At White Plains Hospital, you have an opportunity to work side-by-side with some of the most talented people in the world.
We have been widely recognized for our exceptional culture, world-class physicians, Magnet-designated nurses and passionate employees who make a real difference in our community. With tremendous growth opportunities, great benefits, and flexible work schedules, it is no wonder why we are consistently recognized as a Great Place To Work.
Position Summary
The Manager of Patient Accounts is responsible for all aspects of the revenue cycle. They will implement development of department strategies to maintain and manage key performance indicators to high performance and best practice. They will support the development of strategic direction for department operations and manage the patient accounts team and operations to high performance standards. Responsible for direct oversight and management of billing, follow-up, denials, and payment review teams. They are responsible to assure all teams are functioning at a high level with the result of best practice in compliance, cash flow, and overall revenue. The Manager of Patient Accounts will align with departments throughout the facility to assure timely release of claims with appropriate codes aligning to optimal reimbursement and compliance.
Essential Functions and Responsibilities Include the Following:
- Directs and oversees the overall objectives, policies, and initiatives of WPH revenue cycle activities to optimize workflow, performance, and overall billing collections for the facility.
- Demonstrates leadership skills with the ability to guide, direct, train, and interact with management on a regular basis.
- Reviews, designs, and implements processes surrounding billing, third-party payer relationships, compliance, collections, account resolution, and other financial analysis to ensure that the revenue cycle is effective and properly utilized.
- Monitors and supports daily functions of all related staff.
- Tracks numerous metrics related to the revenue cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.
- Compiles and analyzes information identified through A/R reports through A/R Pivots, Business Objects, or specified billing platforms for current and/or potential billing issues specific to outstanding receivable and denial management.
- Compiles and discusses various reports/metrics to senior Administrative staff.
- Responsible for reporting and tracking department performance metrics.
- Develops necessary summaries or reports using Microsoft Excel/Word.
- Presents data to appropriate parties and partners to develop resolutions with affiliates as necessary.
- Independently works to ensure that daily team operations flow smoothly; to include, but not limited to daily production assignments that will continue to develop understanding and knowledge of processing guidelines and expectations of respective payer mix.
- Works in collaboration with peers, Manager(s), and Director(s) for guidance and reorganization of workflow to ensure internal and external business needs are met.
- Participates in meetings with Payers, internal departments, contact(s), and Management, etc. to address trends in denials or unprocessed claims.
- Creates and distributes department-wide communications or pathways, notifying staff of updated insurance guidelines/processing information.
- Holds regular staff meetings to communicate changes in process, business results, organizational changes, or environmental changes.
- Identifies and facilitates individual and/or team training needs for new or established team members.
- Handles escalated issues that include but are not limited to unhappy patients/callers and client contacts that may require additional system or technical knowledge.
- Ensures the effectiveness of the talent management process for the team by anticipating staffing needs, effective interviewing and onboarding of new staff. Conducts timely and effective quarterly and annual performance reviews, and creates staff development plans to promote competency/skill development.
- Engages in employee performance management; to include, but not limited to creation, maintenance, and delivery of performance documents and appraisals for direct reports, routine review of productivity utilizing applicable reports and systems available.
- Reviews quality assurance reports with team leaders and employees; providing feedback on areas of success and improvement for staff.
- Responsible and accountable for the overall operations of their assigned department. Overall operations of the department include development of department goals and objectives that are consistent with the hospital mission, the management of personnel, preparing/monitoring of, and accountability for the department budgets.
- Understands and adheres to the WPH Performance Standards, Policies, and Behaviors.
- Assures the delivery of quality department/clinical services in accordance with established hospital and regulatory/accreditation agency standards.
- Assures employee compliance with hospital and Human Resources policies and procedures.
- Responsible for development and execution of corrective action measures.
- Assures that employee competency and education requirements are satisfied as per hospital policy.
- As required, participates in the Performance Improvement Program as defined by the organization.
- Attends Management/Leadership meetings as scheduled/required and communicates hospital policies, performance improvement initiatives, and all other required information to their staff.
- Responsible for participation in committees, task forces, and projects as appropriate.
- Works collaboratively with all levels of the hospital interdisciplinary team and promotes the team concept within their department and hospital wide.
- Demonstrates positive customer service fosters positive employee relations and assures that staff adhere to the Customer Service Behavioral Standards.
- Is supportive of hospital initiatives and projects and functions as a positive change agent.
- Promotes a positive and professional image and is a role model, coach, mentor, and resource for staff and peers.
- Develops and submits departmental goals and objectives as required by the Division Administrator.
- Interviews, hires, evaluates, counsels, and terminates employees as per hospital policy.
