Role Description
This position is responsible for providing strategic direction in support of critical Revenue Cycle initiatives and goals. Leads and manages complex Revenue Cycle projects and staff, drives performance, and provides the overall direction and oversight of the functional areas that support the organizationβs financial and operational goals, to include:
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Patient eligibility and demographics
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Billing
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Accounts receivable
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Related analytics and reporting
Develops, implements, and maintains documented best practices and strategic operations related to revenue cycle functions throughout the organization. Ensures compliance with CMS and payer regulations and company policies. Fosters and promotes a culture of excellence in customer service to internal and external clients. Builds trust and collaboration amongst direct reports to create a team environment by enhancing employee engagement, addressing performance results, and providing coaching and mentoring.
Qualifications
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7+ years of business operations experience (call center, enrollment, billing, payment processing, or similar operations) preferably in a healthcare environment
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3+ years of management experience including responsibilities for strategy, oversight of operations analytics, and managing performance of staff
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5+ years of experience in operations related data analytics and reporting to drive performance and quality
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Health insurance and project management experience preferred
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Strategic planning, business planning, and budget development/management experience required
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Strong motivational, written, oral, presentation, and communication skills
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Demonstrated ability to collaborate and achieve results via interpersonal and influencing skills
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Demonstrated customer focus, prioritizing internal and external customer satisfaction
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Proficiency in MS Office applications; database management experience a plus
Requirements
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Partner with the RCM team to provide operational reporting, claims analysis, and workflow support
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Develop revenue cycle KPIβs and reports with focus on quality, efficiency, and throughput
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Design decision flowcharts to help document existing workflows and quickly design new ones as needed
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Proactively monitor the efficiency of workflows through reporting to identify bottlenecks and provide root cause analysis
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Develop and incorporate financial models into workflows that help determine next best steps
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Proactively analyze outstanding claims along with denial and collection trends to forecast collections and provide timely feedback
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Help identify opportunities for improvement and optimization through technology solutions
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Provide workforce management reporting and analysis to better understand cost and efficiency
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Stay abreast of regulatory requirements and overall reimbursement landscape to ensure compliance
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Work closely with other departments outside of the revenue cycle to streamline processes and procedures
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Oversee the development and maintenance of departmental policies and procedures for revenue cycle departments
Benefits
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Regular eye-hand coordination and manual dexterity is required to operate office equipment
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The ability to perform work at a computer terminal for 6-8 hours a day
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Function in an environment with constant interruptions
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Ability to lift and move material weighing up to 20 lbs
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May experience elevated levels of stress during periods of increased activity and multiple deadlines