Revenue Support Manager

Fresenius Medical Care • Detroit, MI

3d

About The Position

PURPOSE AND SCOPE: Responsible for managing all aspects of the commercial revenue function in the Division. This involves the monitoring, analysis and evaluation of pertinent financial and marketing data; detailed tracking and follow-up of all commercial revenue including coordination dates, as well as lost and new commercial patients. PRINCIPAL DUTIES AND RESPONSIBILITIES: Responsible for timely and accurate communication of executed payer agreements to Division management and Revenue Centers. Responsible for compliance with all related data collections and auditing activities as well as contract implementation analysis. Responsible for auditing of billing system to insure accuracy of third party payer contracts. Responsible for tracking contract escalators and timely notification of increases to billing offices. Responsible for monthly review of P&L accounts to identify loss and marginal facilities tied to payer mix. Perform various financial analyses to assist with contract proposals including: analysis of Standard Carrier claims data obtained through the Financial Datamart, analysis of medication utilization for global contracts and analysis of rate structure conversion. Maintains monthly patient insurance download data according to Managed Care directions. Provides business/ payer mix/ revenue by payer/treatment mix on a monthly basis. Produces analytical reports to support managed care efforts on a monthly or as needed basis Review of billing accuracies to ensure that projected revenue is being realized. Maintain monthly report that specifically lists and tracks all patients reimbursing according to commercial rates or single patient Letters of Agreement. Development and maintenance of contract database Performs quarterly analysis of network data for growth. Performs and maintains competitive analysis of individual markets and competitive provider activity. Maintains data base on health plan membership by product. Mentor other staff as applicable. Assist with various projects as assigned by a direct supervisor. Other duties as assigned. Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Requirements

• Bachelor’s Degree required in Accounting / Finance, Business or Health Management
• 5 – 8 years’ related experience; or a Master’s degree with 3 years’ experience; or a PhD without experience; or equivalent directly related work experience.
• Working knowledge of Generally Accepted Accounting Principles (GAAP).
• Strong computer skills with demonstrated proficiency in word processing, spreadsheet, database and email applications.
• Detail oriented with strong analytical and organizational skills.
• Strong oral and written communication skill to effectively communicate with all levels of management.

Nice To Haves

• Residing in CST or EST time zone, highly preferred.
• Healthcare experience, highly preferred.

Responsibilities

• Responsible for managing all aspects of the commercial revenue function in the Division.
• Responsible for timely and accurate communication of executed payer agreements to Division management and Revenue Centers.
• Responsible for compliance with all related data collections and auditing activities as well as contract implementation analysis.
• Responsible for auditing of billing system to insure accuracy of third party payer contracts.
• Responsible for tracking contract escalators and timely notification of increases to billing offices.
• Responsible for monthly review of P&L accounts to identify loss and marginal facilities tied to payer mix.
• Perform various financial analyses to assist with contract proposals
• Maintains monthly patient insurance download data according to Managed Care directions.
• Provides business/ payer mix/ revenue by payer/treatment mix on a monthly basis.
• Produces analytical reports to support managed care efforts on a monthly or as needed basis
• Review of billing accuracies to ensure that projected revenue is being realized.
• Maintain monthly report that specifically lists and tracks all patients reimbursing according to commercial rates or single patient Letters of Agreement.
• Development and maintenance of contract database
• Performs quarterly analysis of network data for growth.
• Performs and maintains competitive analysis of individual markets and competitive provider activity.
• Maintains data base on health plan membership by product.
• Mentor other staff as applicable.
• Assist with various projects as assigned by a direct supervisor.
• Other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees