Manager, RMF Revenue Cycle

DHR Health - US:TX:Edinburg - Days

Summary:

MISSION STATEMENT:

Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time.

VISION:

Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence.

POSITION SUMMARY:

Manage and coordinate the overall functions of our centralized Professional Revenue Cycle to ensure timely, legally compliant, and accurate billing while maximizing the cash flow related to the collections of Account Receivable. Develop and maintain the company's policies for charges, payments, appeals and collection practices. Other responsibilities include resolving difficult billing problems; assisting with the preparations of the operating and capital budgets; and maintaining knowledge of third-party payer regulations including Medicaid, Champus, Workers Compensation and non-governmental payers. You will also manage the training, supervision and job evaluations of assigned personnel and recommend merit increases, promotions and disciplinary actions as appropriate.

POSITION EDUCATION/QUALIFICATIONS :

• Three (3) years of Professional Revenue Cycle experience including 2 years as a Manager over Billing or Collections.
• High School/GED required
• Bachelor's degree in Business Administration, Accounting or related field is preferred
• Excellent customer service skills.
• Computer skills required with knowledge of Microsoft Office suite.
• Good written and verbal communication skills required.
• Bilingual – English/Spanish.

JOB KNOWLEDGE/EXPERIENCE :

• Three ( 3 ) years of proven managerial / leadership experience ideally at the Director level preferred.

• Seven ( 7 ) years of experience in Hospital Admissions.

• Working knowledge of managed care (i.e. Medicare, Medicaid, Blue Cross, and related federal and state regulations / requirements).

• Knowledge of government and insurance payers admission and billing regulations; proven computer system and various software program experience.

• Demonstrated knowledge of operations and healthcare management; TJC and other local, state and federal regulations.

• Communicates clearly and concisely and is able to work effectively with other employees, patients and external parties.

• Demonstrates proficiency in Microsoft Office applications, be able to type at least 35 WPM, and good working knowledge of Excel is required.

• Medical Terminology, ICD-10 Codes, CPT Codes, HCPCS code, Modifier knowledge preferred.

• Able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly and spell correctly.
• Requires reasoning ability, good independent judgment and organizational skills.
• Requires working with frequent interruptions.

Must project a professional image.

Responsibilities:

POSITION RESPONSIBILITIES:

• Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices.
• Ability to manage teams billing multiple specialty types
• Meets regularly with Professional Revenue Cycle Managers/Supervisors for the purpose of establishing Professional Revenue Cycle goals and objectives in addition to monitoring Revenue Cycle performance
• Coordinates available resources for all Professional Revenue Cycle needs
• Responsible for orientation of new Professional Revenue Cycle Managers/Supervisors
• Performs regular audits of Professional Revenue Cycle operations
• Ensures that corporate policies are disseminated and adhered to
• Maintains open lines of communication with all members of organization
• Assists in the development and implementation of the annual budget
• Participates in DHR committees as appropriate
• Participates and executes project directly impacting billing
• Attends assigned organizational meeting and revenue cycle department meeting
• Analysis current workflows and adjusts or recommends areas of improvement
• Works closely with Business Intelligence department on reporting and approved billing system
• May be assigned other duties by CAO/VP Professional Revenue Cycle
• Conducts or assists with special projects as requested by the VP Professional Revenue Cycle, Chief Revenue Officer and Chief Financial Officer and any other member of the senior management team.

• Other duties as assigned
  

LINES OF REPSONSIBILITY :

(Chain-of-command)

1. Director of Professional Revenue Cycle 2. VP of Revenue Cycle 3. Chief Ambulatory Officer

Other information:

CUSTOMER SERVICE:

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

AGE SPECIFIC :

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret the appropriate information needed to identify each patient’s requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT: (ADA) :

A. Essential Duties : Indicated by bold print within performance standards, preceding individual numbered criteria.

The following table provides physical requirements that will be associated with, but not limited to, this position:

B. Working Conditions : The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.

C. Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

D. Aptitudes : HIGH 1 2 3 4 5 6 LOW

Intelligence: General learning ability: The ability to “catch on” or understand instructions and underlying principles. Ability to reason and make judgments. 3

Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3

Numerical: Ability to perform arithmetic operations quickly and accurately. 2

Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to “visualize” objects or two or three dimensions, or to think visually of geometric forms. 2

Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3

Clerical Perception: Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2

Motor Coordination: Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3

Finger Dexterity: Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3

Manual Dexterity: Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3

Eye-Hand-Foot Coordination: Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3

Color Discrimination: Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3

I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform.

If applicable ____________ certification will be completed within _________ time frame of hire/transfer date.

Employee Signature: ________________________________ Date: ____________________

Transfer/Hire Date Effective: ________________________.