PATIENT ACCOUNTS MANAGER in St. Louis, Missouri at FAMILY CARE HEALTH CENTERS

I. BASIC FUNCTION:

Responsible for managing FCHC’s accounts receivable, including maintaining current billing procedures and

objectives. Coordinates operations with other sites and medical staff in relation to accounts receivable. Interprets

policies and recommends policy changes to Chief Financial Officer. Manages the Billing Department to obtain the

objectives/goals as stated below:

1) Gross accounts receivables > 120 days should stay under 30% of the gross accounts receivables.

2) Days of gross charges in accounts receivables should be less than 60.

3) All charges should be posted within 3 days from the date of service.

4) Self-pay collection rate should be 25% as measured by federal indicators.

All employees of FCHC must ensure service standards are delivered, including:

FCHC Core

• Demonstrates a commitment to FCHC mission and vision.

• Demonstrates a positive attitude towards patients, employees, role, and the health center.

• Demonstrates FCHC core values (accountability, courtesy, excellence, flexibility, integrity, respect).

Customer Service and Professionalism

• Smiles and makes appropriate contact, greets individuals upon entry into building and space.

• Is customer service oriented to both internal (colleagues) and external (patients, clients, vendors, etc.)

customers. Treats patients, customers and colleagues with dignity and respect.

• Provides timely response to requests, tasks, and inquiries. Demonstrates good service turnaround.

• Demonstrates good communication skills and communicates in a tactful manner.

• Exhibits conflict resolution skills in order to foster effective working relationships and embraces a team

approach.

• Adheres to FCHC’s dress code policies. Employee appearance and grooming appropriate.

Show(s)

• Consistently shows commitment to position and team performance (i.e., attendance and punctuality).

• Consideration and acceptance of cultural differences of others; works well with individuals of diverse

backgrounds, supporting a culture of justice, equity, diversity, and inclusion.

• Participates in training and professional development and completes required trainings in a timely manner.

Safety

• Adheres to and promotes a culture of safety and cleanliness.

• Adheres to HIPPA/Confidentiality standards.

• Respectful of FCHC property, properly and safely uses Health Center Equipment.

JOB DESCRIPTION

DEPARTMENT: FINANCE

JOB TITLE: PATIENT ACCOUNTS MANAGER

PATIENT ACCOUNTS MANAGER

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II. INTRADEPARTMENTAL RELATIONSHIPS:

Department Officer: Chief Financial Officer

Reports to: Chief Financial Officer

Supervises: Lead Patient Accounts Specialist and/or Patient Accounts Specialists

Works closely with: IT Director

III. PRIMARY RESPONSIBILITIES:

1. Responsible for timely and accurate submission of billings to third parties in order to maximize collections from

payers.

2. Monitors compliance with health center’s policies and directives and is responsible for attaining business office

objectives and goals as set forth by Family Care Health Centers, both financial and non-financial.

3. Responsible for exploring all options for payment before approving patient for sliding fee. (I.e. Caring Program

for Children, Medicaid, etc.)

4. Responsible for educating staff about HMO plans Family Care Health Centers is associated with, as well as

co-pays may be due, etc.

5. Recommends co-payment collection policies and procedures.

6. Monitors bad debt and contractual losses against budget.

7. Coordinates operations through direct involvement in day-to-day operations. Works closely and is involved in

the business office, working side-by-side with the cashiers, billing clerks, etc.

8. Conducts staff meetings and in-services to inform staff of updates and/or changes in policies and procedures

related to billing.

9. Establishes controls and reviews mechanisms for every procedure to ensure that systems and procedures are

being followed correctly.

10. Develops specific objectives, budgets, and performance standards for each area of responsibility within the

business office.

11. Monitors progress for each area daily, utilizing productivity reports.

12. Prepares Accounts Receivables activity reports monthly.

13. Reviews and approves write-off listing, refunds requests, miscellaneous cash adjustments, etc.

14. Reviews all remittance advice and determines significant problems causing rejections.

PATIENT ACCOUNTS MANAGER

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15. Maintains listing of current OB patients, identifying payor source to ensure reimbursement for deliveries.

Coordinates plan enrollment and/or third-party payor issues with billing staff and providers.

16. Coordinates current billing and managed care reimbursement issues with staff at all sites. Coordinates billing

procedures for various state, city, and federal programs. Advises all staff when procedural changes are

required.

17. Reviews fee schedule annually to ensure optimum reimbursement for all services rendered, in liaison with

Chief Financial Officer. Utilizes physician fee analyzer, RBRVS and/or other acceptable methodology in

setting fees.

18. Monitors billing staff efficiency and productivity. This includes coordinating the department schedules to

ensure adequate staffing levels and adjusting daily, as necessary.

19. Maintains good working knowledge of current Medicaid, Medicare, and other third-party payor regulations and

billing procedures. Reviews Medicaid and Medicare bulletins monthly. Advises Family Care Health Centers

staff, Chief Financial Officer, and Chief Medical Officer of procedural changes.

20. Monitors accounts receivable aging report to determine status of claims by payer type. Work towards

minimizing the balances in the aging report to maximize collections.

21. Advises the Chief Financial Officer on an ongoing basis of the status of claims processing, payments, and

rejections.

IV. PERIODIC DUTIES:

1. Contributes to Center activities.

2. Participates in Center staff problem-solving groups.

3. Performs other duties and projects as assigned.

V. WORKING RELATIONSHIPS:

Inside Center: All inclusive.

Outside Center: Patients, Medicaid, Medicare, commercial insurance plans, other health centers, auditors, etc.

PATIENT ACCOUNTS MANAGER

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VI. QUALIFICATIONS:

1. Bachelor’s degree in Business Administration or related field desirable.

2. Five plus (5+) years experience in all phases of billing and collections desirable with prior supervision

experience required.

3. Participation in special workshops and/or training sessions in Medicare, Medicaid, Medicaid Managed Care

plans and commercial insurance plans procedures to maintain current knowledge relative to these procedures

is required.

4. Knowledge of and experience with automated systems required.

5. Previous managed care experience required.

6. Good working knowledge of ICD-10, CPT and Healthcare Common Procedure Coding System (HCPCS)

coding necessary, education required.

VII. CONFIDENTIALITY:

Respect for and maintenance of client and staff confidentiality is required.

The above duties/requirements describe the chief function (requirements) of the job (holder) and are not to be considered a

detailed description of every duty (requirement) of the job (holder).