Manager Business Operations - Physical Medicine and Rehab (Full Time)

UnityPoint Health•Cedar Rapids, IA

22h

About The Position

The Manager Business Operations for PMR is accountable and responsible for overseeing business office operations within our PMR division. As Business Operations Manager, assures accurate and timely billing, scheduling, charge and data entry, insurance pre-authorization and benefit verification, report preparation, filing and record keeping and other duties which assist with the delivery of timely and effective rehabilitation services. Also responsible for overseeing all financial workques assuring payment is timely and all denials reviewed and appealed as needed for the Division. The Manager has responsibilities in the areas of planning, organizing, budgeting, supervising, evaluating, staffing, scheduling, training and educating scheduling/financial specialists. Is responsible for financial/chart audits, divisional charge master for PMR services. Works closely with St. Luke’s financial analyst to assure reimbursement is captured per payer contract. Has management responsibility of all PMR outpatient clinic front office staff, insurance specialist, and Leads of business office services in the PMR division. Why UnityPoint Health? At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members. Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in. Here are just a few: Expect paid time off, parental leave, 401K matching and an employee recognition program . Dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members. Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow your family . With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together. And, we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience. Find a fulfilling career and make a difference with UnityPoint Health.

Requirements

Bachelor’s degree in Administration, Business or Bachelor’s degree in a medical field required, or an equivalent combination of education and experience.
Writes, reads, comprehends and speaks fluent English
Experience in Microsoft Word, Excel, Power Point and Outlook
Must demonstrate an aptitude and interest in health care billing functions and reimbursement.
Applies well-developed human relation skills in individual and group interactions

Nice To Haves

Prior health care experience preferred
Five years business office experience in a health care setting preferred
Management experience preferred
Experience with medical insurance processing preferred
Extensive knowledge of Medicare, Medicaid, ICD-10 CCI edits, local payer coding and billing guidelines as they pertain to physical, occupational, or speech therapy is preferred
Requires extensive knowledge of commercial and worker’s compensation insurance
Understands health care reform related to assigned area
High organizational skills
Ability to multi-task
High attention to detail
Possess a high level of integrity and initiative and communicates effectively

Responsibilities

Collaborates with Physical Medicine and Rehabilitation management, physicians and others to facilitate planning, implementation and evaluation of strategic plan and other initiatives including recommending annual goals and objectives for assigned area.
Assists with planning and implementation of written goals and objectives.
Effectively communicates hospital and division mission, vision and strategic framework.
Facilitates the organization and coordination of the delivery of services and care provided through assigned area.
Assists Director of PMR with development of annual F.T.E’s., revenue and expense budgets, and capital budgets for PMR division.
Reviews referral and monthly data for the division to analyze trends and advise on potential referral development opportunities.
Assists with management of PMR division wide business operations.
Responsible for the daily management of the business office personnel and delegation of duties to ensure the efficient operation of the business office
Investigates variances and initiates corrective action or justifies non-adherence to quality, financial and patient satisfaction outcome goals.
Maintains appropriate office support staffing levels to meet business service needs.
Assists with process improvements for supply management, approves supply orders
Oversees staffing of business office functions in accordance with FTE budgets for PMR division.
Supports business office Leads and PMR managers to screen applications, conducts phone interviews, sets up and completes in person interviews for scheduling and finance specialists.
Works closely with Leads to ensure all orientation and on-boarding of scheduling and finance specialists occurs effectively.
Completes and delivers performance assessments for scheduling and finance specialists and office Leads.
Works with PMR business office Leads to assure daily staffing needs are being met, and to determine schedule changes and staff reallocation.
Collaborates with all relevant PMR areas to determine schedules and staff reallocation.
Anticipates staffing and scheduling needs, overtime usage and vacation replacement needs.
Ensures adequate competence of scheduling/financial specialist staff in assigned areas.
Assists with in-service, on-the-job training and continuing education programming to meet identified staff development needs.
Assists with education programming for staff in assigned area.
Oversees office lead scheduling and financial specialists for PMR division who is responsible for adequate staffing, orientation, competency training, and denials, and assisting supervisor with projects and performance improvement.
Oversees and ensures the timely processing of department payroll in all the PMR outpatient areas as it relates to schedulers/financial specialist/insurance coordinators.
Oversees scheduling/receiving/greeting of patients.
Ensures welcoming environment for person’s served.
Effectively manages positive relationships with referral sources and other members of the team.
Oversees billing/insurance/counseling : insurance verification, pre-authorizations, benefits checking of all incoming patients, and patient notification of insurance coverage for therapy, which may include coordination with Price-line and counseling patient on process for prompt pay and financial assistance applications.
Stays current on changes with insurance plans (HealthPartners, Medicaid). Updates schedulers and therapists on changes.
Oversees accurate billing/collection/denials.
Oversees the proper and accurate posting of payments and adjustments to patient accounts.
Resolves insurance denials and patient concerns regarding billing.
Problem solves, analyzes and collaborates with patient, therapist, providers, case managers, Central Billing Office, Revenue Cycle department, and insurance companies to identify and resolve billing and denial issues, including sending appeals and trouble-shooting and correcting claim or account errors.
Responsible for the management of medical records, ensures proper storage, retrieval and release of medical records.
Manages and oversees insurance specialist and business office front line staff to assure Monitors are in place and accounts are complete on multiple work queues in EPIC, including referrals and denials.
Identifies denial and billing processes that need improvement to maximize efficiency and ensure proper payment within the department.
Responsible for processing and reconciling of month end reports.
Oversees data collection and is responsible for summaries of statistics and data.
Oversees the maintenance of scheduler orientation manuals and insurance resource files
Oversees outcome collection and data entry
Maintains the PMR division charge master and assures timely updates.
Incorporates latest reimbursement guidelines into billing process.
Serves as liaison between PMR division, St. Luke’s finance department and UnityPoint CBO and charge master personnel.
Conducts/oversees routine billing audits with collaboration from appropriate departments to validate accuracy and compliance.
Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.
Demonstrates ability to meet business needs of department with regular, reliable attendance.
Employee maintains current licenses and/or certifications required for the position.
Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.
Completes all annual education and competency requirements within the calendar year.
Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse.
Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff.
Takes appropriate action on concerns reported by department staff related to compliance.