Job Summary: The Patient Financial Services (PFS) Project Manager is responsible for ensuring that NorthStar Care Community is in compliance with federal and state regulatory billing requirements and optimizing third party payer cash flow. Ensures efficient and effective electronic billing occurs, manages software related issues with external vendors, and works with Information Technology (IT) staff to ensure that PFS staff have the necessary tools and reports they need.

Essential Functions:

• Works with third party payers on electronic billing problems to ensure claim payment and minimize interruptions in cash flow.
• Stays abreast of new federal and state regulations that impact electronic billing, claim processing including new data elements required, and Medicare cap reporting.
• Establishes and manages project plans with timelines for NorthStar Care Community billing and regulatory compliance by determining affected departments, assesses impact on current processes, coordinates interdisciplinary meetings, determines data needs, completes any gap analysis, identifies process owners, and outlines accountability goals.
• Works with PFS staff to identify, document, and communicate to upper management, IT, and NorthStar Care Community software systems personnel any billing/accounts receivable system errors and issues. Represents PFS in the bi-weekly NorthStar Care Community software systems conference calls. Communicates issues; inquires as to the status of previous requests; escalates stalled issues on the part of NorthStar Care Community software systems.
• Assists Billing Systems Analyst when needed in ensuring accurate physician visit billing, reporting, and pass-through reimbursement to eligible physicians.
• Maintains confidentiality of patient, employee and all other NorthStar Care Community records and/or reports.
• Collaborates closely with Information Technology and NorthStar Care Community software systems to develop and design effective data entry and reporting structures as well as to identify gaps and inaccuracies in data integrity across multiple NorthStar Care Community software systems.
• Regularly communicates status of outstanding issues of NorthStar Care Community software systems with Director and PFS staff.
• Analyzes electronic billing problems with PFS staff to determine root cause analysis of the problem and whether follow-up is necessary with the payer or the software vendor. Performs necessary follow-up.
• Communicates implications of upcoming federal and state billing regulations with PFS staff and all other relevant stakeholders within NorthStar Care Community to ensure compliance.
• Participates with the PFS Billing Systems Analyst in EMR software vendor early validation testing when appropriate and assist with systems setup as required.
• Provides system administrative support for PFS staff for payers’ systems, and acts as a resource for electronic billing and NorthStar Care Community software systems questions.
• Downloads NorthStar Care Community software systems billing templates when needed.
• Writes IT report requests in order to provide needed information for PFS staff, Director, Controller, General Accounting, Accounts Payable, and the CFO.
• Works with PFS staff to ensure all necessary tools (e.g. reports, task codes, collection notes, etc.) are available to them for monitoring and measuring individual performance.
• Develops project plans for large multi-departmental process revisions.
• Identifies appropriate measurements, data integrity, and the computer tracking tools and report formats for ongoing NorthStar Care Community indicators including survey completion; thoroughly and consistently documents processes.
• Works with Finance staff on completing Medicare cap analysis for each provider number and submits to the Medicare Administrative Contractor.
• Adheres to the NorthStar standards to care for every person, every time, 100% of the time.

Qualifications:

• Bachelor's degree in accounting, health care administration, computer technology, business administration, finance, or other related field required; Master's Degree preferred.
• Three to five years hospital/health care operational experience required.
• Previous process improvement experience preferred.
• Experience in managing multiple projects with differing priorities in a dynamic environment by establishing project goals and objectives as well as individual working group member roles and responsibilities.
• Proven ability to work effectively with other staff members and as a team player.
• Must possess excellent and accurate computer skills, including Microsoft Office Suite. MISYS experience preferred.
• Must be able to effectively communicate, orally and in writing, with internal and external audiences for all essential job functions.
• Must have an action-oriented personality with an innate sense of pace and urgency as well as ability to work productively and proactively, both independently and as part of a team.
• Must have reliable transportation.
• Must be eligible to work in the United States.