1. Professionalism and Compliance:
2. Maintains a professional appearance and adheres to the company dress code and code of conduct.
3. Ensures patient confidentiality and adheres to all Federal and State regulations.
4. Reports to work on time and as scheduled, wearing proper identification.
5. Completes annual education requirements and attends annual performance reviews.
6. Actively participates in performance improvement initiatives.

1. Communication and Collaboration:
2. Possesses strong written and verbal communication skills in English to effectively collaborate with colleagues across departments.
3. Build positive working relationships with staff, departments, and providers.
4. Represent the organization professionally and positively.

1. Technical Skills and Knowledge:
2. Proficient in hospital billing software systems, Microsoft Office Suite, and other relevant software programs.
3. Possesses in-depth knowledge of hospital revenue cycle processes, best practices, and compliance regulations.
4. Utilizes excellent analytical and problem-solving skills to identify and resolve complex issues.

SECTION 2: SPECIFIC MAJOR DUTIES AND RESPONSIBILITIES

1. Leadership and Oversight:
2. Lead and coordinate activities of PFS staff, ensuring timely and efficient completion of tasks.
3. Oversee all revenue cycle day-to-day functions in the Director's absence.
4. Participate in various meetings to collaborate on process improvement, address challenges, stay informed, and contribute valuable insights.

1. PFS Operations:
2. Run necessary reports as needed to monitor and analyze PFS performance metrics, such as Aging Transaction Balances and Unbilled reports.
3. Close out daily financial activities, ensuring accuracy and completeness.
4. Conduct regular tasks, such as rejecting zero-balance accounts weekly and posting employee benefit write-offs in hospital billing systems.
5. Contribute to intradepartmental audits.

1. Credit Balances:
2. Manage strategies to resolve credit balances efficiently and accurately.
3. Proactively work to minimize the occurrence of future credit balances.

1. Administrative Adjustments:
2. Independently resolve administrative adjustments in accordance with policy.
3. Analyze the root cause of administrative adjustments and implement corrective actions to prevent recurrence.
4. Log and track all administrative adjustments in relation to the root cause.

1. PFS Book of Knowledge (BoK) Management:
2. Disseminate relevant health plan news and alerts to PFS staff and applicable hospital staff.
3. Archive outdated information within the BoK to maintain an accurate and up-to-date knowledge base.
4. Collect information from all PFS staff to ensure the BoK remains current and relevant.

1. Transaction Responsibilities:
2. Manage and reconcile transaction discrepancies to ensure accurate financial records.
3. Oversee the following duties:
4. Deposit and mail processing: Retrieving and processing departmental mail, reviewing accounts, entering payment information, copying and scanning checks, reconciling deposits, and preparing deposit slips.
5. Posting payments from insurance and remittance receipts.
6. Posting credit cards and payroll deductions.
7. Running and processing small balance write-offs weekly.

1. Collections and Bad Debt:
2. Oversee the following duties:
3. Pre-collection activities to ensure reasonable efforts are exhausted prior to placement.
4. Collection agency recalls.
5. Patient billing escalations.

1. Oversee Rural Health Clinic (RHC) Claims Management
2. Ensure the accurate and timely submission of RHC claims to payers, including Medicare, Medicaid, and commercial insurers. 
3. Monitor claim status, identify and resolve claim denials and errors, implement corrective actions, and manage RHC charge capture and reconciliation processes to maintain accurate revenue cycle management.
4. RHC Regulatory Adherence: Stays current on RHC reimbursement regulations and industry best practices.

1. Performs other tasks as appropriate:
2. Providing backup coverage for PFS staff.

Quality Improvement:  Actively participates in the   Hospital-wide  Quality Improvement Program, actively supports and   implements  Department-specific Quality improvement initiatives and   projects,  recommends process improvement as appropriate, reports any   quality  issues in service delivery and consistently commits to a focus   on  quality improvement and organizational excellence. 

Disaster  Management:    As an employee of Penobscot Valley Hospital, the position  has an   inherent role to care for our community members when in need. To  this   regard, the incumbent will be expected to participate in    emergency/disaster preparedness planning and drills as requested. When    called upon during a When called upon during a real life    disaster/emergency event, the incumbent w real life disaster/emergency    event, the incumbent will be expected to participate in the  Hospital’s   ted to participate in the Hospital’s response to this  event, within the   scope of professional and personal ability to do  so.    

Bachelor’s or Associate’s degree (preferred); alternative certificates  with relevant experience may be considered. At least 3-5 years of  experience in healthcare billing and revenue cycle management. Strong  understanding of healthcare billing and coding principles (ICD-10, CPT,  HCPCS).  

Benefits  

PVH has a  Section 125 Cafeteria  Benefits  Plan and pays a portion of the cost of  our health plan,  dental, basic  life, and disability insurance for  employees for 30+  authorized hours,  and provides partial subsidy for  dependent health  insurance.  Part-time  employees are eligible to  receive dental, life,  and disability coverage  and are eligible to  participate in the health  insurance plan. Other  benefits include a  403(b) plan and earned time  off accrual.