Revenue Cycle Manager (Prior Authorizations) - Patient Access Management (PAM) - Patient Financial Services (PFS)

University of Iowa•Iowa City, IA

29d•Hybrid

About The Position

The University of Iowa Health Care department of Patient Financial Services is seeking a Revenue Cycle Manager (RCM) position in the healthcare industry who will be responsible for planning, coordination and management of all aspects of revenue cycle management operations and projects for the Prior Authorization team within PAM. The RCM will have responsibility for supervising 2-5 front-line supervisors, each with additional direct staff report and will manage and direct revenue activities. The RCM will ensure accurate and timely collection all patient information related to registration responsibilities while ensuring day to day operations are conducted in full alignment with Service Excellence standards. The RCM will assist in the coordination of financial assistance activity in collaborative efforts with internal Social Services and Patient Billing units. This position is primarily a combination of remote and onsite (hybrid) work locations. Remote work must be performed at an offsite location within the State of Iowa. Training will be held either on ONSITE at the HSSB building or via zoom, with location and length of training determined by the supervisor. Remote eligibility will be evaluated upon a satisfactory job training opportunity. Per policy, work arrangements will be reviewed annually and must comply with the remote work program and related policies and employee travel policy when working at a remote location. The University of Iowa Health Care-recognized as one of the best hospitals in the United States-is Iowa's only comprehensive academic medical center and a regional referral center. Each day more than 12,000 employees, students, and volunteers work together to provide safe, quality health care and excellent service for our patients. Simply stated, our mission is: Changing Medicine. Changing Lives.

Requirements

Minimum 6 years of medical revenue cycle experience.
Minimum of 3 years of patient access experience with proven analytical skills in the interpretation of financial data.
Proficiency with typical office software such as Microsoft Office Suite (Word, Excel, PowerPoint,)
Experience with multiple technology platforms such as Epic, Web-Based Prior Authorization submission portals, etc.
Success for driving results and instilling accountability throughout the team and organization.
Success with identifying trends, opportunities for operational improvement, etc and providing solutions to improve processes and workflows.
Conflict management skills driving professional and respectful interactions.
Maintain current and aware of industry trends and continually strives for improvement with both technical and professional skills.
Knowledge of HIPAA laws, CMS regulations and treats all information received confidentially.
Supervisory experience (typically 1-3 years) in a high-volume, fast-paced Customer service teamwork environment successfully resolving a variety of personnel issues.
Strong planning and organizational skills.

Nice To Haves

Knowledge of insurance benefits and requirements as related to individual companies and policies.
Knowledge of Epic Prelude, Cadence and Referral modules.
Knowledge of Electronic Eligibility Systems.
Proven collaborator and consensus builder - someone who has a track record of successfully partnering with academic medical staff.

Responsibilities

Develop, implement and enhance standardized prior authorization workflows for new and existing processes.
Determination of prior authorization requirements necessary for workflow triggers for new and existing payers to ensure compliance with payer requirements and regulatory guidelines.
Design, test and implement work processes and technology to promote automation and to increase process efficiencies.
Educate clinical staff on authorization requirements to enhance collaboration and prevent delays.
Ensure accurate and timely collection of all patient information related to prior authorization responsibilities.
Monitor statistical data; including work drivers and denials to monitor, recommend and implement operational procedures and protocols to improve services and reduce costs.
Assist in planning, developing and implementing computer applications, upgrades to billing system, Epic workflows and category lists and other bolt-on software products.
Assist in the coordination of financial assistance activity in collaborative efforts with other PAM units, Departments and internal Social Services and Patient Billing units.
Work closely with the PFS Training Department to create training curriculums and communicate areas of training needs specific to the PAM staff.
Ensure day to day operations are conducted in full alignment with Service Excellence standards.
Drive excellence in all areas of operations by focusing on People, Quality, Service, Financials, Growth and Employee Motivation. Define and track key performance measures, monitor progress, and consistently deliver results.
Develop, implement and monitor staff performance standards including development of motivational incentives within established institutional and state guidelines.
Develop and present to PFS Leadership and UIHC Administration on critical topics tied to revenue management and patient access.
Assist Associate Director with compilation and preparation of special and periodic statistical and financial reports for the Senior Director of Patient Financial Services, Finance, Clinical Department Administrators, Clinic Department Executive Officers, as well as College of Medicine and Hospital Administration.
Perform human resource functions including interviewing, selection, training, performance evaluation, promotion and disciplinary action.
Schedule and assign all supervisory and clerical staff in the assigned areas ensuring staffing levels are maintained to provide excellent patient experience.
Respond to inquiries and complaints from patients, clinical and hospital staff, and public; determine escalation of patient accounts to upper management.
Assist Associate Director in the establishment of annual operating budgetary needs for designated departments and monitor performance to achieve targeted levels of fiscal performance.