Incumbents in this class are responsible for managing the various aspects of patient financial resources and allocations.
Supervises approximately 10 technical and clerical subordinates.
Responsible for recovery and allocation of funds in excess of $10 million annually.
Nature and Scope
Incumbents work under limited supervision from a Hospital Administrator III. Work involves administrative, technical and supervisory responsibility for four separate but interrelated functions; i.e., financial resource determination, application for benefit entitlements, patient trust funds and patient income/expense accounting. A significant aspect of this work involves identifying and claiming unreported assets as well as assisting with estate settlements to effect maximum recovery of patient care costs. An incumbent works in close cooperation with the State Attorney General, Court of Chancery, various Federal agencies and private sector insurance companies to secure maximum patient entitlements and benefits.
Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, incumbents can complete job duties of similar kind not specifically listed here.
Ensures thorough investigation of patient assets and financial resources.
Ensures maximum recovery of patient care costs.
Ensures proper operation of patient trust and patient effects activities.
Presents statistical reports for use in budgetary planning.
Develops, implements and evaluates unit policies and procedures.
Knowledge, Skills and Abilities
The intent of the listed knowledge, skills and abilities is to give a general indication of the core requirements for all positions in the class series; therefore, the KSA’s listed are not exhaustive or necessarily inclusive of the requirements of every position in the class.
Knowledge of state and federal laws, rules and regulations applicable to assigned area.
Knowledge of public sector and private insurance carrier policies, procedures and benefit entitlements.
Knowledge of bookkeeping and accounting procedures and practices.
Skill in interpreting and applying complex rules and regulations.
Skill in dealing with various people during stressful situations.
Skill in developing subordinate staff to their fullest potential.
JOB REQUIREMENTS for Administrator Financial Determination Section
Applicants must have education, training and/or experience demonstrating competence in each of the following areas:
Three years experience in health care reimbursement which includes reviewing and categorizing claims for proper billing, analyzing cost reports, examining cost containment, and interpreting and analyzing laws, rules, regulations, policies, procedures and standards affecting reimbursement and recovery.
Three years experience in accounting using Generally Accepted Accounting Principles (GAAP).
Six months experience in using an automated information system to enter, update, modify, delete, retrieve/inquire and report on data.
Six months experience in staff supervision which includes planning, assigning, reviewing, and evaluating the work of others.
Knowledge of descriptive statistics such as the mean, median, mode or standard deviation.