Mgr Revenue Cycle Pt Accts at Beacon Health System – Granger, Indiana

Reports to the Director of Revenue Cycle. Responsibilities include organizing, planning and managing the daily operational activities of assigned areas, which include insurance billing and follow up, cash posting, and self-pay collections. Ensuring that established policies and procedures are followed. Maintains responsibility for the overall level of dollars and days outstanding in both patient receivables and insurance receivables. This role includes the management of vendor relationships to ensure a high performing partnership.

MISSION, VALUES and SERVICE GOALS

• MISSION: We deliver outstanding care, inspire health, and connect with heart.
• VALUES: Trust. Respect. Integrity. Compassion.
• SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Manages the daily activities of assigned areas by:

Scheduling the workload of the staff in accordance with the priority guidelines set by the Director. Communicating with the Director regarding any concerns or problems. Assigning work and monitoring the staff's workload to ensure the quality and timeliness of work performed. Monitoring the quality and quantity of billing to ensure departmental and Hospital standards are met or exceeded. Recruiting, screening/interviewing, selecting and evaluating the staff and, when necessary, coaching and disciplining the staff. Providing ongoing technical guidance and assistance to the staff (for example, providing training regarding departmental policies/procedures and practices). Planning and coordinating ongoing job-related training and education for the staff and providing a comprehensive orientation for new staff. Developing short and long-term goals and objectives for assigned areas and implementing departmental policies and procedures that will ensure goals and objectives are met. Preparing and conducting Performance Reviews for the staff. Also providing feedback related to job performance and productivity to the staff. Providing ongoing support and maintenance of various computer systems (and overseeing the resolution of problems as necessary). Verifying payroll-related information. Ensuring compliance with the requirements of various regulatory agencies.

Managing all activities related to self-pay collections and external collection agencies by:

Ensuring the timeliness and accuracy of account follow-up and collection. Acting as a liaison with collection agencies and evaluating their performance regarding bad debt accounts. Preparing and analyzing reports and recommending strategy changes designed to improve such things as collection procedures. Ensuring external collection agents are operating within the values and mission of Beacon Health System. Monitoring the performance of external collection agents to ensure the maximum return of investment for Beacon Health System. Maintaining good working relationships with all collection agents to ensure all problems are addressed in a timely manner and also ensuring that outstanding customer service is provided.

Coordinates the daily activities of Cash Application assigned areas by:

Manages and oversees the daily operation of the cash posting team, ensuring accurate and timely posting and reconciliation of all incoming cash payments within the hospital’s revenue operation. Analyzes and evaluates key performance indicators related to cash posting timeliness, accuracy, and backlogs, training the cash posting team on how to do the same. Overseeing the functions of cash application, bank deposit, daily, weekly and monthly posting reconciliation and deposit files. Providing support to the electronic posting of payments.

Coordinates the daily activities of Billing and Follow-up assigned areas by:

Overseeing the processing of hospital charges for services rendered to payers. Monitoring the quality and quantity of billing to ensure departmental and Hospital standards are met or exceeded. Coordinating follow-up, as needed, to help reduce accounts receivable. Facilitating the staff's investigation and response to inquiries and problems to ensure consistent and timely resolution. Communicating updates about governmental and non-governmental regulations to the staff in order to ensure compliance. Monitoring accounts on the system to ensure claims are worked in a timely and efficient manner. Addressing and resolving patient and questions, concerns, complaints and requests in an efficient, prompt and courteous manner. Monitoring staff productivity by running aging reports and holding the team accountable for performance metrics. Monitoring write-offs to ensure proper approvals have been obtained and written off to the appropriate transaction codes. Overseeing the insurance audit process to ensure the external auditors follow our policies and procedures. Managing all activities related to the transmission of all electronic claims (i.e., edit problems or edit changes and the daily download of claims). Identifying download problems and coordinating the resolution of these problems with the Information Systems Department. Managing all activities related to the refunding of overpayments and refunds (for example, patients, third-party payers and governmental agencies).

Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:

Maintaining up-to-date knowledge about government guidelines and industry standards. Developing programs, policies/procedures and plans of action to maintain and improve the Hospital's level of receivables outstanding. Also recommending changes to the Hospital's Billing and Health Information Systems to ensure efficient and effective billing. Communicating with other departments and external agencies to provide or obtain information to resolve outstanding governmental patient receivables and third-party payers accounts. Developing and maintaining strong working relationships with various external departments. Working in a positive, proactive and cooperative manner with other team members, patients, third-party payers and all other customers when providing information, seeking assistance and clarification and resolving problems. Researching, recommending and implementing new processes and technology that will improve the quality of services provided by the Department. Communicating with the Director regarding any potential problems in a timely manner. Performing in a back-up role, as necessary, based on the day-to-day needs of the Department. Maintaining Department records, reports and files as required. Completing other job-related assignments and special projects as directed.

Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:

• Maintaining up-to-date knowledge about government guidelines and industry standards.
• Recommending and providing input for the departmental annual budget.
• Developing programs, policies/procedures and plans of action to maintain and improve the Hospital's level of receivables outstanding. Also recommending changes to the Hospital's Billing and Health Information Systems to ensure efficient and effective billing.
• Communicating with other departments and external agencies in order to provide or obtain information to resolve outstanding governmental patient receivables and third-party payers accounts.
• Developing and maintaining strong working relationships with various Hospital departments.
• Working in a positive, proactive and cooperative manner with other team members, patients, third-party payers and all other customers when providing information, seeking assistance and clarification and resolving problems.
• Researching, recommending and implementing new processes and technology that will improve the quality of services provided by the Department.
• Communicating with the Director regarding any potential problems in a timely manner.
• Performing in a back-up role, as necessary, based on the day-to-day needs of the Department.
• Maintaining Department records, reports and files as required.
• Completing other job-related assignments and special projects as directed.

Leadership Competencies

• Drives Results - Consistently achieving results, even under tough circumstances.
• Customer Focus - Building strong customer relationships and delivering customer-centric solutions.
• Instills Trust - Gaining the confidence and trust of others through honesty, integrity, and authenticity.
• Collaborates - Building partnerships and working collaboratively with others to meet shared objectives.
• Communicates Effectively - Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences.

ORGANIZATIONAL RESPONSIBILITIES

Associate complies with the following organizational requirements:

• Attends and participates in department meetings and is accountable for all information shared.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Completes annual employee health requirements within established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.

Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:

• Leverage innovation everywhere.
• Cultivate human talent.
• Embrace performance improvement.
• Build greatness through accountability.
• Use information to improve and advance.
• Communicate clearly and continuously.

Education and Experience

Bachelor’s degree in a Healthcare or Business related field. Knowledge for hospital and professional billing and follow up is required. Three to five years of management experience is required. Demonstrated success in Revenue Cycle experience for a minimum of five years will be considered in lieu of a Bachelor’s degree. Cerner experience is preferred.

Knowledge & Skills

Requires a thorough knowledge of consumer credit laws and the laws and regulations pertaining to the extension of credit to patient. Requires knowledge of Medicare/Medicaid and commercial payer practices and procedures and ICD CM coding, as they apply to patient account billing and automated information systems. Requires the administrative and management skills necessary to organize and manage assigned areas of responsibility. Also demonstrates the leadership/management skills necessary to elicit cooperation and support from others. Requires the analytical skills necessary to develop, evaluate and administer policies, procedures and maintain staffing levels. Demonstrates advanced computer skills specifically Microsoft 365 with extensive knowledge in data analytics by way of Excel or other software applications. Requires the organization, planning, decision making, problem-solving and critical thinking to plan and estimate project-related activities and timelines and identify and resolve problems and delivery viable solutions. Demonstrates the interpersonal and communication skills (both verbal and written) necessary to interact effectively with patients and families (regarding sensitive financial situations), physicians, other Hospital associates and outside organizations (i.e., insurance companies regarding solutions to problems and reports about the status of accounts receivable. Also requires the ability to develop and maintain effective working relationships.

Working Conditions

• Works in an office environment.

Physical Demands

• Requires the physical ability and stamina to perform the essential functions of the position.