Job Summary
Essential Functions / Task Groups
Functional Duties:
·
Assist in overseeing on a daily basis admitted patients based on the
assigned portfolio and follow up properly on acquiring and verifying the
insurance approvals, HIP, NSSF, Army and other approvals.
·
Retrieve daily from Epic the list of possible discharges, and
prioritize clearing insurance extensions during hospital stay by contacting
insurance companies to upload their approvals.
·
Assist and follow up with the staff on the pending requests with
insurance companies to clear pending requests, and ensure proper documentation
on AS400 Comments Form.
·
Assist in the coordination with the Manager, Collections Office
regarding problematic post-discharge patients’ bills. Contact and negotiate
settlement with patients and/or families post discharge, in full coordination
with the Manager and the Deputy Medical center director for Operations. Provide
input to Manager, Collections Office regarding collections secured or not.
Assist in evaluating several scenarios for problematic bills to get the best
outcome for the Medical Center.
·
Prepare, send, and discuss cases to the Deputy Medical Center
Director for Operations and Managing Director of External Medical Affairs with
clear bill details and summary information from the comment’s forms for
decisions regarding unsettled balances.
·
Assist in the proper patient contact process for settling debt
balances and refunding credits. Listen to patients’ suggestions or complaints in
regards to post discharge processes.
·
Carry out weekly meetings with Manager, post discharge Office, staff
responsible for insurance and third-party payers, to discuss post-discharge
problematic issues and third party payers issues and set up action
plans.
·
Coordinate with the Admitting Department to provide quality patient
services, to clarify differences between estimations and real bills, to resolve
problems emerging due to the admission process and are reflecting on the
collection, etc.
Office Management Duties:
·
Assist in supervising the operations, mainly insurance and third
party payers and the post-discharge team, to ensure smooth, effective and
efficient collection functions.
·
Supervise the Post Discharge and Insurance teams, and carry out
frequent meetings to ensure collection of all pending bills, that old bills are properly handled legally,
installment plans are up to date, and insurance agencies documents are submitted
for bills recomputations till bills are settled, especially to meet the deadline
set.
·
Manage the teams through coaching, development and performance
feedback. Oversee and evaluate the team's work performance.
·
Listen to patient’s suggestions and complaints in regards to
department processes and work on improving areas of deficiencies.
·
Monitor the staff performance by checking timely and questioning the
reasons behind pending clearances of OR requests, expensive medications,
interventional radiology, and PET scan. Also, review delays in responding to the
discharge messages received from the billing department. Support the team and
advise them on the efficient approaches to facilitate discharges while ensuring
bills settlement.
·
Maintain good client relation and provide customer service in line
with the issues and complaints raised by customers/clients.
·
Work in accordance to the organization's standards, practices and
policies, along with the Lebanese governmental agencies (MOPH, NSSF, Army, and
ISF) regulations and standards.
·
Use latest trends and policies to ensure collections of inpatient
bills.
·
Prepare financial reports and present it to the Collection Manager
and Deputy Medical Center Director for Operations and Managing Director of
External Medical Affairs.
·
Perform other related duties as
assigned.
Critical Competencies
Client Focus, Achievement Orientation, Organizational Awareness,
Initiative, Communication Skills, Safety and Health Management, Developing
Others, Resource Management, Problem Solving, Professional Development, Team
Skills, Business Acumen, Planning and Organizing, Human Resources Management,
Information and Records Administration, Quality Management, Professionalism,
Computer Skills, English Comprehension, Financial Management.
Knowledge / Know-How
Knowledge:
Knowledge of principles and practices pertaining to collections
and insurance and third party payers.
Knowledge of applicable laws,
regulations, requirements, standards and practices pertaining to patient
financial issues. Knowledge of medical terminology.
Knowledgeable about third party
coverage processes and procedures
Education:
Minimum Education: Master’s
Degree in Business Administration or
related field
Experience:
Minimum Experience: 8 years’
experience in a similar position with a minimum of 2 years supervisory level
experience.
Languages:
Minimum Languages: Arabic and
English (EEE score >/= 500).
Preferred Languages: French is an
asset.
Computer Skills:
Proficient in the use of Microsoft
Office applications.
Impact of Actions / Decisions
Consistent patient-centered performance ensures the continuity of
patient care and enhances patient/family satisfaction.
Responsibilities carry legal
implications and financial repercussions.
Inefficient work will have a negative impact on the
work flow of the department and other departments (Nursing Units, Collection,
etc.) as well, and will impact the hospital
image.
Job Structure
Work is of standardized nature that may involve a variety of duties
with an increase in use of analytical thought due to increased data and changing
situations.
Managerial / Supervisory Responsibility
Reporting Channel:
1st Level: Manager, Collections
Office
2nd Level: Deputy Medical Center Director for
Operations and Managing Director of External Medical Affairs.
Supervisory Channel:
Supervise the Post Discharge and Insurance teams.
Job Characteristics
Physical Effort:
Moderate Physical
Effort
Work Schedule:
Regular Weekdays
Working Conditions:
Normal