WHAT YOU CAN EXPECT

• Quality Assurance

• Records and evaluates results and audits completion of staff mandatory QA requirement

• Collections Procedures

• Maintains collection procedures and working relationships with area responsible for pertinent information, including the Medical Records Department, Patient Access, and/or physicians.

• Informs management of any negative reimbursement trends or aspects that should be modified.

• Training Education

• Plans, develops, coordinates, evaluates and oversees the in-service training for staff.

• Performance Management

• Supervises the work of others and manages the performance of individuals through feedback and recommendations.

• Performance Improvement - Services

• Identifies and monitors opportunities for performance improvement of services.

• Policy Development

• Assist in the development of department policies, procedures, and training materials.

• Vendor Management

• Attends meetings with payer and vendor representatives regarding issues.

• Revenue Cycle KPIs

• Implements process innovations and works closely with Insurance Payers, Revenue Cycle leadership and Department Managers in revenue-producing departments to reduce denials and to improve upon the Revenue Cycle KPIs.

• Trends and Root Cause

• Analyzes reports and uses software to track, trend and identify root causes of denials; offers suggestions for process improvement to resolve denial issues, supported by documentation and data.

• Department Collaboration

• Collaborates with other departments to align interdepartmental goals and expectations.

• Reimbursement Trend Reporting

• Informs leadership of any reimbursement trends and reviews monthly billing productivity reports.

• Interdepartmental Coordination

• Coordinates department efforts with other departments to align interdepartmental functioning, strategic goals, and expectations.

• Workflow

• Develops and monitors a structured, organized workflow to ensure actions carried out consistently and accurately.

• Escalation Management

• Acts as the first point of escalation within the team by acting as a coach and mentor.

• Reporting

• Prepares operational progress or status reports on a regular periodic basis.

• Relationship Management

• Independently develop effective relationships with patients, hospital departments, and other external parties.

• Compliance Oversight

• Ensures compliance with state and federal billing regulations. Reports suspicious activities to leadership.

• Revenue Cycle Goal

• Works with management to increase efficiencies to achieve Revenue Cycle goals.

• Report Documentation Preparation

• Develops reports, policies, procedures and training materials for coworker training and business improvements.

QUALIFICATIONS

• Preferred associate's degree