Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

Scheduled Weekly Hours:

Position Overview

SUMMARY (Basic Purpose of the Job)

MINIMUM REQUIREMENTS

Education:Bachelor's degree. A High School diploma or equivalent and additional years of experience may be considered in lieu of a formal Bachelor's degree.

Experience:Five years of patient accounting experience, including one year of patient accounting supervisory experience, when accompanied by a Bachelor's degree. Nine years of patient accounting experience, including one year of patient accounting supervisory experience, when accompanied by a High School diploma or equivalent.

Other Credentials:

Knowledge and Skills:Excellent analytical and interpretive skills. Possesses excellent organizational, interpersonal, verbal and written communication skills. Ability to effectively manage multiple projects simultaneously and ability to aggressively pursue third party payments.

Special Training:Requires a strong understanding of complex payor contract language and terms. Knowledge of finance systems, basic computer skills. Familiarity with medical terminology, CPT-4 and ICD-10 coding.

Mental, Behavioral and Emotional Abilities:

Usual Work Day:8 Hours  

Reporting Relationships

Does this position formally supervise employees? Yes

If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.

ESSENTIAL FUNCTIONS

• Manages and resolves complex and technical system billing and receivable issues in a timely manner. Meets regularly with staff to discuss, inform and resolve department issues.
• Monitors payer payment methodologies and reports discrepancies to Payer Relations Department. Possesses thorough knowledge of all third-party contracts.
• Attends payer meetings with the Payer Relations Department to bring forth payment and/or processing issues that differ from the terms of the contract.
• Possesses knowledge of workflow system. Remains up to date on all user group assignments, workflow for user groups within the Hospital Billing area. Monitors the data within the workflow and billing systems for gaps and takes appropriate steps for resolution.
• Coordinates and monitors the performance and productivity of hospital billing staff.
• Delegates tasks and responsibilities effectively while ensuring acceptable accounts receivable results.
• Reviews aged and high-balance accounts on a regular basis and provides direction to supervisors and staff.
• Coordinates with leaders of other revenue cycle departments to identify opportunity for improvement to ensure timely, accurate and compliant hospital billing and collections.
• Provides expertise and serves as a liaison to internal departments, all third-party agencies, vendors and payers
• Ensures that claims are processed accurately and completely via the clearinghouse edit process by correcting and validating claims prior to being electronically transmitted.
• Interviews, hires and trains employees as well as plans, assigns and directs workloads; appraises performance; rewards and disciplines employees; addresses complaints and resolves problems. Oversees training of new personnel as documented by completion of new hire competency checklists, completed ninety-day evaluations, and training program attendance. Develops and maintains effective recruitment and retention practices in order to avoid preventable turnover.
• Assists Director of Hospital Billing with the preparation of the yearly departmental operating budget. Demonstrates proactive vigilance in identifying opportunities for revenue enhancement and cost reduction.
• Monitors completeness and accuracy of the State required data transmission that is instrumental to ensure Capital Health meets State Reporting Guidelines.
• Performs other duties as assigned; possesses willingness to adapt to changing departmental demands.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include:

Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl

Continuous physical demands include: Sitting , Keyboard use/repetitive motion

Lifting Floor to Waist 20 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Minimal Hearing

Anticipated Occupational Exposure Risks Include the following: N/A

This position is eligible for the following benefits:

• Medical Plan

• Prescription drug coverage & In-House Employee Pharmacy

• Dental Plan

• Vision Plan

• Flexible Spending Account (FSA)

- Healthcare FSA

- Dependent Care FSA

• Retirement Savings and Investment Plan

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance

• Disability Benefits – Long Term Disability (LTD)

• Disability Benefits – Short Term Disability (STD)

• Employee Assistance Program

• Commuter Transit

• Commuter Parking

• Supplemental Life Insurance

- Voluntary Life Spouse

- Voluntary Life Employee

- Voluntary Life Child

• Voluntary Legal Services

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance

• Voluntary Identity Theft Insurance

• Voluntary Pet Insurance

• Paid Time-Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level. 

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.