Shire Jobs

Facility: Corporate Offices

City San Diego

Department

Job Status

Regular

Shift

Day

FTE

1

Shift Start Time

Shift End Time

Bachelor's Degree

Hours :

Shift Start Time:

Variable

Shift End Time:

Variable

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements:

As Needed

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$52.340 - $67.536 - $82.731

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

Provides management direction, project development and analysis, implementation planning, and results reporting in the areas of computer systems (both PC-based and ICD or CCD patient accounting systems), payment processing, chargemaster maintenance, and staff development.

Under the direction of the System Director, Institutional Care, PFS, the Manager of System Operations is responsible for all hiring, training, coaching, evaluating, disciplining, and termination of staff in functional unit. The Manager prepares budgets and financial reports for the functional areas, develops operational plans (short-term and long-term) determines appropriate staffing ratios, evaluates performance, recommends and implements changes that improve operating efficiencies, billing production, cash flow, and reimbursement. Maintains centralized dictionaries and chargemasters, assures timely input of all chargemaster coding to ensure compliance with State and Federal billing regulations. Coordinates all computer conversion activity, performs all system testing and quality controls, verifies accuracy and completeness of all mapping criteria, and continues implementation of EDI applications. In addition to Chargemaster Analyst, BAR and HPA/Meditech Analysts, provides management support to the PFS Trainer/Educator, Payment Processing staff, Shared Service Analyst, Uncompensated Care Specialist, and Hospital Auditors. The Manager is responsible for coordinating with ICD and CCD department Managers/Directors on a regular basis to ensure efficient and effective interdepartmental work processes. The Manager assures employees possess the training and knowledge to competently achieve expected outcomes and performance goals. The Manager provides leadership to assure that staff practice safe work habits, and that the working environment is consistently within regulatory standards.

Required Qualifications

• Bachelor's Degree

• 3 years' experience in large hospital setting, medical group, or A/R consulting company in inpatient accounting.

Preferred Qualifications

• Epic system experience.

Other Qualification Requirements

• Bachelor's degree in business administration or equivalent knowledge and experience, preferably in accounting or finance. - Required

Essential Functions

• QUALITY Maintains and updates Hospital and Community Care chargemasters in a manner that ensures proper charging, coding, and item descriptions. Assures compliance with all Medicare and Medi-Cal billing regulations by reviewing bulletins and billing manuals timely and making necessary chargemaster edits.MEASUREMENT: All billings are in compliance with Medicare and Medi-Cal billing regulations. No facility is on Focus Medical Review for controllable billing non-compliance.Assures PFS billing products are accurate and patient-friendly. Performs random review of charge audit findings to assure prompt response to repeat/recurring charge errors.MEASUREMENT: Identified charge errors are not repeated. Upon approval, recommended charge description updates are entered within 7 days of request.Assures smooth, well-planned, computer conversions. Performs all necessary testing and quality control functions to guarantee accurate and complete conversion of patient account receivables. Develops conversion schedules, checklists, and time lines to coordinate conversion activities with peers and support staff.MEASUREMENT: Conversion schedules, checklists and time lines are presented to Director 3-4 months prior to planned conversion activity. Conversion is completed with all A/R identified and mapped according to conversion plan.

• FINANCIAL PERFORMANCE Manages Department budget within confines of approved budget. Contributes to the identification of and operationalizes cost reduction measures.MEASUREMENT: Department expenses are within 95% - 100% of budget.All cash receipts are posted prior to each month-end. Shared Services accounts are reconciled monthly. Assures timely and accurate uncompensated care review and bad debt turnover. Monitors self-pay outsource. Issues affecting Bad Debt turnover and/or self pay outsource activities are reported to Director within 24 hours of identification. Action plans are developed and implemented, as necessary.MEASUREMENT: Month-end closing includes all lockbox and hospital cash posted as well as appropriate account adjustments. Shared Service A/R does not exceed 45 days. Monthly bad debt turnover and charity reviews are completed and adjusted prior to month end.System enhancements that assist PFS in achieving department billing and cash goals are recommended and implemented.MEASUREMENT: Implements 2-3 system improvements per year.

• SYSTEM INTEGRATION Implements and provides training to ICD, CCD, and SDHA staff to assure maximum competency in computer functionality, customer service, and general admission, insurance, and billing criteria.MEASUREMENT: Training sessions are offered and conducted monthly, with a minimum of 1-2 sessions per month.Coordinates all system download activities, tape drops, etc. with Information Systems to ensure clean passing of information to internal partners or outside vendors. Considers all areas potentially affected and informs parties accordingly.MEASUREMENT: In collaboration with download recipient, defines download criteria and implements tape drop procedure.

• LEADERSHIP Enforces all policies in a consistent and fair manner. Manages and resolves all payroll, compensation, evaluation, training, hiring, termination, grievance, disciplinary, and development issues for assigned staff.MEASUREMENT: All human resource issues are resolved in a satisfactory and timely manner with no more than 1 exception annually. 95% of performance reviews are completed on or before due date.Creates an environment that fosters appropriate development and utilization of human resources. Effectively communicates external changes which impact the Department as well as organizational changes, issues, plans, and directives on a routine basis. Serves as a professional role model in overall conduct and communication.MEASUREMENT: Maintains an availability to staff in informal and formal settings. Conducts at least 12 staff meetings per year at which System, Hospital, and Department issues are discussed. Meeting business is documented with minutes. Topics to include several of the following:Quality ImprovementFinancial ReportsCustomer RelationsInsurance UpdatesSafetyEmployee RecognitionEmployee Motivation/Morale EnhancementAssures that all staff training, training material, and training checklists are developed, current, and available to employees.MEASUREMENT: Evidenced by producing material upon request of PFS System Director and maintaining employee checklists and inservice records in employee files.

• Regular one-to-one supervision with the System Director, Institutional Care, Patient Financial Services.

Knowledge, Skills, and Abilities

• Appropriate affiliation with national organizations which provide or enhance expertise and ongoing knowledge.

• Knowledge of the continuous quality improvement concept required.

• Strong professional level of written and oral communication skills.

• Ability to defuse volatile situations, use good judgement and tact in dealing with the public.

• Working knowledge of hospital and ambulatory care charging policies, contractual payment schemes, and collection agency policies.

• Working knowledge of medical terminology, ICD9 coding, RVS coding, and CPT4 coding.

• Ability to discuss personal and financial matters with patients or their representatives.

• Ability to withstand pressure, meet deadlines, and positively react to stress associated with job duties.

• Ability to use resources in an organized manner.

• Bilingual preferred.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class.

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