RCM Patient Financial Services Manager

Overview

We have an exciting Patient Financial Services and Customer Service Manager opportunity for an experienced professional to join our team at Pediatrix Medical Group. We are a national organization, and one of the nation’s largest providers of prenatal, neonatal and pediatric services.

Talented business professionals from diverse backgrounds choose Pediatrix because we are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere. We are confident that you'll love being a part of the Pediatrix team.

Responsibilities

The RCM Patient Financial Services and Customer Service Manager is responsible for all aspects of operation for the Customer Service Department, including oversight of daily operations, implementing policies and procedures, staffing, training, product development, quality assurance, and continuous quality improvement. The Customer Service Manager is responsible for assuring all clients, both internal and external receive exceptional service.

Maintain the structure of the Customer Service Department.

• Maintain staffing levels proportionate to call/work volume to preserve optimum efficiency and superior service levels, while managing the use of overtime.
• Maintain established Customer Service procedures to ensure Customer Service Representatives have up to date reference material.
• Improve work methods and processes used by the Customer Service Department to improve the quality and efficiency of our service.
• Investigate and test commercial products related to customer service that would enhance the quality of service offered by the Customer Service Department. Implement new products if proven cost effective and beneficial.
• Work closely with the alternate Customer Service site’s Manager to ensure structural unity of the National Customer Service Department.

Manage the daily operations of the Customer Service Line

• Monitor telephone coverage and service frequently during the day.
• Investigate and analyze problems presented by Customer Service Representatives and offer solutions for these problems.
• Delegate and monitor work assignments to Customer Service Representatives when the need arises.
• Review and approve adjustments on all Customer Service initiated accounts.
• Effectively communicate operational and financial policies and procedures to all Customer Service Representatives.
• Provide an escalation outlet for problem calls received by Customer Service Representatives.
• Conduct yearly performance evaluations and additional evaluations when necessary.
• Provide developmental plans and goals for performance improvement for both representatives and the department.

Maintain quality of service

• Develop a Quality Assurance Program within Customer Service to verify and maintain the highest quality standards of customer service.
• Maintain the Quality Assurance Program by adjusting aspects of job monitored and quality guidelines to continue the evaluation of service performance.
• Monitor and ensure work productivity, accuracy, integrity, validity, and efficiency.
• Create recommendations and action plans for management evaluation and review in regard to customer service issues.
• Evaluate trends reported by Customer Service Representatives and present to Regional Director with concise details and examples with possible solutions if applicable.
• Develop a customer service survey to evaluate the service delivered by the department from the client’s point of view. Administer the survey at least twice per year.
• Analyze the data obtained from the survey and present a report to management summarizing the survey results.
• Implement departmental changes based on the data obtained from the survey.
• Provide recommendations to other departments to improve service levels based on the survey results.\
• Complete special projects and all other duties assigned by the Regional Director.

Provide statistical data on the Customer Service Department’s performance.

• Develop statistical reports that clearly demonstrate the performance of the Customer Service Department.
• Analyze statistical reports and provide meaningful management overviews of all call and work data.
• Adjust the report method when necessary to demonstrate trends or new statistical measurements that may be of a concern or simply requested.
• Ensure that timely reports are provided with service statistics on volume of calls, types of calls, # calls per region.
• Work closely with the alternate Customer Service site’s Manager to provide a total performance report for the National Customer Service Departments performance.

Operate Customer Service line when necessary.

• Provide clients with correct answer in regard to the account(s) in question.
• Verify and update account information. This includes demographic information and correct insurance information.
• Obtain payment on accounts that are patient responsibility.
• Payments include balance paid in full, settlements, and payment plans. All must be within specific regional guidelines.
• Transfer accounts to appropriate queues for follow-up.
• Handle client complaints in a professional and serious manner.
• Review accounts for accuracy (correct statement groups, financial class, etc.).
• Process adjustments as necessary (settlements, refund requests, etc.).
• Perform follow-up on worked accounts when necessary.
• Review and work daily correspondence received from patients.
• Assist with account audits when necessary.
• Perform a variety of other duties as directed by incoming calls.

