Oversee the physician billing operation for MCMF, including both the services provided for Nautilus MSO clients and for the physicians of MemorialCare Medical Group.Responsible for ensuring effective revenue cycle management protocols, compliance with regulatory requirements, and achievement of industry standard accounts receivable performance metrics.Provide high level analytics and report as required to MCMF stakeholders.
Essential Functions and Responsibilities of the Job
Demonstrate strong verbal and written communication skills while cultivating a wholesome environment of team spirit and high achievement.
Provide professional and courteous service to all customers.
Maintain clean, well-organized, properly stocked and secure working area.
Maintain complete patient/employer confidentiality per company and HIPAA requirements.
Perform job functions in accordance with current departmental and company Standards, Polices and Procedures.
Professional and confident interactions with physicians and office staff to develop and maintain effective office billing protocols and to ensure ongoing communication and customer satisfaction.
Consistently provides ongoing evaluation and refinement of internal processes to ensure maximum productivity and collection results.
Conducts proactive analyses and monitors reimbursement trends as well as maintaining up to date knowledge and proficiency with respect to coding guidelines and medical billing requirements.
Reports results and metrics to senior leadership and clients monthly.
Essential Job Outcomes
Directs all aspects of the Physician Billing department and, through effective oversight and process development, monitors accounts receivable performance to ensure acceptable collection results for both MCMG and Nautilus Billing Service clients
Provides direction and guidance to PBS Leadership Teams regarding resource allocation, personnel management issues, process evaluation and improvement, customer relations, etc.
Utilizes automated system reporting capabilities to analyze accounts receivable and implement programs to ensure prompt collection. Reports results and performance metrics in an appropriate manner to designated stakeholders.
Develops and employs analytical tools and other monitoring mechanisms to proactively identify potential reimbursement and compliance issues.
Interacts with senior management and multiple departments to collaborate on shared issues, coordinate operational policies and strategic direction.
Ensures that departmental operations and policies are consistent with MCMF compliance program including continual process review to ensure compliance with all applicable regulations
Continually evaluates departmental organization, resource allocation and processes with respect to keeping up with growth and volume changes
Acts as primary liaison with customers and other departments with respect to problem resolution, reporting requirements and A/R performance analysis. Promotes and maintains positive relationships with office customers (physicians, physician offices, payers, patients).
Stays abreast of changes in billing and reimbursement issues, new legislative programs, insurance and regulatory requirements, etc. and ensure that appropriate communication takes place to stakeholders.Functions as subject matter expert for ambulatory billing issues.
Works collaboratively with MCMF Operations leadership to coordinate revenue cycle activities with medical clinic front office functions.
Participates in or leads workstreams for special projects or strategic acquisitions that have a revenue cycle impact.