Role: Senior Revenue Executive
The purpose of the role
Contributes to the Phoenix group by accurately billing all diagnosis and procedures from the medical records and charge sheets based on agreed medical billing codes. The Biller is responsible for record maintenance daily charges, and preparing and submitting claims to third party payers. Other duties include: applying contractual adjustments, other adjustments, credit balance review, and audits to include refund requests as needed
You will provide an exceptional service to patients, consultants and third parties to facilitate their overall care and ensure the financial aspects of the patient journey is billed and that revenue is captured and appropriately allocated.
The successful candidate will be a strong team player with the ability to work flexibly and demonstrate tact and diplomacy. They will show a high degree of accuracy and attention to detail and will demonstrate strong problem-solving skills. The ability to meet deadlines and work under pressure are essential as well as the ability to show commercial acumen and seek opportunities to maximise revenue and return on capital.
Duties & Responsibilities include but not limited to
- Assigns diagnosis and procedure codes for each case utilising currently accepted structures while adhering to guidelines for correct assignment of codes.
- Submits insurance, third party and patient bills.
- Transmits claims electronically or mails out paper claims within 48-72 hours
- Maintains charge entry on a daily basis.
- Applies contractual adjustments and other adjustments for insured and other contracted patients.
- Monitors logs to make sure claims are submitted and received properly.
- Corrects rejected claims and re-bills in a timely manner.
- Follows-up with insurance companies to ensure receipt of bills within 28 days.
- Generates patient statements as required.
- Prepares refunds to accounts for authorisation by senior management.
- Ensures computer profiles and charges are set up, and enters concise and accurate notes in the “comments” section of the patient account in a timely manner.
- Performs quality audits on admitting paperwork.
- Verifies that all supplies are correctly captured and billed.
- Ensures that all scheduled or performed cases are accounted for and billed.
- Documents all phone calls on electronic patient account.
- Where applicable maintains daily communication with purchasing manager and A/P to ensure all supplies are captured and billed appropriately.
- Resolve billing queries in a professional and efficient manner.
- To make improvements to processes, procedures and policies when necessary.
- To perform any other functions required to assist the department to meet its overall goals and objective.
- Act as an ambassador of Phoenix with patients, referrers and other stakeholders.
- As an essential user of relevant IT systems, to maximise the use of the systems infrastructure and to champion best practice in the use of all IT systems particularly Compucare.
- To work with other members of the finance team to set and achieve agreed service and financial targets.
- Assist in devising and maintaining strong internal controls: o Providing an input to policy making
- Working on regular internal audit sampling of billing and credit control procedures If appropriate and required, prepare consultant/physician payment runs
- Carry out reconciliations for large sets of data and complex commercial agreements
Required skills & experience
- +5 years’ experience in private healthcare billing
- Experience of liaising with overseas embassies
- Previous admin experience within a healthcare environment is essential
- Strong communication skills
- Focus on excellence and customer service
- Well-developed systems skills including use of excel and ideally Qinec/Compucare
- Positive and collegiate approach
First and foremost, we pride ourselves on providing exceptional clinical care to all patients, in a very supportive environment.
Phoenix Hospital Group has four sites encompassing two London outpatient centres: 9 Harley Street and 25 Harley Street, and two hospitals: Weymouth Street Hospital (London) and Phoenix Hospital Chelmsford (Essex).
If you think you would be a great fit, apply now.