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Fort Bend County

Deputy Chief - Patient Account Services and Revenue Cycle, Emergency Medical Service

Clinical Support & Patient AdministrationUpdated on Nov 12
Full-timeMissouri City, TX, USA$51.29 - $64.12 /hrIn-person

About the Job

Requirements

  • A bachelor's degree in healthcare administration, business administration, finance, accounting, public administration, health information management, or a closely related field is required. Four years of relevant progressively responsible EMS revenue-cycle experience may substitute for the educational requirement, in addition to the five-year experience requirement.
  • Five years of documented experience in ambulance or healthcare revenue-cycle operations, including billing, coding, collections, denial management, payer relations, or accounts receivable, with supervisory or management responsibilities.
  • Knowledge of ambulance coding, Medicare and Medicaid billing, commercial insurance, claims processing, medical necessity, payer appeals, coordination of benefits, accounts receivable, healthcare compliance, HIPAA, auditing, electronic claims and remittance transactions, and patient collection practices.
  • Ability to analyze financial and operational data, identify revenue leakage, develop corrective strategies, interpret payer policies, manage complex accounts, communicate with insurers and regulators, and translate billing requirements into operational policies and employee training.
  • Ability to communicate verbally and in writing and to apply management, supervisory, organizational, and interpersonal skills when dealing with the public, employees, vendors, payers, regulators, and elected officials.
  • A nationally recognized ambulance billing or coding credential approved by the department, such as Certified Ambulance Coder certification, must be obtained within six months of employment and maintained thereafter.

Responsibilities

  • Develop and direct the EMS revenue-cycle strategy to maximize lawful reimbursement from insurance carriers and other responsible third-party payers before seeking payment from patients.
  • Establish policies and procedures for insurance discovery, benefits verification, coordination of benefits, claims processing, payer follow-up, patient billing, payment arrangements, collections, refunds, write-offs, and account adjustments.
  • Oversee accurate and timely coding, submission, correction, resubmission, and follow-up of Medicare, Medicaid, commercial insurance, workers' compensation, liability, and other claims.
  • Direct denial management and appeals, identify reimbursement trends and revenue loss, review payments for accuracy, and implement corrective actions to address denials, underpayments, non-payments, and improper adjustments.
  • Collaborate with EMS Operations, Clinical Practice, Quality Assurance, Information Technology, hospitals, and other healthcare organizations to obtain documentation and information supporting accurate billing, medical necessity, and reimbursement.
  • Maintain an ambulance billing compliance program consistent with federal and state requirements, payer rules, County policy, and standards addressing coding, documentation, auditing, overpayments, refunds, and prevention of fraud, waste, and abuse.
  • Establish internal controls, conduct or coordinate billing audits, investigate compliance concerns, and work with EMS leadership, the County Attorney, Finance, Internal Audit, and other departments to implement corrective action.
  • Establish performance goals and monitor revenue, collections, accounts receivable, claim acceptance, denials, appeals, write-offs, patient balances, staff productivity, and other revenue-cycle measures.
  • Use financial and operational data to identify trends, forecast revenue, prioritize accounts, evaluate fees and payer performance, support budget preparation, and recommend improvements.
  • Develop and maintain daily, weekly, and monthly dashboards and reports on overall cash collections and billing operational performance.
  • Serve as the department's primary liaison with government and commercial payers, clearinghouses, collection agencies, billing vendors, hospitals, and other revenue-cycle partners. Oversee payer enrollment, credentialing, revalidation, electronic claims and remittance processes, and vendor performance.
  • Ensure patient billing and collection activities are accurate, respectful, transparent, and consistent with applicable law and County policy. Oversee resolution of billing questions, disputes, complaints, financial-hardship requests, payment arrangements, and account corrections.
  • Direct Patient Account Services personnel functions, including employee selection, orientation, assignments, training, professional development, performance management, retention, and corrective action.
  • Coordinate Patient Account Services staff participation in emergency-management activities when directed by EMS Command Staff.
  • Develop and document policies and procedures, training programs, and new employee orientation programs for Patient Account Services, field providers, and leaders throughout the organization.

Desired Qualifications

  • Direct experience with governmental EMS billing is preferred.
  • Certified Ambulance Coder certification or another nationally recognized ambulance billing or coding credential approved by the department is preferred at appointment.

About the Company

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