Directs, manages, supervises, implements and maintains efficient operations of the Billing and Insurance Collections Department. The primary role is to ensure a very accurate, timely submission, and reconciliation process of claims for both professional and facility services. Oversees the performance and integrity of the department through accurate reporting, monitoring, and training. Directly responsible for developing and implementing ways to enhance all billing procedures through system and manual enhancement processes.
Responsible for retrospective compliance reviews of all hospitals billing activity, as directed by leadership or the Geisinger Annual Compliance Work Plan.
Analyzes and provides an estimate of net revenue impact for Finance Department accruals.
Responsible for billing and collections of the assigned insurance categories.
Responsible for collection of the accounts receivable portfolios for assigned insurance categories for Geisinger hospital and clinic entities.
Directly manages the integrity, quality, accuracy, and performance of the Billing and Insurance Collections Department.
Develops, implements, and ensures automatic processes are in place to ensure clean claim billing processes.
Develops, implements, and monitors all reconciliation processes to ensure claims are billed and received accordingly in the most efficient manner.
Develops and implements staff alignment goals across the departmen Develops, implements, communicates, and monitors reporting tools and feedback to identify and process improve issues that negatively impact the accurate and timely production of claims in the billing cycle.
Identifies and develops a comprehensive procedure manual of all billing processes.
Develops, monitors, and reports on department metric performance to ensure that organizational goals and objectives are completed.
Recruits and develops new personnel.
Ensures training, development, discipline, and performance appraisals on current personnel are completed timely along with recommending direction and improvements to help the employee meet department goals.
Directly responsible for tactically overseeing and monitoring all related automated editing and claims scrubbing and billing tools.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and degree obtained (Associate's Degree = 2 years; Bachelor's Degree = 4 years).
High School Diploma or Equivalent (GED)- (Required)
Minimum of 4 years-Relevant experience* (Required), Minimum of 5 years-Managing people, processes, or projects (Required)
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.