Under general direction, assists with planning, organizing, coordinating, staffing and directing a wide range of patient billing, collections and other Business Office activities at San Joaquin General Hospital; assists with and helps coordinate various patient financial services related functions within the Department of Health Care Services; and does related or other work as required in accordance with Rule 3, Section 3 of the Civil Service Rules.
CLASS CHARACTERISTICS
An incumbent in this single position, mid-management-level class has significant responsibility for contributing to the overall revenue cycle for San Joaquin General Hospital by assuring that billing, collections and other Business Office activities are performed in an efficient, effective and appropriate manner.
TYPICAL DUTIES
Assists with the planning, organization, coordination, staffing and directing of the clerical, technical and administrative work of the Business Office; provides appropriate guidance and technical expertise to staff performing various patient billing, credit/collections, and related services; develops workload and productivity standards; assures that Business Office activities are performed in a manner that meets organizational needs while maintaining positive customer service and patient satisfaction.
Assists to ensure adequate and appropriate Business Office staffing; assists with hiring, and assigns, trains and evaluates subordinate personnel; takes appropriate action on disciplinary matters; verifies and assures staff proficiency; ensures that staff development needs are met and directs training and education activities as required; manages personnel and policy-related issues.
Assists in the development and implementation of goals, policies, strategies, and procedures for the effective and efficient management of activities in the Business Office; initiates and implements action plans when changes are needed; coordinates and cooperates with other Health Care Services managers/staff, insurance providers, outside agencies, and others as needed to maximize revenues, cash flow, and billing compliance while minimizing accounts receivable days, bad debts, and write offs.
Develops and implements quality control and quality improvement programs for the Business Office and other assigned areas; monitors work in progress as well as completed work to verify accuracy and efficiency; reviews, analyzes and interprets various complex reports and documents to evaluate and improve activities in assigned areas and ensure compliance with federal, state and other regulations.
Assures appropriate utilization of information technology and related tools to support assigned operations; participates in the planning, development and testing of new and/or upgraded computerized revenue cycle systems.
Resolves patient account discrepancies and negotiates settlements within limits of authority; assures that necessary communication of patient information is done appropriately and confidentially.
Represents the Health Care Services agency to individuals and groups as assigned; attends meetings and conferences and participates on committees as assigned.
MINIMUM QUALIFICATIONS
Education: Graduation from an accredited four-year college or university with a major in business or public administration, accounting, economics, finance, mathematics, health science, or a closely related field.
Experience: Two years of patient accounting supervisory experience in a health care setting within the last five (5) years, including at least one year of direct hospital Business Office experience supervising and follow-up for at least two of the following payers; Medicare, Medi-Cal and contract insurance.
Substitution #1: Additional qualifying supervisory experience within the last seven (7) years may substitute for the education on a year-for-year basis to a maximum of three (3) years.
KNOWLEDGE
Principles and practices of management, supervision and administration; principles and practices of quality control, general hospital business practices and procedures; and terminology related to health care services billing/collections; state and federal regulations related to the health care billing and reimbursement process; current Medicare, Medicaid and insurance billing/collections practices; current standards and requirements for medical bill coding; medical managed care practices; accreditation standards for hospital business office activities; revenue cycle computer information and reporting systems; data analysis and report writing techniques.
ABILITY
Supervise the revenue cycle activities of a hospital business office; staff in the performance of supervisory, paraprofessional, technical, and hospital billing, collections and related work; interpret complex health care billing regulations and ensure compliance with such regulations; develop and administer budgets and perform related general management activities; establish and maintain effective working relationships with third party payers, physicians, health care managers, patients, and others; work cooperatively with others; influence positive process changes; utilize complex information technology to maximize the efficiency and quality of revenue cycle activities; analyze and interpret complex data and draw logical conclusions to develop and address revenue cycle operational processes; communicate effectively, both orally and in writing.
PHYSICAL/MENTAL REQUIREMENTS
Mobility-Frequent operation of a data entry device; frequent sitting, standing, and walking for long periods; occasional driving, climbing stairs, pushing, pulling, bending, and squatting; Lifting-Ability to occasionally lift up to 15 pounds; Vision-Constant reading and close-up work and good overall vision; frequent eye/hand coordination; occasional color/depth perception and peripheral vision; Dexterity-Frequent holding, grasping and writing; occasional reaching and repetitive motion; Hearing/Talking-Constant hearing normal speech, talking in person and on the telephone; occasional hearing faint sounds; Emotional/Psychological-Constant public contact, decision making and concentration; frequent working alone and exposure to trauma, grief and death; Special Requirements-May occasionally work weekends/nights; Environmental-Occasional exposure to noise, emergency situations.
San Joaquin County complies with the Americans with Disabilities Act (ADA) and, upon request, will consider reasonable accommodations to enable individuals with disabilities to perform essential job functions.
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