Healthcare Provider

QUALIFICATIONS AND EDUCATION REQUIREMENTS

• Bachelor’s degree in Healthcare Management or Business Administration, Master’s degree preferred
• 10+ years of progressive management experience
• Minimum 5 years of management experience or experience working in a healthcare organization
• Minimum of 5 years Revenue cycle operations knowledge
• Knowledge of current behavioral health industry trends, regulations, and policies strongly preferred
• Knowledge of medical terminology
• Must be able to assess situations, identify issues/problems and prioritize duties
• Proficient in Microsoft Office applications required
• Strong working knowledge of EMR
• Strong interpersonal skills, including the ability to manage others to inspire behavioral changes and work effectively with all levels of the organization.

ESSENTIAL DUTIES:

• Oversee all Revenue Cycle functions to assure proper handling and direct billing activities to ensure timely billing and reimbursement
• Assess and respond to current and future internal and external healthcare trends in order to establish and ensure the necessary direction for the revenue cycle activities.
• Develop denial management processes to eliminate denial root causes and reduce the denial impact on the organization.
• Review departments' performance and ensures compliance, accreditation, legal and other regulatory requirements.
• Partner with finance and operations teams to evaluate collection capabilities and adherence to payer contracts.
• Manage individual(s) including, but not limited to, hiring, training, work assignments, performance evaluation, and conducts professional development plans.
• Ensure productivity meet and support the operational goals of Revenue Cycle Management.
• Continually improves processes, implements industry best practices, and improves outcomes by implementing innovations and using lean methodology.
• Accurately enter patient/client billing data, nursing home rates, level of care, per diem, and physician billing or charges, visit charges, fee for service charges, and verify discharge and admission data.
• Develop processes to timely bill and adjudicate claims that supports maintaining a benchmark cash goal level.
• Develop and monitor department budget and ensure budgetary goals are met. Ensure the efficiency of operations and the cost to collect.
• Participate in all mandatory staff in-services and meetings
• Maintain compliance with internal annual education requirements
• Abide by and demonstrate the company Mission
• Timely submission of all documentation
• Conduct all business activities in a professional and ethical manner
• Ensure overall compliance with local, state and federal laws, Medicare regulations, and established personnel policies and procedures
• Performance of other duties as required