Summary & Objective
The Manager, Facility Fiscal Services is responsible for the overall organization and coordination of the financial services at the facility level. Integrates the policies set by the Centralized Business Office and adapts it to pricing, admissions and discharges. The position entails a broad range of reporting and support to the CBO on, the pre-billing and billing cycles, in the audit and appeal processes, in coordination with the admissions office, case management, and health information management departments. Responsible of the charitable care assistance process at the facility level.
Essential Functions
- Maintains control of all cash and cash receipts, including the Resident Trust Fund, indigent fund, petty cash and determines the surety bond amount. Oversees and manages the private pay patient financial services functions, including billing, collection, cash receipts, and customer service. (If applicable)
- Make decisions and finalize the process of making the facility become the resident’s representative payee (Social Security) or implement a direct deposit account for resident. (If applicable)
- Independently manages the enrollment and updated enrollment of all long term care residents in their Medicaid managed care plans. Ensure annual eligibility for all long term care residents and independently facilitate with resident and residents family that eligibility is current. (If applicable)
- Coordinates Medicaid applications with Medicaid contractor.
- Participates in daily, weekly and/or monthly management team meetings to discuss patients and/or resident’s status, financial obligation, census changes, or patient and/or resident’s complaints or concerns.
- Enter all census charges in billing software.
- Prepares and/or assists in the completion of third party payer appeals process to facilitate payment for clinical denials in collaboration with the Director, Executive / Administrator and Corporate Business Office.
- Ensure proper coding of all receipts to the appropriate accounts
- Implement controls to ensure appropriate submission, billing and payment cycles by coordinating information flow (receipt of charges, invoices, checks, etc.) between CHS and facility via use of courier service, email, scanning, faxing, etc.
- Prepare and delivery of bank deposits, ensuring that all receipts are deposited to the appropriate bank account as necessary in operation account and Resident Trust accounts. (If applicable)
- Cash Petty cash checks as needed.
- Balance out cash received against receipts and submit control totals to CBO/ controller for reconciliation purposes. Reconcile Resident Trust accounts monthly. (If applicable)
- Prepare billing documentation as requested by insurance companies, legal teams and family members.
- Responsible for the financial updates and changes reported on UR weekly meeting as well as in the interdisciplinary team conferences.
- Print billing statements and email as requested by family members.
- Resolve internal and external customer financial issues in a timely manner using common sense and judgment
- Responsible for collection activity for all in-house private pay accounts.
- Process and verify designated ancillary charges on a monthly basis if applicable.
- Facilitates the billing process by assisting CBO with pertinent detailed information
- Verifies insurance coverage on a monthly basis to determine whether patient insurance is currently active.
- Keep abreast of the Patient Trust Fund and Social Security/Pension Income if applicable
- Review and control the cash collected directly from patients and/or residents. In addition, submit all refund requests to CBO for processing.
- Liaison between the facility and charitable fundraisers with CBO
- Oversee accounts payable submission to CHS if applicable.
- Coordinate with CHS on distribution of accounts payable checks if applicable.
- Plans, organizes, implements, directs, evaluates and controls the overall operation of the Business Office.
- Meets with Administrator to discuss escalated matters, obtain direction and set time frames for planned activities.
*Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.
Other Duties
- Prepares and reviews financial assistance application to deem eligibility with Director, Executive / Administrator for submission to CBO.
- Prepare Resident Trust Fund quarterly reports and distribute them to Residents/Next of Kins. (If applicable)
- Reviews and distributes mail received to facility in collaboration with Administration if applicable.
- Maintain/scan patient and/or resident financial documents/recording into storage software and paper filing systems if applicable.
- Maintain postage machine and postage par levels.
- Maintain Sunpass account at par levels.
- Maintain log for non-coverage notices. (If applicable)
- Maintain log for all bedholds.
- Conduct facility tours when Admissions personnel is not available.
- Maintain Medicaid resident files and update billing software as necessary.
- Implement and control pre-billing audit in billing software.
- Review month end closing to ensure census accuracy and submit to CBO.
- Hold and document valuables in facility safe.
- Coordinate with Social Service and Medicaid Specialist on all Medicaid pending cases.
- Communicates with patient and/or responsible party on patient responsibility in event of appeal loss.
- Promotes positive employee engagement, teamwork, and mutual respect and safety work practices.
- Maintain mandatory skill updates
- Comply with all policies, local, state and federal laws and regulations.
- Perform other duties as assigned
Supervisory Responsibility
- May serve as an interim department leader depending on need
Physical Requirements
- Must be able to lift and/or move up to 50 pounds and push/pull up to 250+ pounds, walk, climb stair or ladders, stand on feet for extended periods of time, etc.
Disclaimer
The job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.
EEOC Statement
CHS provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
