Description
Duties and Responsibilities
- Work independently while maintaining full accountability for clinic operations in compliance with hospital internal controls, policies, and procedures.
- Develop, implement, and maintain clinic-specific policies while ensuring alignment with hospital standards.
- Oversee revenue cycle functions, including billing, collections, insurance payments, accounts payable, and regulatory compliance.
- Monitor operational performance and proactively identify and implement process improvements.
- Communicate effectively with the Director of Practice Management regarding clinic performance and needs.
- Interview, hire, train, supervise, and, when necessary, terminate clinic staff
- Maintain staff schedules, ensuring appropriate coverage at all times.
- Conduct and document staff meetings to promote communication and teamwork.
- Counsel and develop employees, administer disciplinary actions, and foster a positive work environment.
- Cross-train staff to ensure operational continuity
- Build and maintain professional relationships with providers, medical staff, and referring providers.
- Promote teamwork between clinical and administrative staff
- Ensure compliance with physician contractual agreements.
- Communicate proactively with providers regarding quality of care and revenue opportunities.
- Maintain current provider enrollment, credentialing, and licensure.
- Ensure clinic operations align with the organization’s mission, vision, and quality standards.
- Support adherence to nursing practice guidelines and the applicable code of conduct.
- Collaborate with ancillary services to maintain a safe, clean, and secure environment.
- Assist accounting with payroll, timecard verification, and accounts payable.
- Generate and analyze monthly reports on patient volume, services, and year-over-year comparisons.Â
- Reconcile financial records, including balancing ledgers to bank statements.
- Collect, open, and distribute daily mail.
- Assist with ordering clinic and office supplies.
- Review explanation of benefits (EOBs), resolve denials, and resubmit claims with appropriate corrections as well as coordinates with the Physician Billing Department on accounts receivable and collections processes.
- Review accounts prior to referral to collections or credit bureaus.
- Work with patients to establish payment arrangements and reduce collection activity.
- Create and manage reports, files, and operational documents.
- Troubleshoot systems and support cross-training efforts.
- Utilize external resources such as Availity, Passport, and other required platforms.
- Coordinate facility maintenance and repair needs.
- Utilize internal tools such as email, calendars, word processing, and spreadsheets.
- Address patient concerns and complaints in a professional manner.
- Perform additional duties as assigned by the director or provider.
Requirements
Regulatory Requirements
- Completes annual educational requirements within the assigned time frame.
- Maintains regulatory requirements, including all state, federal and Joint Commission regulations related to their department and, as appropriate, to the hospital.
- BLS Certification
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