responsible for interviewing and hiring. Provides employee counseling, updates position descriptions, prepares and presents employee performance evaluations within appropriate timeframes.
Collaborate with PBS Customer Service to ensure a positive patient experience related to timely and accurate payment posting and refund processing.
Participate on revenue cycle committees as a representative of Patient Business Services to assist the institutional members in understanding revenue cycle processes related to payment posting, credit balances and refunds.
Other duties as assigned by management.
Required Education:
Bachelor's degree in Business, Healthcare Administration or related field.
Required Experience:
Five years of supervisory experience in a healthcare setting. May substitute required education degree with additional years of equivalent experience on a one to one basis. Successful completion of the LEADing Self Accelerate program may substitute for one year of required supervisory or management experience.
Preferred Experience/Skills:
Healthcare background, experience in medical accounts receivable with thorough knowledge of managed care and healthcare reimbursement for all payors (Medicare, Medicaid, Managed Care and Commercial); proficient in Excel, Word and PowerPoint; excellent oral and written communication skills; experience with revenue cycle, financial reporting, denial processing, billing, Epic.
Other Requirements:
Must pass pre-employment skills test as required and administered by Human Resources.
It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html
Additional Information
Requisition ID: 156227
Employment Status: Full-Time
Employee Status: Regular
Work Week: Days
Minimum Salary: US Dollar (USD) 84,500
Midpoint Salary: US Dollar (USD) 105,500
Maximum Salary : US Dollar (USD) 126,500
FLSA: exempt and not eligible for overtime pay
Fund Type: Hard
Work Location: Remote (within Texas only)
Pivotal Position: No
Referral Bonus Available?: No
Relocation Assistance Available?: No
Science Jobs: No