ESSENTIAL FUNCTIONS
- Develops a mastery of the RCM systems to provide training implementation best practices and analysis of system performance and for end users and stakeholders.
- Maintains RCM system performance through system monitoring reconciliations and work closely with IT and RCM for efficient and expected operations.
- Regular audits end to end claim through put accuracy and compliance from order to template charge entry billing and payment posting. Develops recommendation plans for improvement based on trends.
- Assesses reports of billing system or workflow disconnects that have created financial or compliance consequences. Investigates the report of charge claim or payment posting disruptions.
- Provides billing implementation support and system reviews.
- Provides regular billing system maintenance including table updates enhancement and upgrade implication assessments charge master hygiene transactional code set up and maintenance and database updates.
- Answers resolves and trends the root causes of RCM support tickets to identify system enhancement opportunities to minimize work disruption system bugs and inefficiencies.
- Participate in various ad-hoc revenue cycle optimization initiatives as assigned.
EDUCATION
- Bachelors degree in HIM IT or related field preferred.
- Experience will be considered in lieu of education.
EXPERIENCE
- 8 years experience in revenue cycle management operations with a progressive track to and / or interface to billing system implementations structure and / or maintenance.
- 4 years experience in operational planning operational excellence change management or similar experience.
- 2 years experience in direct HIT system related work.
REQUIREMENTS
- Travel up to 5% of the time to stakeholder markets in the US
- Meeting facilitation both virtually and in person
- Creating and presenting operational outcomes
- Gathering and organizing meaningful market stakeholder data
KNOWLEDGE
- Strong knowledge of healthcare billing claim operations and payment models.
- Knowledge of executing large complex projects with competing priorities and deadlines.
- Charge master administration and maintenance required.
- Knowledge of implementation planning and execution with systems and processes.
SKILLS
- Communication:Communicates well both verbally and in writingwith strong conflict resolution skills in both
- Team building:Motivates others and works well with a team
- Decision making:Can make quick and informed decisions even when all the necessary information isnt available
- Emotional intelligence: Can understand manage and express emotions dependent on the situation and recognize appropriately the emotions of others.
- Business acumen:Uses company resources efficiently and in line with the organizations goals
- Risk management:Can assess risks and know when to take them
- Interpersonal skills:Can work well with others
- Leadership development: Can lead others and drive business growth
ABILITIES
- Effective time and reputation management
This role must be able to manage their resources wisely prioritize and gain respect within the organization
This role must be able to implement strategies to help the organization succeed
This role must be able to think long-term and create plans to help the organization grow
This role must have the ability to think creatively on self-driven initiative to make sure their plans align with the companys goals and vision
This role must be able communicate well with their teams and other stakeholders even under pressure
This role must be able to empathize with others negotiate and compromise calmlywith a focus on problem solving
This role must be able to collect analyze synthesize and interpret data from a variety of sources
This role must be able to make decisions in an efficient time frame
ENVIRONMENTAL WORKING CONDITIONS
- Primarily remote in nature with travel to HOPCo offices and sites
PHYSICAL/MENTAL DEMANDS
- Sitting for long periods of time.
- Stress from competing priorities financial pressure and escalated expectations
ORGANIZATIONAL REQUIREMENTS
- HOPCo Mission Vision and Values must be acknowledged and adhered to
- List additional organization requirements such as training conducted by organization
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities knowledge skills abilities and working conditions may change as needs evolve.
Required Experience:
Unclear Seniority