SUMMARY: Under general direction, responsible for the coordination, monitoring and supervision of all daily activities within an assigned billing or collection unit within the Patient Accounting Department. Supervision includes selection of new employees, training and orientation, workload assignment and completion of performance evaluations for employees at the PFS Account Specialist, Sr. PFS Billing Specialist, Sr. PFS Collection Specialist & Cash Posting Specialist I/II  level and below. Performs complex billing, collection and payment posting tasks requiring the application of specialized knowledge and a comprehensive understanding of billing and collection functions. Assigned functional responsibility for the maintenance of a major portion of a complex billing operation including the establishment of performance standards, policies and procedures and work assignments. Performs related duties as required.

DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.

1. Assumes responsibility and oversight of accounts for specific payor classes or billing unit; including posting payments, adjusting, resolving billing discrepancies and managing denials and appeals.

2. Audits claims, billing documents and hospital charge data to ensure the accuracy and completeness of claims; collects, organizes, and summarizes statistical data and maintains specialized records in connection with the various billing programs.

3. Compiles accounting, program revenue, and statistical reports for departmental review or as required by State and Federal agencies; acts as a liaison with other outside agencies and Alameda Health System departments regarding billing and collection activities.

4. Keeps abreast of specific payor and billing and collection requirements; applies knowledge to ensure that claims are accurate, billed correctly and compliant with current billing regulations and payor requirements.

5. Leads or assists with the implementation of information system projects and applications that improve internal departmental operations and claims processing; resolves technical issues and problems with outside vendors.

6. Performs special research, develops new policies and procedures, implements process improvements and troubleshoots billing and collections procedural problems.

7. Supervises specific billing and collection units, hires and trains new employees, assigns work, disciplines and counsels work related performance issues and responsible for managing staff against workload goals and standards of performance.

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

MINIMUM QUALIFICATIONS:

Minimum Experience: Two years of experience in the class of PFS Account Specialist, Sr. PFS Billing Specialist, Sr. PFS Collection Specialist & Cash Posting Specialist I/II, or in an equivalent or higher-level class with AHS; OR four years of full-time experience performing medical billing or medical accounts receivable functions; at least two years in a supervisory capacity.