Job Description

The primary purpose of this position manages, plans, directs, and coordinates the billing, collection, credit control and patient account maintenance activities; implements appropriate billing, credit and collection procedures; insures that patient accounts receivable records are kept in accordance with established procedures; advises staff on daily implementation and interpretation of policies and procedures; reviews the work of staff for compliance; provides training on new information and modifications to policies and procedures in operations; develops, establishes and modifies procedures for prompt and systematic flow of information; plans the organization of the office and determines need for staff; supervises, trains and orients new personnel. This position also keeps abreast of all reimbursement billing procedures of third party and private insurance payers; implements controls to insure appropriate submission, billing and payment cycles; develops, implements and modifies procedures for follow up on third party reimbursements, billing and collection on overdue accounts; provides instruction and directions to staff in resolution of difficult claims and resolve complaints on charges, payments, credits and other billing related matters; interpret policies and procedures, rules and regulations relating to billing and collection activities, processing of claims by various insurance companies, governmental agencies and other programs; develops and maintains policy and procedure manuals.

POSITION SUMMARY

• Responsible for managing the billing, collection, credit control and patient account maintenance activities for the East Hawaii Region.
• Manages the work of the staff by empowering, coaching, answering questions, and giving guidance, leading by example and as appropriate implementing progressive discipline.
• Ability to apply state and federal laws and regulations for Medicare, Medicaid, Contract Payers and commercial insurance for acute care, long term care facilities, CDM Coordinators, Cash Posting team and assist with billing and collections processes as needed for the East Hawaii State Veterans Home.
• Monitors on-line claims, editing submissions. Ensures compliance of CPT, HCPCS and ICD-9 coding regulations and guidelines.
• Develops and delivers departmental education program targeting the enhancement of staff development and knowledge.

MINIMUM QUALIFICATIONS: To qualify, you must meet all of the following requirements. Please note that unless specifically indicated, the required education and experience may not be gained concurrently. In addition, qualifying work experience is credited based on a 40-hour workweek.

Education Requirement:

Bachelor’s degree from an accredited four (4) year college or university.

Excess work experience of the type and quality described below or progressively responsible professional work experience which provided knowledges, skills and abilities equivalent to those normally acquired in four (4) of successful study leading to a bachelor’s degree may be substituted for education on a year-for-year basis.

Experience Requirement:

Except for the substitutions provided below, applicants must have had progressively responsible experience of the kind and quality described in the following paragraphs and in the amounts indicated in the table below:

Specialized Experience:

Progressively responsible professional work experience which has demonstrated general knowledge of public and private health care programs including billing, credit, collection and account maintenance activities of a healthcare institution. This experience must have provided familiarity with, and knowledge of health insurance programs; general financial practices of healthcare providers; and the ability to evaluate the bases of medical rates and costs; or

Progressively responsible professional work experience which has demonstrated general knowledge of hospital admission and registration functions and activities.

Supervisory Experience: Work experience which demonstrated the applicant's knowledge of and ability to apply the principles, practices, techniques and methods of supervision including: (1) planning, organizing and directing the work of others; (2) assigning and reviewing work; (3) advising others on difficult work problems; (4) timing and scheduling work; and (5) training and developing employees.

Substitutions Allowed: Possession of a master’s degree from an accredited college or university in Healthcare administration or related field may be substituted for one (1) year of Specialized Experience.

QUALITY OF EXPERIENCE: Possession of the required number of years of experience will not in itself be accepted as proof of qualification for a position. The applicant's overall experience must have been of such scope and level of responsibility as to conclusively demonstrate that he/she has the ability to perform the duties of the position for which he/she is being considered.

Company Description

As the Big Island’s leading providers of inpatient and outpatient care, the East Hawaii Region of Hawai`i Health Systems Corporation (HHSC), consisting of Hilo Benioff Medical Center, Honoka'a Hospital, Ka′u Hospital, and the Yukio Okutsu State Veterans Home, delivers a full range of services and programs. Our three hospitals include 290 beds and over 1,700 employees. Our medical staff is comprised of 250 physicians, physician assistants and Advanced Practice Registered Nurses, representing 33 specialties. East Hawaii Health is our network of clinics offering primary and specialty care. Hilo Benioff Medical Center functions as a Level III Trauma Center, which includes the second busiest emergency room in the state, providing 24-hour care and serving more than 50,000 patients annually. Hale Ho′ola Hamakua and Ka′u Hospital are designated as Critical Access Hospitals. To learn more about the East Hawaii Region, please watch our Video Yearbook or visit www.hbmc.org, www.halehoolahamakua.org or www.kauhospital.org.

Benefits

• 13 paid holidays each year (104 hours); 14 (112 hours) during election years*
• 21 paid vacation days (168 hours) per year*
• 21 paid sick days (168 hours) per year*
• Medical, dental, vision, and prescription plans
• Employee Assistance Program
• Participation in the State of Hawaii’s retirement system
• Potential eligibility for various student loan repayment & scholarship programs

• Rates listed for paid holidays, vacation and sick days are for 1.0 Full Time Equivalent (FTE) positions assigned to 8 hour shifts. Accruals for these benefits are otherwise prorated based on FTE.

Benefits

Relocation Assistance is available for this position.

Pre-Employment Health Requirements

Offers of employment will be contingent on successfully passing a pre-employment examination, which includes a drug screen and other regulatory medical requirements such as, but not limited to, a tuberculosis (TB) screen. The cost for drug screening and blood draw for QuantiFERON and Titers, shall be borne by the Hawaii Health Systems Corporation.

Pre-Employment Assessments for External Candidates

As part of the recruiting process for this position, external applicants (job applicants NOT employed by HHSC’s East Hawaii Region) are required to complete pre-employment assessments shortly after application submission. If you are not an employee of the East Hawaii Region of HHSC, you will receive an email containing assessment instructions. We ask that you complete the assessments within two days of receipt of the request.

Equal Opportunity Employer

The East Hawaii Region of Hawaii Health Systems Corporation is a drug free workplace and an Equal Opportunity Employer.

Shift Details

Must be available to work shifts, weekends and holidays as necessary based on hospital operations. Services are provided 24/7.