Franciscan Missionaries of Our Lady Health System

General

• Assist in developing and maintaining financial information related to volume, financial performance, and profitability for each managed care contract
• Prepare preliminary interpretations of analysis for project teams, departments, and/or management
• Assist in developing reimbursement strategies and policies and procedures related to contract negotiations
• Maintain current information and knowledge of the managed care environment, including local, state, and national developments
• Develop and maintain relationships with appropriate agencies
• Assist in contract negotiations
• Communicate changes in managed care processes and support adherence by employees
• Collaborate with Financial Operations, Revenue Management, Business Office, and other internal departments to optimize reimbursement and resolve reimbursement, operational, and clinical issues
• Work with affiliated entities on managed care contracts and strategies

Payor Relations Coordinator

Human Resources

• Implements effective, fair and consistent employee relations strategies
• Provides coaching and consultation on conflict resolution, facilitates problem solving, administers performance improvement plans and progressive discipline procedures
• Ensures adverse employment actions comply with policy, regulations, and laws and align with company mission and values
• Conducts HR investigations, documents findings, and makes recommendations to close cases in a timely manner
• Maintains employee relations data and ensures the tracking system is updated accurately
• Tracks, trends, and analyzes employee relations data and develops strategies with HRBP and HR Leaders to address trends
• Represents FMOLHS in unemployment filings, hearings, and appeals
• Partners with legal, risk, compliance, HR Business Partners, and HR Centers of Excellence as needed

Employee Relations Specialist – Experienced

Navigator

• Serve as a trusted resource for team members experiencing life events by providing guidance regarding benefit programs, leave options, and available resources
• Advise team members on eligibility requirements, enrollment actions, required documentation, and applicable timelines
• Educate team members on the impact of leave on benefits, payroll deductions, arrears, and return-to-work requirements
• Manage and resolve routine and moderately complex benefits and leave inquiries
• Collaborate with Benefits Analysts, Leave Specialists, and other subject matter experts
• Maintain thorough, accurate, and compliant case documentation in designated systems
• Prepare and deliver clear, empathetic communications
• Interpret and explain benefit and leave policies, eligibility provisions, and program requirements
• Guide team members and leaders to systems, tools, self-service capabilities, job aids, FAQs, and educational materials
• Assist in developing and maintaining job aids, FAQs, reference materials, and educational content
• Deliver foundational education on benefits administration and leave procedures
• Partner with askHR, Benefits, Leave Administration, Employee Health, Payroll, and external vendors
• Contribute to process improvement initiatives and cross-functional projects

Benefit Navigator

Patient Coordinator

• Monitor and improve Patient Service Center processes
• Track assigned metrics using custom applications or tools
• Research, report findings, and make recommendations on process improvement, service-level compliance, and metrics data
• Collaborate with departments and leaders to research issues, improve services, and develop or change processes
• Complete daily reports and compile data for leadership review
• Mentor and train PSC staff members and leaders
• Develop and comply with standards for documentation, end-user instructions, computer deployment, ticket logging, and monitoring
• Prepare departmental performance metrics, review trends, provide coaching and feedback, and escalate issues when needed
• Monitor and upload metrics to the shared database
• Participate in developing and implementing data-driven performance improvement processes
• Ensure security, integrity, and privacy of FMOLHS data
• Provide end-user support services for employees and customers
• Troubleshoot, document, log, escalate, and follow up on technical issues
• Assume other team members' roles as necessary to maintain acceptable service levels
• Perform other duties and special projects as assigned

Patient Service Center Performance Coordinator – Patient Scheduling

Patient Access Representative

• Register patients accurately in Epic and validate patient information
• Verify insurance coverage and collect required patient payments
• Advise patients about collection and billing procedures, anticipated charges, liability, and payment responsibilities
• Welcome patients and families and address questions and concerns
• Inform patients of their rights and Advance Directives upon request
• Monitor patient schedules and manage patient flow through the clinic
• Review accounts, determine financial responsibility, and arrange payment plans
• Assist patients with government and community healthcare resources
• Coordinate referrals with physicians, nurse practitioners, and nursing staff according to payer requirements
• Facilitate access to patient information, including MyChart
• Update patient records and enter patient charges
• Schedule and reschedule appointments
• Perform clerical duties, including answering calls, retrieving medical records, recording data, and typing memoranda
• File patient charts and referral documentation
• Research claim edits and denials and resolve discrepancies within two days
• Research billing information and resolve discrepancies within two days of receipt
• Key charges, process batches daily, and prepare bank/deposit summaries
• Review diagnosis and procedure codes and enter data at point of service
• Verify and collect patient payments, reconcile account balances and daily cash funds, and manage cash securely
• Maintain knowledge of health plans, including co-pays, deductibles, and co-insurance
• Meet site collection goals
• Provide clinic backup, support operational improvement initiatives, and provide training or orientation when assigned

Patient Access Representative – Patient Scheduling

Payroll

• Compile, analyze, and report on payroll, compensation, timekeeping, and workforce program data
• Identify compliance risks, utilization trends, policy exceptions, and operational improvement opportunities
• Develop dashboards, metrics, and actionable insights for leadership
• Lead corrective actions, risk mitigation strategies, and process improvement initiatives
• Conduct internal audits of payroll operations, physician compensation interfaces, workforce investment programs, sponsorship agreements, educational assistance programs, and forgiveness program eligibility
• Monitor changes in federal, state, and regulatory requirements affecting payroll, tax reporting, educational assistance, workforce investment programs, and forgiveness initiatives
• Develop, update, and implement policies, procedures, and controls
• Develop educational resources and provide consultation to leaders and stakeholders
• Maintain documentation, audit records, compliance evidence, reconciliations, and reporting
• Partner with Payroll, Human Resources, Talent Acquisition, Finance, clinical departments, and operational leaders

