Job Summary:Perform functions to manage the reimbursement activities of multiple infusion and specialty pharmacy business units, focusing on account management, authorizations, intake, billing, collections, payment posting, and medical records. This includes the development of a highly effective team that can successfully meet the critical challenges of timely revenue collection from payers. Establish and maintain outstanding customer relationships to build patient loyalty and franchise satisfaction, with regulatory compliance at the core of all revenue cycle policies and procedures.
Duties/Responsibilities:- Establish and monitor operational and individual metrics to ensure the right team is in place, fully trained, and focused on the priorities to ensure success in all revenue cycle functions at or below industry standards. Along with a Franchise focus that yields loyalty and satisfaction.
- Monitor operations for quality of results through review of specific transactions, audits, and assessment of business analytics. Ensure accuracy of deposits and reconciliations, review and approve adjustments and refunds, and take ownership of the integrity of the database on which decisions are made.
- Define, capture, and utilize key analytics through a standardized audit process, which will identify areas of focus for improving productivity, efficiency, and customer satisfaction.
- Track and monitor key performance metrics related to financial, quality, and productivity. Identify, analyze, and recommend performance enhancement initiatives. Provide regular and ad-hoc management reporting on operational results.
- Transparent and open communication with team members to review team metrics, objectives, and performance and to foster a high-performance team environment through involvement. Facilitate team discussions and activities toward root cause analyses, permanent problem resolutions, and continuing focus on improvement.
- Partner with payers to understand and implement their preferences, ensuring efficiency and compliance are built into the intake and billing processes. Support and supervise payers or finance-requested audits.
- Maintain awareness of key industry information and evolution and act as a technical guide to team members, providing insights, vision, and resources to ensure team growth and development in decision-making.
- Implement software solutions to enhance current systems to improve efficiency, quality, and compliance initiatives.
- Lead efforts in interviewing, selecting, training, and assigning department members to create a highly effective RCM Team.
- Provide mentoring to develop the next-level Leadership Team through effective communication, feedback, and setting expectations to assess their individual Teams' effectiveness.
- Evaluate performance and provide counseling, cross-training, and coaching to team members. Maintain harmonious team member/employer relations.
- Develop and implement staffing plans within related budgets to achieve financial metrics.
- Perform other related duties as assigned.
Required Skills/Abilities:- Highly effective Leadership skills, proven in a high-growth and dynamic environment.
- Strong Revenue Cycle Management experience emphasizing intake, claims processing, collections, and payment posting.
- Knowledge of accounting procedures, healthcare terminology, and experience in government and insurance carrier billing and collections procedures.
- Team building skills and the ability to influence, lead, teach, train, counsel, and coach to accomplish organizational goals.
- Demonstrated expertise in root cause analysis with the ability to problem-solve complex situations while guiding and coaching individuals to bring the desired solution to the organization.
- Proven ability to build an outstanding customer service model resulting in Best-in-Class customer satisfaction and loyalty.
- Excellent verbal and written communication and interpersonal skills. Ability to follow oral and written instructions.
Education and Experience:- Bachelor's degree in business, accounting, or a similar discipline is strongly preferred, along with medical billing and accounts receivable experience.
- Minimum of 10 years of Revenue Cycle Management experience with 5 years of proven leadership experience in a home infusion setting.
Physical Requirements:- Sitting: Prolonged periods of sitting are typical, often for the majority of the workday.
- Keyboarding: Frequent use of a keyboard for typing and data entry.
- Reaching: Occasionally reaching for items such as files, documents, or office supplies.
- Fine Motor Skills: Precise movements of the fingers and hands for tasks like typing, using a mouse, and handling paperwork.
- Visual Acuity: Good vision for reading documents, computer screens, and other detailed work.
Be part of an organization that invests in you! We are reviewing applications for this role and will contact qualified candidates for interviews.
This position is full-time. The salary range for this position is $113,276-$151,365.
