Job Description

B DESCRIPTION:

• Directing the overall operations of the revenue department/section including managing staff and assigning responsibilities
• Educating and training professional staff on implementation of policies and procedures relating to revenue cycle
• Gathering, interpreting, and using data to identify problems and trends to demonstrate outcomes and cost-effectiveness
• Evaluating factors related to safety, outcomes, effectiveness, cost, and social impact when developing and implementing practice innovations
• Utilizing evidence-based practice to develop and implement standards of practice that guide practice improvement initiatives
• Providing support to clients through the development of new programs reflecting best global and regional practices
• Providing consultative services to the facility’s leadership and employees on all revenue related matters
• Utilizing participative management principles in planning and coordinating patient complex discharges
• Monitoring Accounts Receivable and Billing department/section in all aspects of claims processing and collection efforts
• Working closely with registration and admissions department/section to ensure registration of patients follows facility policies, and that appropriate documentation is captured for claim processing
• Monitoring Utilization Review department/section to ensure patients are provided appropriate care while monitoring the average length of stay for claims
• Developing and maintaining relationships with insurance carriers to keep the department up to date with all billing and processing requirements from outside payers
• Coordinating discussions between billing clerks and utilization nurses for insurance denial claims resubmission
• Supervising and making recommendations for claim adjustments, bad debt provision, and contractual allowances
• Managing billing processes to ensure claim packets are accurate, complete and submitted timely to the insurance payer
• Reviewing and reconciling bank deposits
• Managing remittance processing and posting miscellaneous cash to general ledger accounts
• Managing daily entries to the general ledger, reconciling accounts, and ensuring entries completed for timely month end close
• Providing accounting staff with accurate and timely reports of monthly revenue and accounts receivable balances
• Providing statistical analysis of financial data as needed from a variety of sources; example facility management team/HAAD/SEHA
• Working with management, clinical and other departments, and the patient accounting staff to improve processes, increase accuracy, create efficiencies, resolve related issues, and achieve the overall goals of the department
• Maintaining collaborative and effective relationships with other key management personnel and keeping abreast of significant economic, social and technical trends, and regulatory guidelines, which may influence assigned functions and/or the facility
• Acting as a Senior – manager to the team; checking workload, ensuring performance management, day to day supervision, training and orientation of the staff
• Delegating responsibilities appropriate to licensure, education, and experience of staff
• Acting as a preceptor/mentor for staff in the revenue cycle department
• Identifying and developing projects and programs that would benefit the facility
• Providing input and guidance on revenue cycle related matters and on operational decisions impacting facility patients/clients
• Remaining involved in operational committees and task forces as appropriate
• Complying consistently with facility policies, procedures and practices and ensuring alignment with SEHA facilities policies
• Completing and maintaining regulatory requirements including: licensure and certification and other mandatory training within established time frames
• Maintaining confidentiality with regards to any information exchanged or received in the current capacity of role in accordance with facility policy
• Assuming the role of a brand ambassador for the facility and promoting a customer focused philosophy in dealing with any stakeholders
• Maintaining positive and effective working relationships within the department/division and also with other departments/sections within the facility
• Performing any other duties as may be assigned relevant to the basic responsibilities of the role
• Adhering to requirements of the Occupational Health and safety guidelines and infection control guidelines
• Recognizing the necessity of continuously developing skills and acquiring additional knowledge appropriate to the position
• Dressing appropriately to meet the expectations of the specific work area and in alignment with the Occupational Health and Safety policies

QUALIFICATIONS

Required:

• Bachelor’s degree or equivalent in Accounting/Finance/Commerce/Business Administration or relevant field OR Diploma in relevant field with 3 years of additional experience

Desired:

• Master’s degree or equivalent in Accounting/Finance/Commerce/Business Administration or relevant field
• Experience Required
• 8-10 years of relevant progressive experience in a similar role with 5 years of supervisory experience