- Schedules staff based on budgeted staffing plan and department needs.
- Manages relationships with outside vendors to ensure effective performance.
- Assures compliance with state regulations and accreditation standards.
- Assures completion of staff orientation, annual and ongoing competency and education requirements.
- Attends and participates in educational programs or activities to maintain current level of knowledge or expertise to manage department.
- Participates and assures department involvement in ongoing Performance Improvement initiatives as required. Submits reports as required.
- Responsible for audit and upkeep of charge master.
- Ensures proper billing protocols and guidelines are followed.
- Works in conjunction with members of the management team to upkeep system dictionaries.
- Develops and implements policies and procedures to streamline and standardize workflow as well as improve current operations to best practice.
- Monitors staff and workflow to ensure hospital policy, procedures, and protocol are followed accordingly.
- Attends Management/Leadership meetings as required.
- Conducts monthly staff meetings to update staff and/or address department issues and records meeting minutes for all staff.
- Utilizes multiple methodologies to communicate information.
- Adheres to safety standards for employees and patients.
- Interacts with hospital ancillary revenue departments, patient registration, and case management to ensure compliant practices and streamline revenue.
- Participates in committees, task forces, projects, etc. as required.
- Submits all other work reports as required/requested by the Division Administrator.
- Designs, implements, and maintains procedure manuals for all areas of responsibility.
- Designs and implements control systems to assure the most efficient use of employee’s time including mail and follow-up procedures.
- Oversees all patient accounts activity and staff performance to ensure effective and efficient use of resources to maximize cash collections.
- Maintains the integrity of the accounts receivable to ensure optimal cash flow and timely account resolution.
- Responsible for submitting bi-weekly payroll and maintaining records of holiday, sick, and vacation time for all personnel.
- Assures staff is up-to-date on all courses, including HBI/Clarivate.
- Performs all other related duties as assigned.
- HBI certification certificate required prior to end of probationary period.
Education & Experience Requirements
Graduate of an accredited College or University with a B.S. in Business or Health Administration; Masters preferred.
Minimum of (6) to (10) years in Patient Accounting required, preferably in a hospital setting.
Knowledge of hospital billing and reimbursement of insurance as well as third-party billing.
Knowledge of front-end practices as it relates to Patient Access.
Proficiency with Microsoft Office/Excel to include reporting, Executive level required.
Core Competencies
- Strong leadership and organizational skills.
- Proficient in Excel and preparation of reports and presentations.
- Strong analytical and troubleshooting skills.
- Knowledge of hospital billing and reimbursement of insurance as well as third-party billing.
- Ability to understand payment methodology and utilize formulas.
- In-depth knowledge of the complete healthcare revenue cycle.
- Experience/knowledge of contract language and payment methodology.
- Strong communication skill sets and abilities.
- Ability to establish two-way communication by clearly defining expectations, using a variety of methods, actively listening to ideas and concerns, and responding in an appropriate manner.
- Demonstrates ability to delegate responsibilities appropriately.
- Ensures compliance with state regulations and accreditation standards.
- Participates in ongoing Performance Improvement initiatives as required. Submits reports as required.
- Utilizes multiple methodologies to communicate information.
- Establishes and maintains an in-depth knowledge of revenue cycle principles, practices, procedures, regulatory compliance, and internal controls.
- Submits all other work reports as required/requested by the Division Administrator.
- Keeps the Assistant Vice President Revenue Cycle informed at all times of the status of third-party plan payments and analysis progress.
- Integrity to handle the confidential aspects of work.
- Retains composure under stress.
Physical/Mental Demands/Requirements & Work Environment
May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital’s SDS (Safety Data Sheet) database and may be accessed through the hospital’s Intranet site (Employee Tools/SDS Access). A copy of the SDS database can also be found at the hospital switchboard, saved on a disc.
Must be able to remain in a stationary position 50% of the time.
The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc.
The person in this position frequently communicates with patients who have questions and must be able to exchange accurate information in these situations.
Must be able to detect and greet patients arriving.
Primary Population Served
Check appropriate box(s) below:
- Neonatal (birth – 28 days) Patients with exceptional communication needs.
- Infant (29 days – less than 1 year) Patients with developmental delays.
- Pediatric (1 – 12 years) Patients at end of life.
- Adolescent (13 – 17 years) Patients under isolation precautions.
- Adult (18 – 64 years) Patients with cultural needs.
- Geriatric (> 65 years) All populations.
- Bariatric Patients with weight-related comorbidities.
Non-patient care population
The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of White Plains Hospital.
Location: White Plains Hospital · Patient Accounting
Schedule: Full Time, Day, 8am-4pm
