This position monitors payer trends, trends in accounts receivable, denials, and unpaid claims and reviews information from both payer and division level. This position also provides feedback to management on trends related to coding, scheduling, registration, cash collections, charge-posting, and authorization issues.
- Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
- Excellence in clinical care, service and communication
- Collaborative within our institution and with others who share our mission and goals
- Leadership that set the standard for pediatric health care today and innovations of the future
- Accountability to our patients, community and each other for providing the best in the most cost-effective way.
- Interprets claims processing reports and applies information to produce clean claims as well as, maintains current knowledge of regulatory billing requirements
- Identifies delays, negative trends, and process slippages on assigned projects. Determines sources of problems and corrective actions required. Initiates corrective procedures as appropriate and expedites same.
- Monitors accounts receivable to help ensure the integrity and accuracy of the revenue cycle. Assists in obtaining appropriate reimbursement on all claims.
- Participates in a variety of unit and hospital educational programs to maintain current skill and competency levels.
- Participates in relationship management activities with payers. Facilitates payer meetings by providing information and examples of specific issues and trends. Coordinates follow-up with payers or responsible department until the issues are resolved.
- Meets or exceeds productivity standards in the completion of daily assignments and accurate production.
- Works closely with management to gather, analyze, summarize, and prepare recommendations for plans, denial trends, and operating forecasts.
- Works with contract management to maintain proactive knowledge of payer requirements to minimize financial risk to the institution. Maintains a working knowledge of MPV and all associated reporting.
- Performs miscellaneous job related duties as requested.