Overview

Are you an experienced Revenue Cycle leader looking to join an established health care organization? We at M Health Fairview are looking for a Manager Revenue Cycle to join our Insurance Billing team!

This work from home opportunity is scheduled for Day Shift, 80 hours/2 weeks, with no weekend! Join M Health Fairview, where we're driven to heal, discover, and educate for longer, healthier lives.

Some of the benefits we offer include medical insurance - as low as $0, dental insurance - also a $0 option, PTO (24 days per year), and 403B with up to a 6% employer match; visit www.fairview.org/benefits to learn more!

Hiring Process

We may send you a link to complete a video interview. This is a phenomenal opportunity to showcase who you are and why you want to work for us plus we have the ability to share these with our hiring leaders directly.

Responsibilities Job Description

This position is responsible for managing all aspects of Revenue Cycle operations including overall general supervision, regulatory, policy and procedure compliance, personnel training and development, performance measurement and appraisals. This position will manage team supervisors and/or leads and exempt or non-exempt staff. The Manager is responsible for delivering the highest quality of service as efficiently and effectively as possible while meeting financial, performance and quality goals. The Manager must have the ability to work cross-functionally with other colleagues and work cooperatively with all levels of the business including both internal and external partners and vendors. The ideal candidate will be results oriented with a proven record of creating an engaged workforce and identifying ways to improve the patient, provider, and workforce experience.

Responsible for managing effective and efficient billing operations including people, processes and technology that results in leading practice clean claim creation and submission daily supporting strong and stable cash-flow; Leads employees and influences stakeholders to follow appropriate standards, workflow as well as a systematic improvement process.

Sets assignments and projects as appropriate, prioritizing work ensuring pre claim and claim workflow is worked in a timely and accurate manner. Ensures department and staff level metrics and goals are set, published, monitored, and measured with appropriate actions to achieve expectations.

Provides subject matter expertise on technical and compliance areas that impact claims processing including EPIC PB and HB system, and payor requirements. Obtains and maintain certification in EPIC Resolute Hospital and Professional Billing. Maintains proficiency in claim and clearinghouse solutions.

Leads and sustains customer, intra-department and vendor relationships and ensuring stakeholders are appropriately trained to perform designated responsibilities that result in timely and accurate pre claim and claim work resulting in creation and submission.

Forms and maintains programs ensuring stakeholders remain current with regulatory and policy requirements and have clear structure to communicate, submit issues and receive direction related to completion of work. Creates an environment where staff and customers can identify opportunities, barriers, and solutions to sustain strong and successful outcomes.

Creates and sustains departmental metrics, reports, productivity, benchmarks, and associated programs to ensure department and stakeholders have clear lines of accountability to achieving expected outcomes.

Communicates information to all areas on a regular basis with the result of excellent customer service.

Performs monthly quality assurance checks to monitor adherence with accuracy, timeliness, and adherence with financial controls. Investigates and resolves problem accounts and deal directly with payer, patient or 3rd party.

Identifies, recommends, and implements changes related to billing, compliance and data integrity which improve productivity, quality, financial performance, AR days and lean flow practices. Identifies and recommends process and quality improvements for the department. Develops workflows and controls to increase the accuracy of staff. Collects and utilizes staff feedback to provide education on denial outcomes.

Manages the development and implementation of standards, policies, and procedures related to the billing activities.

Acts as a leader with revenue oversight taskforce teams preparing and reporting on schedules related to unbilled, and billing matters requiring attention.

Qualifications

Education

• Bachelor’s degree preferred or minimum of 7 years in relevant revenue cycle management role.

Experience

• Minimum of 3 years’ experience in revenue cycle management role.

Additional Requirements (must be obtained or completed within a period of time) :

• EPIC certified preferred

• Strong knowledge of 837i and 837p formats as well as UB04 and 1500 bill forms;

• Ability to research, interpret and activate payer requirements

• Effective oral and written communication

• Proven success with leading staff and change management

EEO Statement

EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status