Archived listing. The details below describe a past opening.
Summary The primary purpose of this position is to manage the billing process and liaison by communicating and resolving root cause analysis (RCA) between Flight Coordination and follow-up to ensure maximum reimbursement to MHP. Acts as a focal point within the company for all revenue cycle activities, Quality Assurance, and Billing. Relationships Interfaces To: All employees, vendors and customers Essential Duties & Responsibilities
- Develops reoccurring reimbursement/revenue cycle reports for revenue cycle. Troubleshoots Salesforce Workbench reports and trains staff on how to effectively report. Reports include target vs. actual collection rates and actual vs. target A/R days.
- Analyzes workflow and operational procedures to identify opportunities for improved reimbursement, develops and implements policies and procedures to ensure all services are captured, recorded, processed and billed in an accurate and timely manner.
- Analyzes monthly A/R reports by payor and monitors overall department performance. Recommends corrective follow-up actions and changes in procedures and/or negotiations with payors.
- Ensures payment is received, credited and recorded at contracted rates. Identifies and researches discrepancies and provides feedback to leadership.
- Analyzes billing and accounts receivable reports. Identifies payor trends, categories of aged receivables and provides action plans to departments to improve results. Works with payors and follow-up personnel to train on revenue cycle metrics.
- Works with Legal to ensure proper payment is received.
- Analyzes reports on reimbursement and collections to identify opportunities for improved coding and billing. Makes recommendations for new procedures to appropriate management staff.
- Monitors insurance cash collections policies and procedures and educates Flight Coordination staff to ensure best practice sharing across company.
- Provides reports, feedback and analysis of on QA functions associated with reimbursement
- Meets regularly with revenue cycle leadership to address their reimbursement and data needs and recommends target areas for reimbursement analysis.
- Understands vendor revenue cycle contracts, tracks and trends vendor effectiveness and provides feedback to revenue cycle leadership.
- Presents reimbursement findings to senior leadership highlighting action plans and areas of opportunity.
- Drives various revenue cycle meeting agendas, creates action plans, and follows up on department meetings
- Directs reimbursement staff projects, areas of opportunity and reporting focus with the help of Revenue Cycle Director
Workflow / Process Improvement
- Ensures Revenue cycle goals and productivity standards are met for optimum utilization
- Helps identify methods to improve service delivery
Qualifications
Required
- Education: High school diploma or GED, coding certified or a higher level of education.
- Experience: A minimum of five to seven years in a healthcare environment or work related experiences in the billing, auditing and reimbursement area work or related experiences and/or educational accomplishments with knowledge of project management, data analytics, Salesforce. A combination of both will be considered.
- Working knowledge of registration, billing, insurance follow-up and analysis of commercial insurance.
- Strong communication, analytical skills and the ability to work independently and handle multiple tasks is a must.
- Ability to manage staff and understand and adhere to human resource guidelines is required.
Preferred
- Education: Bachelor’s degree
- Experience: Process Improvement skills (Lean, Six Sigma, Process Excellence); Healthcare and revenue cycle experience (medical billing, collections); Experience reviewing 1500 claims; SalesForce.com experience. Knowledge of collections, reimbursement and Salesforce is highly preferred.
Benefits
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Pet insurance
- Vision insurance