[ref. j27249601] Senior Office Manager

Overview:

John's Riverside has been and continues to be a unique and comprehensive network of medical professionals dedicated to a tradition of service that spans generations.

In 1894, the Cochran School of Nursing, the oldest hospital-based school of nursing in the metropolitan area, was founded, thus making the St. John's Nursing Staff more than just the backbone of the hospital, but the heart and soul. St. John’s dedicated nurses give superior attention to those who need it most with a strong emphasis on patient and family-focused nursing care.

St. John’s Riverside Hospital staff is committed to making life better for all patients. The hospital continues to elevate the services provided with the goal of increasing the quality of life for all who entrust St. John's Riverside Hospital to their care.

Personalized care together with advanced technology is what it means to be Community Strong

Responsibilities:

Responsibilities extend to clinic additional locations.

1. Oversees timely and accurate patient registration process including preparation of weekly caseload list for staff.
2. Oversees all aspects of patient billing and related documentation to ensure accuracy and to maximize program revenue under Hospital guidelines and the APG methodology. Communicates all pertinent changes in eligibility or plan requirements to staff in a timely manner. Supervises daily reconciliation of patient encounters, cash receipts and deposits to Hospital.
3. Coordinates with staff, including Finance Department representatives, all efforts to verify and otherwise maximize insurance coverage for patients. Maintains updated knowledge of all hospital insurance contracts.
4. Responsible for maintaining and forwarding all managed care authorization, re-certification and denials to clinicians and clinical supervisors.
5. Responsible for verification and reporting of Medicaid/insurance eligibility and reporting changes to staff and business office. Updating of all patient demographic, financial and insurance information.
6. Maintains all administrative and financial records in an organized, accessible, and secure manner and in compliance with all applicable regulatory requirements.
7. Directs and coordinates the patient accounting function to consistently produce accurate bills which are paid in a timely manner.
8. Responsible for billing practices including standard codes sets, OASAS APG, CPT4 & ICD-9 coding
9. Reviews denials, payments, and adjustments reports. Creates Billing reports as required.
10. Assists with, and responds to inquiries from patients, insurance companies, Medicare, and other parties regarding charges and/or billing activity reports.
11. Contacts third party payers to identify and resolve account collection problems for maximum collection results
12. Follow-up on billing queries with Netsmart (i.e., Claim submissions, denials, insurance changes, AR, etc.)
13. Review and reconcile remittance files for Medicaid FFS, Medicaid Managed Care, Medicare B, and Commercial payers. Review client ledger and apply Bundled Billing where applicable.
14. Export billing and submit data to Netsmart. Follow-up on billing queries with Netsmart (i.e., Claim submissions, upload remittance files, denials, insurance changes, AR, etc.)
15. Track and log D.O.C. (Department of Corrections) Wellpath visits for billing purposes
16. Ensure that BAM’s and WHOQOL’s are completed for applicable clients.
17. Log and track monthly PHQ-9 Surveys
18. Review EOB’s, EOP’s, Overpayment Letters, Claim Resubmission Letters, and Refund Requests Letters then submit them to Netsmart for final review and processing
19. Ensures the security, organization and accessibility of patient chart room and storage areas.
20. Responsible for petty cash security, reconciliation, receipts and timely replenishment.
21. Responsible for the supervision, scheduling and training of registrars and clerical staff.
22. Oversees patient transportation schedule, coordinate with MAS.
23. Responsible for ordering all office and program supplies and inventory control.
24. Responsible for obtaining proper approval on all invoices to be paid and forwarded to BHS Administration and Finance Department.
25. Maintains daily summary of program service volume; compilation and submission of all required OASAS PAS reports on a timely basis.
26. Follows St. John’s Riverside Hospital attendance policy.

Qualifications:

EDUCATION

Bachelor’s Degree required; Business Administration, Health Care Administration or Accounting major preferred.

1. At least two years of office operations with related experience is required. Previous computer and financial experience is required.
2. Expansive third-party billing experience
3. Must be organized, articulate and personable, demonstrating appropriate leadership skills and strong computer skills.
4. Demonstrated ability to communicate in writing is required.