Job Description

The Patient Accounts team within Sunnybrook Health Sciences Centre's Finance department has an immediate opening for a Ministry of Health (MOH) Accounts Receivable Specialist. This full-time, 24-months temporary position will play an important role within this fast-paced department responsible for billing and collecting revenues across the Hospital. This role facilitates and oversees the OHIP billing process for Medical Imaging procedures performed at the Hospital.

Summary of Duties

MOH Billing & Reconciliation:

Post and reconcile Ministry of Health (MOH) remittances to bank deposits. Review and post exceptions and payment clawbacks; follow up with MOH to resolve discrepancies and complex billing issues. Ensure hospital billing system (HRCM) aligns with MOH Schedule of Benefits and stay current with MOH guidelines and bulletins. Review billing rules with the Department of Medical Imaging to ensure MOH compliance.

Accounts Receivable & Financial Reporting:

Reconcile A/R control accounts to the General Ledger and manage prepayments, applying payments to charges and preparing refund cheques for overpayments. Prepare journal entries to allocate revenue to appropriate cost centres. Prepare and present monthly financial reports to Radiologists and Hospital leadership. Monitor and review aging reports; identify and execute adjustments; investigate and resolve anomalies and discrepancies.

Physician Payments & Bad Debt Management:

Prepare cheque requisitions to compensate physicians based on exams performed. Prepare Medical Imaging bad debt write-offs and maintain accurate financial records.

Team Leadership & Support:

Supervise and support two billing clerks, ensuring timely and accurate billing processes. Provide guidance and updates on billing rules, supporting team development. Collaborate with manager and team to address and resolve aging report issues.

Stakeholder Communication & Liaison:

Liaise with MOH, Radiology staff, Physicians, and external departments regarding billing issues, processes, and procedures. Communicate with patients to resolve outstanding billing issues or concerns.

Policy, Compliance & Continuous Improvement:

Develop and maintain Medical Imaging billing policies and procedures. Maintain up-to-date technical knowledge of MOH billing practices to maximize revenue and ensure compliance. Contribute to team initiatives and complete ad hoc duties as required.

Qualifications and Skills:

In order to succeed in this role, the successful candidate must possess the following required and preferred qualifications and skills:

REQUIRED:

Completion of a diploma program in Business Administration or equivalent. Superior knowledge of OHIP billing, practices, and procedures required. Minimum 5 years of OHIP billing experience. Advanced knowledge of medical terminology is preferred Knowledge of the MOH Schedule of Benefits and a demonstrated ability to interpret it is an asset. Excellent written and oral communication skills with the ability to communicate effectively with many different internal and external stakeholder groups. Advanced knowledge of MS Office suite of products (e.g. Word, Excel). Excellent organizational and time management skills with the ability to multi-task ad hoc projects, while ensuring the billing and collection goals are achieved. Demonstrated ability to work independently.

PREFERRED:

Understanding of Canadian immigration policies and OHIP eligibility requirements. Prior work experience in a healthcare setting. * Experience using HCRM/MediAR or other healthcare patient billing systems.