Sup, Rev Cycle Mgmt, Hospital Job at University of Rochester (Rochester)

Job Description

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Responsibility

Organizes and conducts operations that affect the revenue cycle (e.g., billing, collections, payment processing)
Develops and implements processes to meet revenue cycle goals in collaboration with medical practices
Conducts related training, monitoring, analysis and reporting on revenue cycle processes and results
Develops and implements practice-specific process improvement recommendations
Coordinates and supervises the daily activities of a support, production or operations team
Sets priorities for the team to ensure task completion
Provides overall supervisory, technical support and direction to the team
Trains staff to understand and adhere to contract language by payer for appropriate reimbursement to the hospital and ensure the accuracy of account reconciliation
Monitors compliance with timely filing requirements and takes corrective action if guidelines are not followed
Maintains knowledge of all current third-party coverage, federal and state billing, and reimbursement and compliance regulations and procedures
Serves as a contact to answer questions, solve problems for difficult and unusual accounts, and assist in problem identification and resolution
Reviews, compiles, approves, and submits patient refunds and complete balance transfers
Reviews mid-dollar report for approval for write-offs
Ensures requests for information from patients and external contracting agencies are responded to in a timely manner
Prepares team operational reports and special reports as needed to identify key indicators using specific criteria measuring quality, quantity and timeliness of tasks performed
Prepares, and in collaboration with staff, reviews the weekly and monthly quality indicators in the billing area
Initiates corrective action or recommends solutions as appropriate
Prepares specific reports developed with payers to identify accounts requiring provider intervention
Resolves flagged reports to ensure timely submission of claims to payers
Monitors and ensures worklists are completed in a timely manner
Monitors cash flow, receivables, Hold Bills, Claim Edits, and aging reports, as well as payment and denial worklists
Performs monthly audits of account notes and adjustments
Attends monthly team meetings with the Outpatient Manager and appropriate payer representatives
Runs, distributes and ensures resolution of accounts on reports
In collaboration with leaders, develops audit procedures within billing area to ensure payments from all third-party payers are based on rates identified on negotiated contracts
Ensures timely processing of secondary credit balances for government plans
Reviews reports generated within the billing systems to ensure accuracy and reconciliation
Coordinates and provides support for all internal and external billing audits, reviews or projects
Provides training, coaching and reinforces billing and customer service skills to team members to ensure exceptional service
Seeks feedback from other departments to improve processes and level of service within internal department area
Communicates with other departments regarding problem visits
Develops goals, objectives and operating policies and procedures for the billing team, in collaboration with leadership
Develops cross training programs within specific billing area for outpatient billing
Adds policies and procedures to the Patient Accounts shared drive
Completes performance evaluations for designated staff
Screens, reviews, interviews and make recommendations for new hires
Handles time reporting requirements in accordance with state and federal regulations
Addresses personnel disciplinary issues
Represents department at meetings and seminars, when appropriate
Provides cross coverage for leadership peers in other department areas, as needed
Represents the department on various internal and external committees, as needed
Attends continuing education seminars offered by local payers, as well as by Medicaid and Medicare
Other duties as assigned

Requirements

Bachelor's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

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Sup, Rev Cycle Mgmt, Hospital

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