Customer Service Liaison

• Serve as a liaison between Regional Directors, Managers, Customer Service Coordinators, Patient Account Administrators, payers, and clients when necessary (troubleshoot accounts, fax claims to insurance companies to expedite processing, service/ charge disputes).
• Contact payers to check claim status when beneficial to clients.
• Perform telephone appeals for denied or low payment claims when requested by client and deemed necessary and beneficial.
• Process disputes by obtaining medical records and explaining procedures.
• Review diagnosis and procedure codes with the Coding Department when necessary.
• Elevate accounts to Collection Administrators, Managers or Regional Directors when appropriate.

Insurance Verification

• Verify patient's insurance and eligibility and update account as needed.
• Submit claims to the insurance company.
• Document the steps involved in the verification and claim submission process in Collections Plus Notes in the GPMS system.

Adheres to all policies and procedures.

• Maintains strict confidentiality of all patient information.
• Compliance with all established policies and procedures.
• Maintains constant awareness of potential safety hazards ensuring necessary safety precautions.

Communicates effectively.

• Openly communicates with others in the company offering honest and productive efforts to resolve issues.
• Conducts Customer Service staff meetings offering updates on new and adjusted information.
• Promotes the teamwork effort in all Customer Service functions.

Qualifications

Education/Experience:

• Bachelor’s degree (B.A.) from a four-year college or university.
• Previous customer service experience mandatory.
• Two (2) years revenue cycle management experience in the health-care setting or training or equivalent combination of education and experience.

Skills:

• Excellent interpersonal and listening skills.
• Excellent supervisory and management skills.
• Ability to read, analyze, problem solve, and reason.
• Ability to effectively communicate to all clients both verbal and written.
• Ability to write business correspondence and procedure manuals.
• Ability to effectively present information and respond to questions from Regional Directors, Company officers, clients, and the public.
• Ability to calculate figures and amounts such as discounts, interest, percentages, and to draw and interpret bar graphs. Ability to apply concepts of algebra.
• Ability to define problems, collect data, establish facts, and draw valid conclusions.
• Ability to interpret an extensive variety of technical instructions in mathematical and diagram form and deal with several abstract and concrete variables.

Software:

Familiar with GPMS, Master Database, Imaging, and Medi fax (preferred)

Proficient in Excel and MS Word required.

Benefits and Compensation

Benefits for Full Time employees and qualified dependents:

• Medical, Prescription, Dental, Vision Insurance
• Progyny Fertility Benefits
• Livongo Diabetes Management
• Teladoc Health and Second Opinion Services
• Smart Shopper
• 401(K) Thrift Program & Sharing Plan**
• Employee Stock Purchase Plan (ESPP) – 15% discount*
• Basic Employee; Spouse; Child Life Insurance
• Accidental Death and Dismemberment (AD&D)
• Employee Optional Life and AD&D
• Short & Long Term Disability
• Pre-Tax Health Savings Accounts (HSA)
• Employee and Dependent Flexible Spending Account (FSA)
• Family Medical Leave Act (FMLA)**
• Parental Leave Benefit
• Sick Pay Bank
• Employee Assistance Program (EAP)**
• Group Aflac Policies
• Identity Theft Protection
• Employee Charitable Fund
• Care.com
• Various Discount Programs

*Part Time Regular employee classifications also receive this benefit

**Available to part-time regular and part-time casual employees aged 21 and over

About Us

Pediatrix Medical Group is one of the nation’s leading providers of highly specialized health care for women, babies and children. Since 1979, Pediatrix has grown from a single neonatology practice to a national, multispecialty medical group. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. The group’s high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives.

Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site: www.pediatrix.com/careers.

Pediatrix is an Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.