Sup, Rev Cycle Mgmt, Hospital

University of Rochester•Rochester, MN

1d•Hybrid

About The Position

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Provides overall supervisory, technical support and direction to the team. Trains staff to understand and adhere to contract language by payer for appropriate reimbursement to the hospital and ensure the accuracy of account reconciliation. Monitors compliance with timely filing requirements and takes corrective action if guidelines are not followed. Maintains knowledge of all current third-party coverage, federal and state billing, and reimbursement and compliance regulations and procedures. Serves as a contact to answer questions, solve problems for difficult and unusual accounts, and assist in problem identification and resolution. Reviews, compiles, approves, and submits patient refunds and complete balance transfers. Reviews mid-dollar report for approval for write-offs. Ensures requests for information from patients and external contracting agencies are responded to in a timely manner. Prepares team operational reports and special reports as needed to identify key indicators using specific criteria measuring quality, quantity and timeliness of tasks performed. Prepares, and in collaboration with staff, reviews the weekly and monthly quality indicators in the billing area. Initiates corrective action or recommends solutions as appropriate. Prepares specific reports developed with payers to identify accounts requiring provider intervention. Resolves flagged reports to ensure timely submission of claims to payers. Monitors and ensures worklists are completed in a timely manner. Monitors cash flow, receivables, Hold Bills, Claim Edits, and aging reports, as well as payment and denial worklists. Performs monthly audits of account notes and adjustments. Attends monthly team meetings with the Outpatient Manager and appropriate payer representatives. Runs, distributes and ensures resolution of accounts on reports. In collaboration with leaders, develops audit procedures within billing area to ensure payments from all third-party payers are based on rates identified on negotiated contracts. Ensures timely processing of secondary credit balances for government plans. Reviews reports generated within the billing systems to ensure accuracy and reconciliation. Coordinates and provides support for all internal and external billing audits, reviews or projects. Provides training, coaching and reinforces billing and customer service skills to team members to ensure exceptional service. Seeks feedback from other departments to improve processes and level of service within internal department area. Communicates with other departments regarding problem visits. Develops goals, objectives and operating policies and procedures for the billing team, in collaboration with leadership. Develops cross training programs within specific billing area for outpatient billing. Adds policies and procedures to the Patient Accounts shared drive. Completes performance evaluations for designated staff. Screens, reviews, interviews and make recommendations for new hires. Handles time reporting requirements in accordance with state and federal regulations. Addresses personnel disciplinary issues. Represents department at meetings and seminars, when appropriate. Provides cross coverage for leadership peers in other department areas, as needed. Represents the department on various internal and external committees, as needed. Attends continuing education seminars offered by local payers, as well as by Medicaid and Medicare. Other duties as assigned.

Requirements

Bachelor's degree and 2 years of relevant experience required Or equivalent combination of education and experience

Responsibilities

Organizes and conducts operations that affect the revenue cycle (e.g., billing, collections, payment processing).
Develops and implements processes to meet revenue cycle goals in collaboration with medical practices.
Conducts related training, monitoring, analysis and reporting on revenue cycle processes and results.
Develops and implements practice-specific process improvement recommendations.
Coordinates and supervises the daily activities of a support, production or operations team.
Sets priorities for the team to ensure task completion.
Provides overall supervisory, technical support and direction to the team.
Trains staff to understand and adhere to contract language by payer for appropriate reimbursement to the hospital and ensure the accuracy of account reconciliation.
Monitors compliance with timely filing requirements and takes corrective action if guidelines are not followed.
Maintains knowledge of all current third-party coverage, federal and state billing, and reimbursement and compliance regulations and procedures.
Serves as a contact to answer questions, solve problems for difficult and unusual accounts, and assist in problem identification and resolution.
Reviews, compiles, approves, and submits patient refunds and complete balance transfers.
Reviews mid-dollar report for approval for write-offs.
Ensures requests for information from patients and external contracting agencies are responded to in a timely manner.
Prepares team operational reports and special reports as needed to identify key indicators using specific criteria measuring quality, quantity and timeliness of tasks performed.
Prepares, and in collaboration with staff, reviews the weekly and monthly quality indicators in the billing area.
Initiates corrective action or recommends solutions as appropriate.
Prepares specific reports developed with payers to identify accounts requiring provider intervention.
Resolves flagged reports to ensure timely submission of claims to payers.
Monitors and ensures worklists are completed in a timely manner.
Monitors cash flow, receivables, Hold Bills, Claim Edits, and aging reports, as well as payment and denial worklists.
Performs monthly audits of account notes and adjustments.
Attends monthly team meetings with the Outpatient Manager and appropriate payer representatives.
Runs, distributes and ensures resolution of accounts on reports.
In collaboration with leaders, develops audit procedures within billing area to ensure payments from all third-party payers are based on rates identified on negotiated contracts.
Ensures timely processing of secondary credit balances for government plans.
Reviews reports generated within the billing systems to ensure accuracy and reconciliation.
Coordinates and provides support for all internal and external billing audits, reviews or projects.
Provides training, coaching and reinforces billing and customer service skills to team members to ensure exceptional service.
Seeks feedback from other departments to improve processes and level of service within internal department area.
Communicates with other departments regarding problem visits.
Develops goals, objectives and operating policies and procedures for the billing team, in collaboration with leadership.
Develops cross training programs within specific billing area for outpatient billing.
Adds policies and procedures to the Patient Accounts shared drive.
Completes performance evaluations for designated staff.
Screens, reviews, interviews and make recommendations for new hires.
Handles time reporting requirements in accordance with state and federal regulations.
Addresses personnel disciplinary issues.
Represents department at meetings and seminars, when appropriate.
Provides cross coverage for leadership peers in other department areas, as needed.
Represents the department on various internal and external committees, as needed.
Attends continuing education seminars offered by local payers, as well as by Medicaid and Medicare.
Other duties as assigned.