Berkeley Emergency Medical Group is seeking a skilled professional to fill the Full-Time position of Patient Accounting Manager.
Primary Functions: Responsible for managing Berkeley Emergency Medical Group Patient Accounting Department, including the oversight of accurate posting of payments and adjustments; timely submissions of claims; follow up on claim rejections; and monitoring the accuracy of the daily deposit.
Duties and Responsibilities:
Directs billing functions including manual and electronic claim submission for all vision benefit, medical benefit and patient responsible claims including implementing new goals and procedures, overseeing billing operations and coordinating office efforts to expedite payment of accounts.
Supervising staff members by directing workflow, training and evaluating performance. Initiates disciplinary action as required. Monitors daily operating activity of department and makes necessary adjustments in work assignments.
Validate payer accuracy via detailed claims review and analysis. Researches non-covered and/or denied claims to identify root causes. Provides feedback and training to divisional managers and staff in order to implement corrective actions.
Identifies coding, charging, and/or billing issues and patterns that result in inaccurate payment and work to resolve issues.
Initiates audits to ensure compliance and reimbursements are appropriate. Supports internal and external auditors and requests for record reviews from 3rd party payers.
Monitors the charge-adjustment-receipt structure and initiates changes or improvements. Reviews practice's fee schedule in comparison to Medicare and other payer's fee schedule and implements revisions when needed.
Ensures effective and efficient credit and collection policies and continuously monitors for improvement.
Reviews the current status of patient accounts to identify and resolve billing and processing problems in a timely manner. Coordinates the final disposition of patient accounts and monitors the collection rate of receivables.
Oversees the accurate and timely posting of payments and adjustments.
Ensures the timely submission of claims, as well as the monitoring and follow-up of claims not paid in a timely manner.
Oversees the refund process for patients.
Oversees the daily cash and contractual posting and monitors the accuracy of the daily deposit.
Initiates and answers pertinent correspondence. Prepares and writes reports. Maintains required records.
Maintains knowledge of and complies with established policies and procedures including government, insurance, and third-party payer regulations.
Utilizes metrics to improve performance and maintains a metrics database.
Attends administrative meetings and participates in committees as requested. Conducts special projects and studies as directed.
Participates in professional development activities and maintains professional affiliations.
Monitors staff for compliance with the organization's confidentiality policy in accordance with the Health Insurance Portability and Accountability Act (HIPAA) regulations.
All other duties as assigned.
Bachelor's degree in healthcare administration, business administration or related field preferred.
5 + years' experience in healthcare revenue cycle/financial operations.
Berkeley Emergency Medical Group, Inc. is an independent democratic group employing 44 physicians, 6 physician assistants, and 20 billing and administrative staff. Our physician group staffs the Emergency Departments of Alta Bates Summit Medical, Berkeley, and Oakland locations.