DescriptionManage teams both internally and externally with the goal of driving timely and accurate Accounts Receivable resolution. Regularly review and provide solutions to further increase the effectiveness of both internal and external teams. Maintain and recommend on key metrics in support of Simon Med business goals. Drive value by optimizing cash flow, cash timing and collections. Quickly identify opportunities as they arise and work resolutions as far upstream as possible to prevent further incursions.
- LOCATION: Remote
- Travel % (if applicable): 10-20%
ESSENTIAL FUNCTIONS:
- Provide day-to-day supervision of front and back-end functions, including authorizations, billing, and AR.
- Review/oversee charges to ensure complete and accurate capture of charges for batch reconciliation
- Review/oversee prior authorizations as required by the patient's insurance carrier and coordinate with clinicians, hospital staff, and third-party authorization vendors to track and communicate authorization status and billing requirements supported by SOP(s) creation.
- Review AR reports to identify payer trends, issues and aged A/R and work with payors on coverage limitations and other needs.
- Keeps informed regarding current billing requirements and company/department policies and procedures as it applies to the field of all modalities and effectively applies this knowledge.
- Works and/or maintains accounts in AR.
- Instructs the team responsible for carrier/patient follow (AR aging)
- Reviews and responds to carrier correspondence via mail/email/portal/lockbox.
- Assists with third party payor and other audit requests.
- Reviews and approves write off adjustments for accounts as needed.
- Reviews and approves refund requests and sends to AP department for processing monthly.
- Performs site visits for Front end process review and other projects related to billing compliance in fulfillment of the practice's compliance program.
- Root Cause Analysis/Resolution
- Denial Management
- Assists in developing and executing educational plans related to clinical related denials.
- Assists in the development of procedure manuals/SOPs related to billing compliance.
- Monitors and reports volume of work as well as any outstanding issues to applicable manager.
- Assess workflow and develop strategy to complete all necessary work prioritizing tasks as necessary.
- Review & approve employee time for semi-monthly payroll.
- Monitor overtime.
- Manage employee activity such as the interview process, job performance, and quarterly performance reviews.
- Manage employee relations issues appropriately as they arise and escalate to manager as necessary.
- Reporting
- Maximize IT system integrations for EMR and Practice Management system.
- Work with onshore and offshore team members to enhance A/R collection speed and increase efficiency
- Work with vendors to further utilize technology enhancements and increase effectivity and reduce cost of collections.
- Regularly assess team capabilities and talent gaps. Build learning plans and growth opportunities within to grow capabilities and ensures accurate, timely results and solutions.
- Work across departments (both internal and external) and levels thereof to apply data-driven improvements to all aspects of the end-to-end process.
- Provide accurate read outs of RCM performance and opportunities.
- Adheres to policies, procedures, guidelines relative to departmental operations
- Additional responsibilities may be assigned to help drive our mission of improving the patient journey.
Essential Competencies:- Attendance is an essential job function.
- Excellent written and verbal communication skills with the ability to effectively communicate and establish collaborative relationships with physicians, patients, clinical and administrative staff, and the public.
- Excellent customer service skills with the ability to process patient and public inquiries, including complaints, and respond with poise and efficiency.
- Knowledge of clinic office procedures, prior authorizations, and medical billing guidelines.
- In depth understanding of Managed Care Organizations and payer guidelines
- Knowledge of clinic office procedures, medical practice and medical terminology.
- Ability to interpret, adapt and apply guidelines and policies and procedures.
- Ability to successfully organize, delegate, and supervise.
- Ability to recognize, evaluate and solve problems.
- Ability to successfully plan, implement and manage multiple projects simultaneously.
- Strong organizational skills and attention to detail.
- Ability to work remotely
- Strong knowledge of Windows-based software applications. (E.g.: Word, Excel, Outlook...)
- Excellent Customer Service skills.
OTHER DUTIES: Please note this job description is not designed to cover or contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time or without notice.
MINIMUM QUALIFICATIONS:
Education:
- Bachelor's degree preferred
- License/Certification:
Experience:
- 5+ yrs of Revenue cycle leadership
- 3+ years of data analytics and automation
- Offshore Vendor management preferred
- Coding experience preferred
- Radiology billing experience preferred
- Data Analytics preferred
- Imagine experience preferred
PHYSICAL DEMANDS: This position may require duties including lifting and carrying up to 40 pounds, sitting for prolonged periods of time, with frequent standing and walking.
BENEFITS: Your health, happiness and future matters! At SimonMed Imaging, we offer medical, vision and dental insurance, 401(k) eligibility, paid holidays plus PTO, Sick Time, opportunity for growth, and much more!
DRESS ATTIRE: Business Casual or scrubs dependent on department