Payroll Audit and Compliance Analyst

Technician

• Perform accurate and complete pre-donor health histories to determine donor eligibility
• Perform donor screening and blood collection procedures
• Maintain adequate inventory levels by preparing requisitions, verifying supplies, and disbursing ordered supplies
• Call blood donors as needed
• Determine donor eligibility through related testing and evaluation of medical histories
• Assist physicians with special tests and procedures
• Recruit blood donors and complete confidential donation records
• Participate in mobile and in-house blood bank operations
• Assist in preparing blood components
• Follow hospital and laboratory policies, safety, quality assurance, and infection control standards
• Establish cooperative relationships with patients, physicians, pathologists, staff, and others
• Coordinate and prioritize duties efficiently while maintaining flexibility
• Maintain work-area supply inventory and request or order supplies as needed
• Perform other duties as assigned

Blood Donor Technician, PRN Premium

Account Manager

• Perform billing, collections, payment processing, and customer service tasks
• Review and update patient accounts, including ownership, notes, balances, and next steps
• Apply contract knowledge and expertise to drive revenue
• Investigate root causes and resolve account issues to maximize revenue, minimize write-offs, and maintain customer satisfaction
• Complete transactional updates and complex scenarios independently, collaborating with internal departments and external entities
• Identify account issue patterns and trends and escalate root causes for improvement
• Maintain subject matter expertise on regulations, processes, and policies through training and daily application
• Meet production and quality requirements related to accounts receivable, claim counts, and past-due balances
• Respond to customer, coworker, and management requests promptly and professionally
• Participate in internal and external meetings as a department representative
• Serve as a subject matter expert and provide training or shadowing support to new team members
• Identify system and process improvements and communicate issues to appropriate owners
• Collaborate with Payor Relations and vendors on contract, payment, and reimbursement issues
• Create and update workflows to drive process improvements
• Lead special projects and updates

Patient Account Representative, Level 4 - Hospital

• Answer inquiries from patients, co-workers, and employees regarding patient accounts
• Assist with training and orientation for assigned employees
• Advise patients or guarantors about third-party payer benefits and estimated private payer amounts
• Collect partial payments before admission
• Review patient documentation for accuracy and research account, billing, insurance, and payment issues
• Contact third-party payers, reconcile patient accounts, and arrange payments
• Coordinate payroll deduction actions and oversee collection-letter mail-outs for delinquent accounts
• Send itemized patient account statements in response to attorney requests or subpoenas
• Review claims for payer-specific billing requirements
• Follow up on claims, determine and apply adjustments, and update accounts
• Work with external agencies to provide prompt reimbursement for hospital services
• Explain hospital charges, services, and payment policies to patients and families
• Maintain a 95% quality accuracy average
• Maintain management-set production levels for the specialty focus
• Complete assigned tasks within requested timelines
• Perform other assigned duties

Patient Account Representative, Hospital

Analyst

• Handle administrative and medical appeals requiring clinical input or interpretation
• Direct and coordinate all aspects of denied claims
• Coordinate comprehensive clinical documentation to third-party payers and state agencies to secure accurate payment
• Identify coding or clinical documentation issues
• Provide ongoing trend analysis to identify reasons for denials and apply corrective action steps
• Research and understand payer issues
• Troubleshoot and resolve issues impacting revenue
• Facilitate the internal appeal process
• Work through denied claims, gather information, and take appropriate action to ensure proper adjudication
• Utilize equipment, supplies, facilities, and resources prudently and efficiently
• Perform other duties as assigned or requested

Denial Analyst – RN

Accountant

• Prepare assigned journal entries accurately and timely
• Ensure accuracy of complex system-wide financial statement journal entries, including long-term debt, equity investments, short-term investments, and long-term investments
• Prepare assigned bank, bond, and investment reconciliations
• Prepare variance analysis against budget and prior periods for quarterly FMOLHS financials
• Attend quarterly meetings with the System CFO, Accounting Director, and Accounting Manager to review and explain variances
• Prepare cash forecasts for the FMOLHS operating account
• Work directly with external auditors on year-end audit schedules for bonds, investments, and other reporting requirements
• Prepare quarterly packets for the FMOLHS Finance Committee and FMOLHS Investment Committee
• Develop consolidated financial reporting in EPSI (Allscripts)
• Prepare external surveys, including CHA
• Work with the Accounting Director on system-wide projects and reporting
• Ensure eliminating and intercompany entries are accurate
• Coordinate invoicing of expenses incurred between facilities

Accountant 3

• Register patients accurately and efficiently in Epic
• Validate and update patient and insurance information in the clinic computer system
• Verify insurance coverage and collect required payments, account balances, and outstanding balances
• Advise patients about collection and billing procedures, anticipated charges, financial responsibility, payment plans, and patient rights
• Welcome patients and families, answer questions and concerns, and facilitate access to MyChart and community resources
• Monitor patient schedules and manage patient flow; schedule and reschedule appointments
• Coordinate referrals with physicians, nurse practitioners, nursing staff, and other providers in accordance with payer requirements
• Perform clerical duties including answering telephone calls, retrieving medical records, recording data, typing memoranda, and filing patient charts
• Research claim edits, denials, billing discrepancies, and physician charge information; resolve discrepancies within required timelines
• Key charges, process batches, prepare bank/deposit summaries, review diagnosis and procedure codes, and enter point-of-service data
• Reconcile daily cash funds, securely manage payments, and meet site collection goals
• Provide backup support, support clinic and health-system operational initiatives, and provide training or orientation when assigned