City and County of San Francisco

Patient Accounts Manager (#1664)

$49.41-$60.04 Hourly / $8,565.00-$10,407.00 Monthly / $102,778.00-$124,878.00 Yearly


Definition

Under general direction, administers the activities of the billing, claims and/or collections unit within a health care agency of the City and County of San Francisco.

Distinguishing Features

This class oversees a small Patient Accounts or Billing Unit, a Health Plan Claims Unit, or other specialized and complex section within an agency’s Patient Accounts Department. It is distinguished from the 1663 Patient Accounts Supervisor in that the latter is responsible for the immediate supervision of a billings, collections, claims processing and/or cash posting unit in a billing department or a specialty health services program. Additionally, the 1664 Patient Accounts Manager is responsible for requesting modifications in the Electronic Health Record (EHRS) system to meet hospital, health plan or agency needs, whereas the 1663 Patient Accounts Supervisor is responsible for the actual details of the Electronic Health Record system as they pertain to individual cases.

Supervision Exercised

Directs and supervises personnel assigned to the Patient Accounts Department.

Examples of Important and Essential Duties

According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job code/class and are not intended to be an inclusive list.

  1. Through subordinate supervisory personnel, administers the staff and activities within the Billing, Claims and/ or Collections department; coordinates activities of the various units, including patient accounts billing, claims processing, payment collections, data entry and control; maximizes staff productivity by assigning duties, making recommendations concerning employee status and planning and implementing the staff development program.
  2. Develops, interprets, coordinates and enforces policies, methods and procedures; conducts staff meetings for the purpose of evaluating and disseminating information about departmental policies and procedures; establishes liaisons with other government and non-government department/organizations
  3. Performs various administrative duties such as preparing input for the annual budget request, investigating complaints about services, attending meetings to exchange information and for planning, developing policies and procedures.
  4. Reviews computer-produced reports, daily statistical data, census reports and accounts receivable records; prepares monthly revenue analysis of charges made by each department providing medical services.
  5. Administers the transfer of delinquent accounts to the Bureau of Delinquent Revenue of the Tax Collector's Office; confers with attorneys, title insurance companies and real estate firms concerning the release of existing liens against patients; property in order to settle unpaid accounts; testifies in court as to the status of patient's bills when legal claims have been filed.
  6. Coordinates electronic data processing, billing and collections and data submitted by departments providing medical and specialty behavioral health services; administers the collecting, editing, transmission and controls over data required for computer processing of itemized bills.

Knowledge, Skills and Abilities

Knowledge: complex federal Medicare, state Medi-Cal and private insurance regulations applicable to hospital and specialty healthcare services billing; sequential billing priorities based upon a patient's type of coverage or healthcare benefits; procedures for collecting payments on delinquent accounts; the basic principles of accounts receivable, including posting payments and adjustments to accounts and reconciling receipts and payments. Requires knowledge of: HIPPA transactions and code sets, CMS 1500 claims, electronic data processing methods, principles and procedures; the operation and use of a complex variable task computer system; appropriate formats for submission of data to the EDP or other Units/ Agencies.

Ability or Skill to: plan, formulate, develop and execute policies for the Billing, Claims and/or Collections Department of a medical facility or healthcare agency; supervise and coordinate the activities of a large group of employees; understand and apply methods and procedures appropriate to the field of health care billing and collections; communicating tactfully, courteously and effectively with a variety of people to explain complex policies and resolve complaints; writing and preparing correspondence, reports and financial records; use of a ten key adding machine and computer operating systems and business software applications to train others in their use.

Minimum Qualifications

These minimum qualifications establish the education, training, experience, special skills and/or license(s) which are required for employment in the classification.  Please note, additional qualifications (i.e., special conditions) may apply to a particular position and will be stated on the exam/job announcement.

Education:

Experience:
Five (5) years of experience billing, claims processing, and/or collecting healthcare service reimbursements or medical claims from Medi-Cal (Medicaid), Medicare, insurance, third party payors, and individual payors in a hospital, healthcare agency, or healthcare billing organization, of which three (3) years must be in a supervising capacity.

License and Certification:

Substitution:

Notes

SUPPLEMENTAL INFORMATION

 

PROMOTIVE LINES

From: 1663 Patient Accounts Supervisor

To:

ORIGINATION DATE:

01/22/1990

AMENDED DATE:

09/21/15; 09/11/19

REASON FOR AMENDMENT:

To accurately reflect the current tasks, knowledge, skills & abilities, and minimum qualifications.

Business unit(s):

COMMN SFMTA SFCCD SFUSD

Disaster Service Workers

All City and County of San Francisco employees are designated Disaster Service Workers through state and local law (California Government Code Section 3100-3109). Employment with the City requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency.

CLASS: 1664; EST: 1/22/1990; REV: 9/11/2019;