Primary Scope of Responsibilities:
Manages patient scheduling for the hospital. This ensures managing all aspects of correct scheduling including accurate directions for each type of test to be performed.
Directs the patient registration process performed by front desk, emergency room, Basalt after-hours clinic and Snowmass clinic.
Manages the language resource needs for the hospital and ensures all patient information is available in both English and Spanish. Language line is used for all other needed languages to ensure no language barrier is present.
Manages the insurance verification function to ensure timely and accurate reimbursement of services provided. This includes providing procedure estimates and quotes to potential patients.
Determines the patient's personal liability for services provided and maximized such collections at the time of service. Also manages all aspects of cashiering for the hospital. Works with physician offices to determine patient's liability for non-covered services in order to establish admission deposit requirements under mutually acceptable terms.
Manages all aspects of the Financial Counseling services including but not limited to payment plans and the use of all applicable Grant Services including CICP. Also ensures availability of same in multiple languages.
Interacts with referral sources and other departments to capture, screen, complete and enter into Meditech pre-admission information to maximize customer service and accuracy of patient information.
Ensures compliance with all third-party contracts regarding pre-admission documentation (such as Consent for Treatment, Medicare as Secondary Payer (MSP), Advanced Beneficiary Notice (ABN) forms).
Acts as the primary liaison between AVH and the outsourced billing office in St. Louis (MedAssist) to ensure the accomplishment of AVH's billing and collection goals.
Analyzes the Daily Accounts Receivable Analysis Report and directs the billing office to take appropriate corrective actions in order to ensure optimal management of accounts receivable.
Ensures that claim production through MedAssist meets all payer requirements, and is accurate and timely, and minimizes payer denials.
Sets specific monthly and annual cash collection goals, as well as customer service standards for the billing office; assists MedAssist to prioritize activities on billed receivables to convert receivables to cash; analyzes receivables regularly to determine where to allocate MedAssist resources for optimal collection of receivables; follows up with MedAssist to ensure attainment of these goals
Assists hospital in remaining current with regulations pertinent to revenue cycle management. Ensures compliance with all applicable laws, regulations and directives from government agencies and private payers.
Manages hospital relationships with payers by ensuring compliance with contracts, and negotiating favorable terms for the hospital. Also ensures that payments received from payers comply with contract terms.
Ensures updates to chargemaster that will optimize reimbursement from payers and be in compliance with all federal and state regulations.
Works with appropriate hospital personnel to ensure maximum charge capture at the point of service.
Works closely with Medical Records Director to ensure timely and accurate coding of accounts.
Population Specific Criteria:
Demonstrates the ability to assess and interact with customers of all ages, recognizing language and learning barriers, and technology challenges.
Able to state his/her duties during a code pink drill.
Minimum of 3-5 years managerial experience in a hospital setting and knowledge of billing/admitting processes is required.
Extensive experience with Critical Access billing is required.
Normal patient care environment with little exposure to excessive noise, dust and temperature
May be exposed to communicable diseases through normal or careless performance of responsibilities
May be exposed to mechanical dangers associated with mechanical devices
May be exposed to stressful situations
Aspen Valley Hospital