Job Description
Job Description
Overview
This Senior Manager of Revenue Cycle Accounts Receivable (AR) is responsible for the day-to-day management of all insurance Accounts Receivables. This includes the complete adjudication of all outstanding Insurance claims and denied insurance claims in accordance with MedQuest Business Standards.
Responsibilities
Leadership:
- Creates a shared vision by words and actions; models behaviors and sets the tone that mission and values guide decision making.
- Aligns others with MedQuest's mission, vision, and values.
- Continuously strives to modify departmental operations to enhance delivery of the ‘Remarkable Patient Experience’ and communicates ongoing customer needs to leadership.
- Demonstrates leadership knowledge and skills, exemplifies honesty, integrity, fairness and trust.
- Delegates appropriately and involves staff in decision-making. Makes each individual feel his/her work is important and aligns the energy and resources to achieve desired results.
- Assures all competencies are demonstrated at the lead and staff levels.
- Participate with Director/Manager in annual reviews, interviews, and personnel actions
Functional Competency:
- Manage the workflows and processes for the AR team ensuring all insurance claims are filed and processed timely. Ensuring reimbursements match to expected rates for services.
- Actively participate in all JOC Novant calls using as a forum to resolve issues and keep current on changes with payors.
- Approve all Level 1 and Level 2 adjustments to patient accounts.
- Collaborate with Novant Analysts on all EPIC upgrades and shares with team pertinent changes to workflow or processes.
- Management of system rules and workflows within the Health Information system(s).
- Liaison with other Revenue Cycle teams, Scheduling/Precertification, and our Center Managers to discuss and resolve issues related to decreasing denials and maximizing payments.
- Develops recommendations and presents proposals to Director to include process improvements, policy and procedures modifications, and training recommendations.
- Leads change and demonstrates improvements in processes where results are not optimal. Involves stakeholders in the change process when improvement efforts impact other business units.
Compliance & reporting:
- Ensure adherence to payer rules, insurance billing regulations, and internal financial controls; prepare reports for management.
- Ensure timely completion of Insurance refunds/Credits.
Other duties as assigned or modified at Managers discretion
Qualifications
Education
- Bachelor’s Degree in Business, Finance or related function required OR additional experience above the minimum may be considered in lieu of the required education on a year-for-year basis
Prior Experience
- Minimum 6 years of progressive experience in health care revenue cycle
- Minimum 2 years of supervisory experience