Sup, Rev Cycle Mgmt, Hospital

University of RochesterCity of Rochester, NY
6d$25 - $35Hybrid

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. Location: Rochester Tech Park (RTP), Gates, NY - Remote options available after in-person training. Occasional onsite meetings / work at RTP are required. Remote location must be within 2 hours of RTP and within New York State.

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.
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