Regional Business Office Consultant

**This position requires up to 75% travel, to support facilities in the Albuquerque, NM market**

We are a healthcare management company for skilled nursing facilities in New Mexico. The Regional Business Office Consultant plays a critical role in managing the financial aspects of our organization, ensuring accurate billing, timely collections, and efficient revenue cycle management among all the facilities within the organization.

Primary business office responsibilities include oversight of accounts receivable management, private pay billing, Medicaid pending accounts and Resident Trust Fund. This position is inclusive of all of the outlined duties and responsibilities for 3 facilities located in the Albuquerque NM. RBOC is to work daily with the each of the facility Business Office Managers, Billers, Revenue Cycle Manager and as needed, the Chief Revenue Cycle Officer (CCRO). Travel is required for this position and would be 75% of work schedule.

Essential Duties and Responsibilities
1. Managing Billing and Collections: Ensuring accurate and timely billing of services provided to patients, following up on outstanding payments, and coordinating with insurance companies to resolve any billing issues.

2. Revenue Cycle Management: Oversee the entire revenue cycle process, including making sure each facility verifies insurance coverage/benefits, request of authorizations and continued authorization, verification of common working file,

3. Financial Analysis: Analyzing financial data and reports to identify trends, patterns, and areas of improvement. Providing recommendations to management for enhancing revenue.

4. Compliance and Regulatory Compliance: Ensuring compliance with relevant healthcare regulations and guidelines, such as HIPAA, Medicare, and Medicaid. Staying updated with changes in billing and regulations.

5. Staff Management and Training: Supervising and training business office staff, ensuring they are knowledgeable about billing guidelines, billing procedures, and compliance requirements.

6. Performance Monitoring: Monitoring key performance indicators (KPIs) related to revenue cycle management, such as accounts receivable, days in accounts receivable. Identifying areas of improvement and implementing strategies to optimize revenue.

7. Technology Utilization: Utilizing healthcare information systems and revenue cycle management software effectively. Collaborating with IT teams to implement system upgrades and enhancements to improve billing and collections processes.

8. Patient Interaction: Assisting patients with questions regarding billing, insurance coverage, and payment options. If needed, resolving patient complaints or concerns related to billing or financial matters.

9. Financial Reporting: Preparing financial reports, analyzing financial data, and presenting findings to senior management. Providing recommendations for improving financial performance and revenue cycle efficiency.

10. Collaboration and Communication: Collaborating with other departments, such as finance, operations, and clinical teams, to ensure coordination and alignment in revenue cycle management processes. Communicating with insurance companies, vendors, and third-party payers to resolve billing and reimbursement issues.

Competencies·

• Prepared participation in daily/weekly/monthly facility meetings as requested by the facility CEO, e.g., “Triple Check”, “Medicare/Managed Care Review”, Start-up/Stand-up, etc.

• Working knowledge of basic billing procedures around Medicare A and Medicare C plans

• Creates enthusiasm for team effort; is an effective team builder; sets a model for teamwork that encourages common goals

• Uses all available and appropriate resources, including team members

• Interacts frequently with customers; takes initiative to inquire about customer needs and opinions and effectively manages concerns

• Able to prioritize work. Sets realistic deadlines for self and others and ensures deadlines are met;

• Presents ideas and information in a concise, well-organized manner

• Manages as if it were his/her own business, keeps up to date with best practices and new developments. Makes informed decisions within the scope of responsibility

• Sets precise, measurable goals that are realistic, challenging and compatible with company goals; demonstrates actions to meet those goals

• Is progressive in outlook; initiates new approaches and ideas; offers creative and effective solutions

• Receptive and open to new ideas; empowers and supports employees to make decisions

• Takes responsibility for his/her own training and development; follows up and integrates training when appropriate

• Listens, concentrates on information presented and takes action

• Observes early signs of changing conditions and responds effectively

MCOA Culture

MCOA is a high performance, collaborative environment, propelled by our LEAD customer service program. The expectation for each team member is to engage as a trailblazer in our complex and dynamic organization by adding value and support to fellow team members.

Work Environment
This job operates in a post-acute setting. This role requires regular walking to various locations around the facility. This role also routinely encounters patients who may have contagious illnesses. Team member is expected to adhere to facility’s no-smoking policy.
Physical Demands
While performing the duties of this job, the employee is regularly required to talk and hear. This position is very active and requires standing, walking, bending, kneeling, and stooping all day. The employee must frequently lift and/or move items over 20 pounds.
Position Type and Expected Hours of Work
This is a position in a post-acute setting that is open 24 hours a day, 365 days a year. Thus, weekend and holiday shifts may be required at times.

Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

HIPAA
Team members are required to adhere to policies and procedures implementing HIPAA requirements for the privacy and security of protected health information. Team members are permitted to use and/or disclose only minimum amount of Protected Health Information necessary to complete assigned tasks. Reports all suspected violation of company’s HIPAA policies or procedures to facility CEO.

Knowledge, Skills and Abilities
1. Interpersonal skills necessary in order to provide effective leadership of subordinates maintain a variety of internal and external contacts, and work cooperatively with a variety of facilities, managers, executives, and team members

2. Analytical abilities necessary in order to evaluate delivery of care systems; respond to deficiencies by identifying and implementing appropriate corrective action; develop and administer sound department policies, procedures and budgets; and organize and oversee work of subordinates

3. Ability to maintain confidentiality

4. Ability to communicate effectively with internal and external customers at all levels of the organization

5. Proficient computer and Microsoft Application skills. Must have an ability to learn new systems

6. Ability to work with a culturally diverse resident and employee population

7. Must have positive communication skills and demonstrated adequate maturity and patience

8. Proficient with the English language. Excellent communication (verbal and written), customer service and interpersonal skills

9. Must have strong organizational skills with attention to detail, as well as strong leadership skills

10. Must be able to successfully prioritize workload, demonstrate initiative, and analyze situations to make sound decisions based on available data

11. Ability to maintain a calm demeanor under pressure

12. Self-directing with the ability to work with minimal direct supervision

Required Education/Experience

• College/University Degree in Accounting, Business, or a related field

• Minimum of three (3) years’ experience in accounts receivable, collections or a similar role

Preferred Education/Experience

• Minimum of five (5) years’ experience in accounts receivable, collections or a similar role