Selling Points:
• Full Benefits (Medical, Dental, Vision)
• 401K, PTO
• Ability to work with a growing, well-known company!
Responsibilities:
• Leads and provides direction for revenue cycle management and determines goals.
• Collaborates with staff to improve information documentation and implement the best practices.
• Reviews, designs, and implements processes surrounding admissions, pricing, billing, third party payer relationships, compliance, collections and other financial analyses to ensure that clinical revenue cycle is effective and properly utilized.
• Tracks numerous metrics related to the patient engagement cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.
• Manages relations with payers and providers to generate high reimbursement rates and a low level of denials.
• Oversees performance of end of episode reviews for Medicare and Non-Medicare clients.
• Oversees and performs (as applicable) claims audits for Medicare and Non-Medicare clients.
• Oversees the reviews and clears held claims (clears as applicable) due to varying reasons while coordinating with Clinical Team Manager, Scheduler, and Medical Records Coordinator, as needed.
• Oversees management of Un-signed orders and coordination with branch and sales staff.
• Oversees Reviews and Management of Coordination Notes regarding the following events: Biller Notification, Funding Source Change Request, Medicare Records Notification, and Seldom Used Payor.
• Runs necessary reports in both HCHB and Forcura for oversight of employee productivity and management of Unbilled.
• Coordinates with Branch Managers to address challenges and identify necessary support for financial success.
• Conducts Order/Claim investigation for Branch performance.
• Organizes practices for consistency to meet target objectives.
• Strategizes and develops corrective plans with team or individuals, as applicable.
• Provides leadership and direction in identification and resolution of operational barriers as it relates to efficient and compliant claim processing
• Responsible for the appropriate use of agency resources including but not limited to, supplies and personnel to ensure financial success.
• Works to maintain positive, collaborative relationships with patients, caregivers, referral sources, and/or physicians.
• Participates in internal staff meetings and training activities, as assigned.
• Collaborates with members of the marketing team to assist in identifying potential referral sources and patients appropriate for home care.
• Performs other duties as assigned.
Qualifications:
• Bachelors Degree (Required)
• 3+ years of active experience in the Health Care setting
• Working knowledge of medical terminology and Medicare/Medicaid rules (preferred)