Patient Accounts Director jobs in Ohio

Position Summary:  The Director, Patient Accounts is responsible for all aspects of Patient Accounts department within Orthopedic One department to ensure expedient collection of payments at the maximum level of reimbursement allowed for the services provided by Orthopedic One physicians and all other billable providers, reporting to the CFO. This position works collaboratively with company leadership of all functional areas in order to achieve strategic objectives and vision of Orthopedic One.

Responsibilities/Accountabilities:

Department/Functional Area

1. Plans and directs patient insurance, billing, collections, and data processing functions to ensure patient satisfaction including accurate billing and efficient account collection.
2. Develops, implements, and maintains a departmental dashboard which includes benchmarking, key performance metrics, and communicates those metrics to management, operations and physicians.
3. Responsible for strategy, process, and technology to continuously improve and manage the Revenue Cycle, increase productivity, decrease denials, reduce days in AR and increase cash collections
4. Coordinates with internal stakeholders to drive optimal patient experience, access, and financial performance.
5. Ensures that physician services are compliantly coded at the optimal level to ensure the highest level of reimbursement allowed according to government, insurance and third-party payer guidelines.  In addition, oversees internal and external coding audits including identifying key trends and educating physicians and others on necessary changes.   
6. Confirms that necessary referral, pre-certification, and workers compensation policies and procedures are in place to ensure timely payment by all payers.
7. Reviews the current status of aging of patient accounts and works with internal and external parties to identify and resolve billing and processing problems in a timely manner.
8. Develops, implements, and maintains a variance identification and collection process for third party payers. Works directly with 3^rd party payers and Clinical Integrated Network providers to resolve variances and provide meaningful data and guidance during contract negotiations.   
9. Establishes and implements a system for the collection of delinquent accounts ensuring third-party payers are contacted.
10. Supervises internal and external credentialing processes to ensure deadlines are met to allow for timely submission of claims. 
11. Establishes and recommends credit and collection policies and makes recommendations for process improvement.
12. Leverages best practices and technology to develop new procedures to improve the quality and quantity of work processed. Ensures policies are communicated and administered consistently.
13. Develops and oversees practice management system related to billing functions and works with HIM to ensure timely and accurate implementation of system upgrades.
14. Maintains knowledge of medical billing and coding procedures and complies with established government, insurance and third-party payer regulations.
15. As requested, analyzes specific physician denials and collection trends.  Additionally, researches coding and reimbursement for new opportunities including but not limited to new equipment. 

Management

1. Participates in planning, developing and implementing strategies for department/functional area consistent with Orthopedic One’s mission, Patients First, and ensuring compliance with regulations of governmental and accrediting agencies.
2. Participates in business development conversations and decisions.
3. Accountable for overall budget and the financial management of resources to the budget including human resources, capital expense and general expense items. Includes analysis of benchmarking, industry metrics and internal performance measures.
4. Responsible for patient satisfaction outcomes for area of responsibility.
5. Develops relationships with third party payers related to reimbursement issues.
6. Works with HR to interview direct reports and timely completion of related documentation.
7. With HR Support, ensures performance appraisals define and measure a high level of work performance.
8. Completes introductory and annual performance appraisals based on observed behaviors and work outcomes supported by appropriate documentation.
9. Works to understand how staff are motivated and balance the needs of the organization and the individual. Sets expectations and rewards staff or achieving desired performance.
10. Initiates coaching, disciplinary action, and performance improvement planning to address violations of policy and/or poor performance.
11. Facilitates conflict resolution with staff with support as required based on circumstances.

Orient and Train Direct Reports

1. Ensures orientation of direct reports, such that they know the purpose of the organization, their department and position.
2. Ensures direct reports have resources, tools, feedback, assistance and training needed to achieve desired performance including productivity and qualitative expectations.
3. Ensures effective on-the-job training such that performance objectives are clear, staff members have knowledge and skills necessary to perform effectively.
4. Builds learning into work performed such that staff gains increasing understanding of how and why work is performed.
5. Instruction and information provided to staff results in complete understanding.
6. Educates staff on all applicable new or established policies, procedures, and expectations.

Leadership

1. Supports the mission, vision, values and code of conduct, goals and objectives of Orthopedic One in customer care, community interactions, and management responsibilities.
2. Proactively reviews metrics important to the department workflow including work volume, customer satisfaction measures, etc. and makes recommendations to modify schedules, staff hours/staffing levels, and workflows to maintain productivity, quality, and accuracy. Communicates metrics with leaders and staff timely and in mediums that maximize understanding.
3. Decisions, including those pertaining to staff, reflect complete and accurate analysis of relevant issues (past practices, work history, individual and group performance, department and company needs, consistency, fairness, regulatory or legal concerns, etc.).
4. Responsible and accountable for budget planning and cost control in area of responsibility.
5. Adheres to and administers company policies consistently and fairly in all matters (Employee Handbook, P&P, Risk, etc.).
6. Manages time and attendance to ensure employees are paid accurately and consistently based on company practices and policies.
7. Maintains department schedule/calendar and provides timely response to PTO requests.
8. Promotes and supports an environment in which leaders and staff members engage in appropriate professional development, continu8ing education, and lifelong learning opportunities.
9. Submits reports/documents to appropriate parties in a complete, accurate and timely fashion (Personnel Action Notice, expense reports, etc.).

Professional Development

1. Prepares appropriately to attend and participate in company meetings or projects as assigned.
2. Facilitates special projects or assignments at the request of management.
3. Attends to own professional development responsibilities and encourages/plans for staff to do the same.

Teamwork:

1. Works cooperatively with coworkers, providers, and management.
2. Shares knowledge and insights with co-workers in a constructive manner.
3. Willingly provides coverage to department, staying beyond scheduled ending time when clinic schedule demands it, volunteering to cover time off or unexpected absences, maintaining workflow in department without direct supervision.
4. Addresses conflicts with person directly before involving manager or uninvolved peers.
5. Is considerate of others with regard to taking breaks or meal periods, use of computer and telephone, and noise in department.

Education, Experience, and Certification/Licensure Required:

Position requires a Bachelors degree in business administration or related field. Minimum of five years of experience in a healthcare business office setting and previous supervisory experience is required. Must be experienced in Microsoft Office products including Word and Excel as well as EMR/PM applications.