Yale New Haven Health System

  • MGR, PATIENT ACCOUNT ANALYSIS

    Job Locations US-CT-New Haven
    Job ID
    66771
    Department
    SBO - PATIENT ACCOUNT ANALYSIS
    Category
    MANAGEMENT/LEADERSHIP
    Position Type
    Full Time Benefits Eligible
    Scheduled Hours
    40
    Work Schedule
    DAYS
    Work Days
    MON-FRI
    Work Hours
    8-5
    Work Shift
    NA
    Requisition ID
    2018-20312
  • Overview

    To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values—integrity, patient-centered, respect, accountability, and compassion—must guide what we do, as individuals and professionals, every day.

    Responsible for the operations of the Patient Account Analysis section. Responsible for preparing reports identifying payment contract variances and assisting in resolving discrepancies in conjunction with other SBO management, Contracting staff, third party payers and Hospital Finance and Reimbursement departments. In conjunction with the Senior Manager, responsible for ensuring all potential regulatory compliance issues are identified and coordinated between the Corporate Compliance Officer, SBO and hospital finance departments. Responsible for reporting operational tracking and productivity of this area. Provides recommendations for future contract negotiations based on findings from staff relative to operation challenges of previous term contracts.Develops that staff both within and outside of the career ladder, to optimize their personal growth and contributions to the organization. Continually monitors the effectiveness of the system(s) and makes recommendations to better enhance the efficiency of the work process.

    EEO/AA/Disability/Veteran

    Responsibilities

    • 1. Manages and coordinates the reconciliation of accounts with third party payers and managed care companies in an effort to resolve contract discrepancies.
    • 2. Establishes and maintains relationships with all third party payers and managed care companies to keep informed of changing contract requirements. Monitors changes in contract specifications as they affect the timely and proper payment of third party claims.
    • 3. Responsible for the selection, training and motivation of section staff; makes recommendations as to hiring, terminating and change of status. Ensures timely completion of employee performance reviews and compliance with YNHHSC, Human Resources and departmental policies.
    • 4. Maintains appropriate procedures and reporting pertaining to all necessary internal controls and enhanced business practices of the unit.
    • 5. Responsible for establishing and maintaining effective communication with the Contracting Department for purposes of identifying changes in contractual terms with payers as well as ensuring consistent interpretation of contracts between the SBO and payers. Coordinates staff feedback in regards to potential contract enhancements based on experiences within variance work.Assist in the financial evaluation of contracting modifications, as required.
    • 6. Establishes and maintains effective relationships with hospital Reimbursement and Finance departments. As necessary, establish communication with revenue producing departments for resolution of SBO issues.
    • 7. Tracks and monitors productive efforts of the section and maintains monthly reporting regarding the levels of additional reimbursement received. Prepares and distributes effective management reports.
    • 8. Coordinates special projects as requested by the Senior Manager, Patient Account Analysis/Quality Assurance
    • 9. Performs other related duties within the System, as required.
    • *cb

    Qualifications

    EDUCATION

     

    Bachelor's degree with major course work in Business Administration, Public Administration, Finance and/or Accounting with work experience in an Accounts Receivable or Contracting environment. Master's Degree preferred.

     

    EXPERIENCE

     

    Three (3) to Five (5) years experience in accounting, billing, auditing or collections; including significant managerial experience and exposure to all aspects of managed care and governmental contracts.

     

    SPECIAL SKILLS

     

    Strong communication, organizational and management skills. Must be proficient with software packages including spreadsheets, word processing, and data base management packages. Requires specialized knowledge of reimbursement, payer contracting and billing regulations with the ability to interpret changes in policy. Ability to motivate and direct the activities of a large and diverse staff.

     

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