Business Operations Manager
14797BR
Business Operations Manager
Watkins Health Services
Position Overview
The incumbent serves as the Business Operations Manager for Watkins Health Services (WHS). The incumbent provides direct supervision to the Business Office and manages assigned financial functions. The Business Office performs all billing and charge functions for patients treated in Watkins Memorial Health Center. This includes services for students, the WHS faculty & Staff Immediate Care Clinic, and the Counseling & Psychological Services Dept., a separate department for which WHS performs financial services. The incumbent also provides services to WHS Administration on budget and contracting functions.
The incumbent in this position will see, hear and possibly have access to confidential information that must be handled in accordance with all relevant state and federal laws and University policies and procedures regarding its use and disclosure. This position is also authorized to review, create and process patient information and/or data in accordance with established procedures in the performance of job duties.
WHS utilizes computer technology in all aspects of its operations, including an electronic health record system. The incumbent must become familiar with and be able to use the appropriate computer hardware and software programs associated with this position.
The incumbent in this position must become familiar with and adhere to the Watkins Health Services Customer Service Plan to ensure appropriate interaction and positive outcomes with both internal and external customers.
Watkins Health Services is a unit in Student Affairs.
Job Description
30% - Management
- Plans and directs, through subordinate staff, the internal Business Office operations.
- Oversees the financial records maintenance, data entry, billing, and insurance claim processing.
- Serves as the primary resource on WHS financial information for university partners, including the Shared Service Center and the Comptroller’s Office.
- Determines appropriate staff permissions within the billing system.
- Conducts cost/benefit analyses for proposed programs.
- Interviews, participates in the hiring and any disciplinary actions, trains and supervises all Business Office staff. Determines job expectations; evaluates staff performance; and assesses staffing needs of the office.
- Develops short and long range strategic plans for the department.
- Maintains Business Office Policy & Procedures manual, along with forms, records, & controls to enforce compliance with an automated financial records system.
- Provides oversight for all Business Office staff tasks, including:
1. Cashiering tasks.
2. Reconciliation of receipts and deposits.
3. Inter-department Transfers (IDT).
4. Coding assignments.
5. Posting of Explanation Of Benefit Statements and payments.
6. Patient account management including accounts receivable aging.
7. Generating insurance claims and patient statements.
8. Generating regular revenue cycle management reports.
9. Confirming eligibility, including insurance coverage.
30% - Business Operations
- Prepares an updated fee-for-service schedules based upon pricing model approved by WHS Administration.
- Researches local market pricing trends using approved external data sources.
- Works closely with WHS departments to ensure all factors are considered in pricing for services.
- Runs loss/gain reports to estimate impact of proposed changes to fee schedules.
- Ensures the Fee Schedule is accurately updated in the billing system and all WHS staff are informed of the new pricing.
- Assists Administration with review and negotiations of health insurance contracts initially and upon renewal and is the prime contact for insurance companies.
- Serves as the KU student health insurance representative to the Kansas Board of Regents Student Health Insurance Advisory Committee.
- Advises WHS Administration on proper and innovative revenue cycle practices.
- Prepares cost accounting models by program as determined by supervisor.
- Works with WHS Administration to project financial status and assists in preparation of the WHS budget
25% - Patient Billing and Collections
- Ensures the Billing system is providing accurate, compliant and timely submission of insurance claims.
- Manages the coding and billing compliance program, ensuring it is up to date
- Oversees "Clinical Dictionaries" & codes within Point N Click to facilitate processing of patient data and generation of financial analysis reports.
- Analyses monthly receivables, maintaining a high collection rate of 90+%.
- Initiates and manages collection efforts.
- Authorizes the lifting of administrative financial Holds with the university.
10% - Account Management
- Works with the staff to research discrepancies in account ledgers (i.e. debits, credits, refund transactions) on patient, insurance company, departmental, and other entity billings and establishes resolutions.
- Serves as liaison between WHS & public sources, etc., on insurance, billings, collections, & other financial matters pertaining to WHS patients & provides technical guidance on medical billing issues.
5% - Miscellaneous
- Performs all other jobs as assigned by supervisor or Director.
- Serves on WHS committees as requested by supervisor.
- Knows and understands the Patient Rights and Responsibilities statement.
- Respects patient privacy and maintains confidentiality disclosing protected health information only as it relates to Payment, Treatment and Healthcare Operations.
- Demonstrates ability to successfully work with a diverse community and provide services from a non-judgmental perspective.
Required Qualifications
- Bachelor’s degree in a related field and three years of related experience; or Associates Degree and five years of related experience; or High School diploma and six years of related experience.
- Two years of management, supervisory experience and/or project team leadership.
- Experience in a medical business office using computerized accounting and financial analysis methods.
- Experience that required knowledge of the medical terminology, technology, and procedures typically utilized and performed in clinics.
- Current CPR certification or within six months of hire.
Preferred Qualifications
- Five years of experience in medical office accounting/auditing work.