Req ID: 7474
Schedule : Full Time
Shift : Days
Salary Range: $29.42 – $39.77
Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.
FLSA Status Exempt Job Role Summary The Professional Services Billing Manager manages and coordinates the daily operations for all professional services billing and reimbursement to ensure appropriate cash flow is maintained, patient satisfaction with the administrative functions at Eskenazi Health are consistently positive, and develops and maintains cooperation with all contracted professional services providers where Eskenazi Health provides the billing for professional services. This position works closely with other areas within Eskenazi Health to ensure optimal generation and collection of professional services revenues with minimal impacts on hospital revenue cycle processes. Essential Functions and Responsibilities Manages and coordinates the daily operations for all professional services billing and reimbursement to ensure appropriate cash flow is maintained, patient satisfaction with the administrative functions at Eskenazi Health are consistently positive, and develops and maintains cooperation with all contracted professional services providers where Eskenazi Health provides the billing for professional services. Works closely with other areas within Eskenazi Health to ensure optimal generation and collection of professional services revenues with minimal impacts on hospital revenue cycle processes. Ensures charge entry team is within the 72 hour goal, payment posting is within 24 hour goal, hospital coding is within the 5 day goal and Provider Enrollment is current and staying updated with applications and their progress. Acts as a role model and leader for Professional Billing Team with a professional and positive attitude. Serves as an eCW Certified Trainer Serves as an eCW system expert as relates to Professional Billing. Assists Decision Support team with Insurance/Provider/Facility updates, electronic claim submission, EFT and ERA set up. Reviews on a monthly basis along with the Director, operating results of Professional Services revenue and reimbursement and adapt changes as appropriate to meet or exceed goals. Establishes performance improvement programs as needed. Responsible for providing appropriate training, guidance, continuing education and overall job competencies of staff. Establishes, maintains and manages productivity and quality standards. Maintains, develops and implements operating policies and procedures pertinent to areas of responsibility. Monitors claim denials and exclusions daily and works with Departments to improve processes to avoid denials. Directs various personnel actions including, but not limited to, hiring, performance appraisals, promotions and transfers and progressive discipline. Keeps Director updated with trends, and Human Resource issues. Completes (or contribute to the completion of) various financial forecasts, including cost center labor and non-labor expenses and productivity, month-end financial reporting, receivables performance, and any long-range strategic plans for the department. Stays abreast of all Governmental and industry trends in the Professional Services operational area, and shares these updates with team members and providers. Reviews internal controls, policies and procedures to ensure compliance with appropriate Federal, State and regulatory entity guidelines and procedures. Stays current with medical policy for all carriers and ensures team and providers are updated as medical policy changes. Troubleshoots current as well as anticipates potential problems and resolves by involving appropriate departments and personnel when needed, having the expertise to know when to involve others to minimize loss of revenue, reimbursement, penalties or sanctions. Provides leadership through effective guidance, feedback and delegation Ensures and advocates excellence in customer service values Job Requirements Bachelor's degree or equivalent experience required, preferably in business, health or public administration, management, or a related field Minimum of 8 years of related experience in a hospital/medical environment may be accepted in lieu of educational requirements. A minimum of 5 years management experience in Physician Billing and/or Hospital Patient Financial Services management required. CPC certification Knowledge, Skills & Abilities In-depth knowledge of physician and allied health practitioner billing and reimbursement Knowledge of healthcare industry financial statistical indicators and best practices Skills in using mainframe and PC computers, including strong analytical and MS-Excel skills Clear, effective communication skills Knowledge of medical policy, coding and compliance regulations Professional, team-oriented, solution-driven approach to problem solving for all types of issues Detail oriented Knowledge of medical terminology Critical thinking skills. Effective Project Management skills
Accredited by The Joint Commission and named one of the nation’s 150 best places to work by Becker’s Hospital Review for four consecutive years and Forbes list of best places to work for women, and Forbes list of America’s best midsize employers’ Eskenazi Health’s programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city’s primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana, the first community mental health center in Indiana and the Eskenazi Health Center Primary Care – Center of Excellence in Women’s Health, just to name a few.