Revenue Cycle/Revenue Mgmt Specialist (Only W2)

General Summary:

Responsible for directing, coordinating, and planning staff for Epic Single Business Office (SBO) functions. Manages cash application and customer service activities for all Bayhealth entities (Medical Center, employed physicians, Bayhealth Medical Group, Wellness Centers, and Occupational Health). Responsibilities for the Customer Service Team include efficient and accurate patient billing and collections, financial counseling, vendor processes, and reconciliation of patient accounts, along with other associated treasury functions. Responsibilities for the Cash Management team include oversight of posting, balancing, and reconciling daily cash activities, as well as researching missing payments and remittances. Must work collaboratively with Bayhealth departments to resolve patient complaints and ensure compliant billing. Adhere to internal controls for applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans.

Responsibilities:

1. Supervises the assigned team and team members engaged in the department. This includes interviewing, hiring, performance evaluation, training and disciplining all system support personnel. Delegates tasks as determined appropriate.
2. Provides a goal-oriented work environment, establishing clear and concise work procedures expectations. Develop and plans goals and objectives for the department with PFS Leadership Team.
3. Complete monthly rounding on direct reports; maintain individual rounding logs and stop light reports to facilitate communication. Promotes employee engagement for individual teams and the department striving for continues improvement.
4. Reviews quality assurance review results with staff providing as necessary education/training to address opportunities for improvement. Contributes to development of education materials for new hire and annual training competencies
5. Career development, ensures staff have the knowledge and tools to be successful, identifies top performers and directs work towards their strengths, establishes career paths as appropriate.
6. Manage Billing Support functions. Responsible for administration of Bayhealth’s uncompensated care and bad debt programs. a) Provide oversight of private pay collections. b) Monitor self-pay collection agency performance and communicating issues. Provide oversight of the Financial Counseling process and oversight of Customer Service Team. Responsible for monitoring all Medical Center self-pay credit balances. Review and respond to patient complaints, legal documents following appropriate customer services, and internal policies.
7. Manages Cash Application functions. Responsible for all payors, Bayhealth Medical Center and employed physician revenue. Oversee the processing of refunds on credit balances and unidentified payment resolution. Identifies opportunities for improvement related to automating cash application processes. Supervises the deposit of non-AR checks on site to PNC and posting in INFOR.
8. Prepares performance reports and distributes to monitor and evaluate the effectiveness of individual teams. Implement appropriate plans of action to improve performance when benchmarks/goals are not being met.
9. Reviews all requests for system changes to determine the impact on processes under the position’s span of control. Ensures supporting research and documentation supporting the change request are accurate and have been properly validated.
10. Implements and adheres to internal controls for applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans.
11. Conduct meetings on a periodic basis or otherwise as needed to maintain efficient and effective operation of department personnel.
12. Participates in meetings and committees related to functions and represents the department as necessary.
13. All other duties as assigned within the scope and range of job responsibilities

Required Education, Credential(s) and Experience:

• Education: Bachelor Degree Business
  In lieu of a bachelor’s degree, will accept a High School Diploma or GED with eight (8) years of Revenue Cycle Progressive leadership experience. (Four years of experience for a verified associate’s degree.)

2. Credential(s): None Required

3. Experience: 
   Required: Five years in patient accounting, third-party reimbursement, or related field, to include a minimum of three (3) years of experience in a supervisor or leadership role. Experience in treasury management.
   Preferred: Seven years in patient accounting, third-party reimbursement, or related field, to include a minimum of five (5) years of experience in a supervisor or leadership role.