PFS Collection Manager

Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-class health care in Palm Beach County and the greater Treasure Coast.

Outstanding physicians, state-of-the-art facilities, innovative techniques and a commitment to serving the community enables Jupiter Medical Center to meet a broad range of patient needs. Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie and Indian River counties to receive a 4-star quality and safety rating from the Centers for Medicare & Medicaid Services (CMS).

Education

• Associates degree in Business, Finance, Accounting, and or Health Care Administration with 2+ years billing/collections experience; Bachelor's degree in Business, Finance, Accounting, and or Health Care Administration, preferred.

• 2+ years of RCM experience preferred.
• Knowledge of RCM billing and collections systems.
• Knowledge of Medicare, Medicaid, and Commercial payer reimbursement procedures and methodologies.
• Ability to work independently while effectively managing different priorities and projects.
• Ability to read, analyze, and interpret common and technical journals, statistical reports, and other related documents.
• Ability to effectively present information to team, leadership, other departments.
• Ability to work with basic mathematical concepts such as probability, statistical methods, and fundamentals of plan.
• Ability to define problems, collect data, establish facts, and draw valid conclusions that drives process improvement, quality, and productivity.
• Ability to analyze business situations, controls, and risks, and recommend practical solutions.

• Responsible for managing all billing and collections components for Provider Group and Urgent Care billing and collections guidelines.
• Understands CPT, HCPCS, ICD-10, and ICD-10 PCS coding guidelines and the use of all applicable modifiers.
• Makes necessary recommendations for any changes to fees and/or billing and collections processes.
• Resolves issues and problems of billing and collections system and discusses with software analysts.
• Attends workshops, seminars and/or meetings on billing and collections, and accounts receivable issues as required.
• Stays current on A/R information (charges, coding, billing) and distributes new information to appropriate personnel via meetings, memos, literature, emails, and other.
• Collaborates with Billing and Collections Supervisor to perform appropriate billing and collections personnel evaluations annually, or as required, and assigns responsibility to billing and collections staff based on their skills.
• Collaborates with Billing and Collections Supervisor to hire, supervise, coach, and provide corrective and or disciplinary actions to billing and collections staff according to policies and procedures.
• Possesses a thorough working knowledge of billing and collections requirements for various payors.
• Oversees billing and collections issues with clients, collection agency, third party payors, and others.
• Conducts bi-monthly (or monthly) meetings with billing and collections staff and appropriate personnel.
• Collaborates with Coding Manager and Coding Educators for coding issues as they relate to billing.
• Collaborates with the Credentialing Team for issues related to credentialing related to billing and collections.
• Works closely with IT for entry of providers in ECW, modification of data, charge amounts, etc. as needed.
• Ensures submission of claim batch(s) daily.
• Conducts integrity audits to ensure compliance with billing and collections policies and procedures are followed in combination with CMS and other governing bodies' guidelines.
• Presents Month-end closing of the Physicians billing statistics.
• Tracks AR statistics, provides daily reporting of AR days, balances, trends, analysis.
• Plans and implements quality assurance for all billing processes.
• Staffing discussions and planning/interviews; team building as well as personnel development, staff meetings, educating team responsibilities.
• Assist with the implementation of changes and or updates of existing and new billing system; keeps relevant edits in place within the billing system.
• Maintains applications' access and requests for staff as needed and or required.
• Have proven ability to perform strategic planning and priority setting for a billing department.
• Strong leadership skills with an ability to motivate direct reports.
• Excellent communication skills both written and verbal, and interpersonal skills.
• Effectively uses and role models current leadership techniques and theories, encouraging the decision-making skills of staff members and providing insight and leadership in complex situations.
• Ensures that information disseminated to staff is monitored for effectiveness and changed as needed.
• Understands and enforces hospital and personnel policies and procedures.
• Serve on hospital and Patient Care Services committees, teams, and work groups as requested.
• Performs other duties as assigned.

• Performs other job-related duties as required.

• Supports the Director of Revenue Integrity and other RCM Management by assisting with research of issues arising from billing and collections and/or identified in reporting trends.
• Supports the Director of Revenue Integrity and other RCM Management by presenting recommendations of QA activities geared to address specific areas of high risk in billing adequacy and compliance.
• Assists the Director with reviewing, routing, and monitoring appropriate resolution of Coding Compliance that pose risk to the Company; while developing process to prevent future discrepancies.

• Performs other job-related duties within the job scope as requested by Director of Revenue Integrity.
• Protects confidential and protected patient health information and maintains strict confidentiality in accordance with HIPAA Laws, regulations, and company policy.
• Presents a positive, professional appearance and conveys a professional demeanor in t.