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ROLE:

The RCM Application Management Support Team Lead is responsible for providing leadership and guidance to the RCM Application Management Support staff and assisting with day-to-day work flow of the department. Direction of the department’s daily operations to be executed in such a manner as to achieve management goals on a timely basis. Oversee RCM applications to insure stable operations; update and maintain core business system master files and tables; maintain integrity and ongoing quality control of RCM configurations and reporting. Ultimately responsible for investigating and escalating when warranted. This Team Lead position will support billing center(s) by acting as primary point of contact with ancillary vendors. In addition, this position may be required to provide representation and/or leadership related to internal billing/operational/IT initiatives. Works with the Manager and Director of RCM Applications Management Support.

TASKS AND RESPONSIBILITIES:

o Provide exceptional customer service to internal and external customers. Interact with customers in a professional manner; help foster teamwork to complete designated tasks

• Schedule and organize work assignments. Prioritize and delegate job tasks to ensure timely completion. Ensure work is performed accurately and efficiently.
• Implement policies and procedures to maintain workflow standards.
• Coordinate, schedule and facilitate training for staff.

o Perform random and focused audits of staff’s work product to validate and verify data entry accuracy and scope of understanding.

o Provide technical assistance and support in adherence to established processes for incoming inquiries and issues as well as QA/Audit processes related to healthcare RCM application

o Maintain RCM application support table configurations; primarily moderate/high complexity in nature

o Ensure proper recording, documentation and closure of problem resolution and conversations to create detailed log of incidents through helpdesk software

o Assess, diagnose and resolve problems related to RCM application in a timely manner

o Execute system and configuration related QA queries, analyze query results, identify errors, take corrective actions

o Coach Internal customers on proper problem-solving process as appropriate

o Make recommendations for changes to enhance system and/or process efficiencies

o Develop and implement processes to validate, monitor and track electronic file formats and transfers (837P, 835, Electronic Invoicing, etc)

o Provide support for operational process changes within RCM

o Properly escalate unresolved inquiries and requests to next level support in a timely manner

o Lead and/or participate in software release testing; acting as primary resource to billing teams. Includes clearly documenting processes, changes, test results as well as escalating issues to vendor

- Functional: Application feature/functionality testing

- Integration: Interface testing

- Business Cycle: Review of transactions and activities that occur daily, weekly, or monthly

- Performance: Application performance (response time, throughput volume, etc)

- Regression: Repeat testing scenarios pre/post upgrade

- UAT Testing

o Function as primary point of contact between billing and ancillary vendors coordinating communications and problem resolution

o Manage, submit, and track both internal and interdisciplinary enhancement requests

o Lead and/or participate in internal billing/operational/IT initiatives

o Create and/or maintain standard operating procedures (SOPs) in support of RCM configuration requirements and other responsibilities

o Exceed and/or maintain standards as set forth by departmental service level agreements (SLAs) and company policies to achieve best practice workflow standards

o Maintain integrity and ongoing quality control of RCM configurations and reporting

o Perform other tasks and projects as assigned to meet the goals of the department

Leadership Management:

• Contributes to performance evaluations and employee discipline following company Human Resource policies and procedures.
• Oversee training and motivate direct reports.

o Takes ownership and accountability for addressing difficult issues.

o Accurately assesses strength and development needs of direct reports.

o Regularly audit staff’s work performance and product to ensure compliance.

o Responsible for team’s quality of work, meeting deadlines, and adherence to code of conduct and billing standards.

SKILLS|EXPERIENCE/KNOWLEDGE:

• Experience with healthcare RCM Application configurations; TELCOR RCM a plus

o Understanding of healthcare claim and invoice processing; long term care experience a plus

o Analytical skills in the areas of registration, claim processing, billing and reimbursement as affected by various data systems

o Ability to investigate regulations to ensure accurate system configurations

o Experience with claims clearinghouses preferred but not required

o Demonstrate ability to convey complex ideas in an easily understood manner to guide audience through written or verbal communications

o Excellent customer service skills

o Demonstrate initiative with the ability to work independently

o Excellent attention to detail

o Able to prioritize, organize, troubleshoot, and problem solve.

• Ability to lead and motivate staff (centralized and/or remote).
• Proficient with revenue cycle systems and master table setup and maintenance
• Proficient with Microsoft Office; strong Excel skills a must

o SQL experience recommended but not required

EDUCATION:

o Minimum five (5) years analytic, technical, and reporting experience with health care data; seven (7) years experience preferred.

o Any equivalent combination of education, training and/or experience that fulfills the requirements of the position will be considered.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is frequently required to stand; to handle or feel; to talk and to hear. The employee is occasionally required to walk, sit, reach with hands and arms and stoop, kneel, crouch or crawl. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by this job include close vision, depth perception and ability to adjust focus.

WORK ENVIRONMENT:

Standard office environment.