Medical Practice Administrator
MEDICAL PRACTICE ADMINISTRATOR
Full time, exempt (salaried) position, reporting to managing partner.
Overall responsibility for planning, leading, directing day-to-day operations and managing all staff; reporting to Physician Owners.
Leading and Planning
Skilled in strategic planning to assist in setting and achieving long-term goals.
Leads physicians in developing business plan and responsible for implementing it.
- Recommends, develops and implements improvements for the practice – an ongoing and indefinite process as the environment and goals change.
- Stays abreast of current trends in industry which can impact regulatory compliance and practice goals
- Skilled in gathering and interpreting data, analyzing situations accurately and taking effective action
- High degree of initiative, judgement, discretion, decision-making and problem solving skills
- Ability to analyze data and take effective action to meet goals, i.e. maximizing revenue and productivity
- Physician productivity analysis and recommendations for maximization
- Develops operating policies, procedures and processes
- Process improvement analysis to achieve excellence
- Marketing including website
- Growth and competition assessment and opportunities for other geographic markets, i.e. additional offices
Financial Management
Financially accountable to physicians and able to handle complex financial transactions, including detailed understanding of “double-entry” accounting, general ledger systems, income statements and balance sheets.
- Works with CPA for preparation of tax returns and other accountant prepared financial reporting
- Prepares quarterly and year-end financial summaries/reports, including trends and benchmarking surveys for use to achieve “better performing” and other desired results
- Reviews monthly financials for accuracy, proper account coding and trends/outliers
- Applies “internal controls” to:
- Safeguard assets
- Deter and detect fraud, errors and theft
- Ensures integrity of financial information
- Understands/interprets business contracts including lease agreement language and its duties and impact on practice
- Cash flow projections
- Reviews outside accountant’s reconciliation of revenue against bank statements/general ledger/patient accounts for accuracy. (Reconciliation not performed by administrator for internal controls/separation of duties.)
- Accounts payable/asset management
- Inventory control - identifies necessary supplies and equipment
- Procurement process - obtains competitive bidding from vendors
- Reviews invoices for accuracy and authorization
- Facilities, equipment and inventory management
Risks and Compliance Management
- Compliance with Medicare and all regulatory agencies that governs health care delivery
- Knowledge of anti-kickback and self-referral regulations
- Physician licensing including regulations for prescribing controlled substances
- Malpractice risks mitigation
- Legal requirements of record keeping (medical chart)
- Knowledge of Texas Medical Board rules for physicians
- Disposal of biohazardous medical waste
- Medical records management and compliance with HIPAA
Organizational Governance
- Legal structure
- Partnership Agreement
- Impact on revenue/expense allocation and related tax returns
- Growth and sustainability of partnership: participates in physician recruitment, employment contract and responsible for all steps to “on-board” new physician.
- Assesses/analyzes alternative practice models (i.e. employed)
- Capable of developing or implementing physician compensation plans, revenue/expense allocation methods
Third Party Payer Contracts
- Ability to interpret and understand ramifications of contract language
- Ensures third party adherence to contract including fees and claims adjudication
- Performs reimbursement analysis
- Negotiates fees and other contract obligations when applicable
- Develops and enhances relationships with third party provider representatives
Daily Operational Management
Accounts Receivable (Revenue Cycle) Management
Oversees and manages charge capture of all services, accurate procedure and diagnosis coding, prior authorization, benefit verification, claims billing, denial and appeal management, collection from payers based on contracted fee schedules, patient financial responsibility collection and final disposition of any unpaid services i.e. write off or referral to collection agency.
- Appropriate documentation and audit trail of charges and claims filing
- Stays abreast of payer policies, including Medicare reimbursement regulations
Quality Patient Care Support
- Staff accountability in achieving high patient and physician satisfaction (clinical, billing and administrative)
- Efficient and effective patient work flow (physician and staff)
- Timely and appropriate chart documentation (physician and staff)
- Develops effective working relationships with key hospital departments/personnel which directly impacts patient care and practice efficiency
Human Resource Management
- Hires and fires all staff
- Implements and oversees training of staff to meet performance standards
- Manages employee performance including motivation and teamwork to obtain high effective and efficient performance including high patient satisfaction
- Determines number of employees needed to accomplish task, restricting when necessary
- Writes job descriptions
- Classifies job categories
- Uses market benchmarks to establish competitive wages
- Develops comprehensive benefits package to compete in relevant market
- Evaluates employee performance and makes recommendations for salary/bonus
- Identifies skills required and develops training specific to meet performance needs/goals
- Compliance with employment law (state and federal), including payroll
- Employee Manual – developed with practice attorney to achieve compliance with applicable employment law including incentives to achieve practice goals.
- Conflict resolution and team building
I.T. Management
Utilizes qualified expert for monitoring and maintenance of all hardware and software, including security and backup of data and reliable access to all necessary and critical programs. Examples: email, internet, networks, servers, practice management software, hospital software etc. Also includes:
- HIPAA compliance for protected electronic data
- Assesses and recommends appropriate computer needs (fit for purpose and cost/benefit analysis)
- Applies updates to software as appropriate
- Secure, remote back up with disaster planning/recovery
- Telephone systems
Miscellaneous
- Physician credentialing (third party payers and hospitals)
- Physician licensing
- Mal-practice coverage
- Business insurance coverage
- Maintenance of physician professional files
Education Minimum of Bachelor’s degree in Business Administration or Accounting
Experience Minimum of 5 years in health care administration management
Certification CMPE (Certified Medical Practice Executive) by MGMA, preferred