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Fort Bend County is ranked as one of the fastest growing counties in the nation. We have capitalized on not only the creed of our location, but on the "quality of life" for our families to call home. Our employees are the key to our success and the heartbeat of our foundation. The diversity and inclusivity of our community is our strength and at the forefront of a workplace environment welcoming to all. Live Here! Work Here!
Develops and directs the EMS revenue-cycle strategy to maximize lawful reimbursement from insurance carriers and other responsible third-party payers before seeking payment from patients.
Establishes 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.
Oversees the accurate and timely coding, submission, correction, resubmission, and follow-up of Medicare, Medicaid, commercial insurance, workers' compensation, liability, and other claims.
Directs denial management and appeals, identifies reimbursement trends and revenue loss, reviews payments for accuracy, and implements corrective actions to address denials, underpayments, non-payments, and improper adjustments.
Collaborates with EMS Operations, Clinical Practice, Quality Assurance, Information Technology, hospitals, and other healthcare organizations to obtain the documentation and information necessary to support accurate billing, medical necessity, and reimbursement.
Maintains 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.
Establishes internal controls, conducts or coordinates billing audits, investigates compliance concerns, and works with EMS leadership, the County Attorney, Finance, Internal Audit, and other departments to implement corrective action.
Establishes performance goals and monitors revenue, collections, accounts receivable, claim acceptance, denials, appeals, write-offs, patient balances, staff productivity, and other revenue-cycle measures.
Uses financial and operational data to identify trends, forecast revenue, prioritize accounts, evaluate fees and payer performance, support budget preparation, and recommend improvements.
Develops and maintains daily, weekly, monthly dashboards and reports on overall cash collections and billing operational performance.
Serves as the department's primary liaison with government and commercial payers, clearinghouses, collection agencies, billing vendors, hospitals, and other revenue-cycle partners. Oversees payer enrollment, credentialing, revalidation, electronic claims and remittance processes, and vendor performance.
Ensures patient billing and collection activities are accurate, respectful, transparent, and consistent with applicable law and County policy. Oversees the resolution of billing questions, disputes, complaints, financial-hardship requests, payment arrangements, and account corrections.
Directs PAS personnel functions, including employee selection, orientation, assignments, training, professional development, performance management, retention, and corrective action.
Coordinates PAS staff participation in emergency-management activities when directed by EMS Command Staff.
Develops well documented policies and procedures as well as training and new employee orientation programs. This includes for all of Patient Account Services as well as field providers and leaders throughout the organization.
MINIMUM JOB REQUIREMENTS:
Bachelor's degree in healthcare administration, business administration, finance, accounting,…