Mgr Revenue Cycle Post Acute at Wellstar Health Systems in Marietta, Georgia

Job Description:

Facility: 1800 Parkway Center



Job Summary:



Under the management of the AVP of Revenue Cycle MGBO and Executive Director of AR, the Mgr. Revenue Cycle Post Acute coordinates and controls 2 primary revenue cycle segments:
Manages the revenue cycle functions for Home Health, Hospice, and other related Post Acute services.
Provides Leadership and accountability for all aspects of Wellstar's Home Health and Hospice Revenue Cycle; end to end functionality.
Brief job description for each segment:
Under the direction of the AVP of Revenue Cycle MGBO & Post Acute Services, this is a management position responsible for Home Health and Hospice billing through final resolution of patients accounts to maximize collectible revenue and minimize outstanding discharged receivables. This position oversees collection and follow-up activities, identification and processing of appropriate write-offs, accurate resolution of all credit balances, and prompt response to follow-up and denial issues. Ensures compliance to contract billing requirements to include all coding edits. Oversee Managed Care Liaison's functions to ensure collaborations with Patient Account Representatives. Provides timely feedback and education to appropriate departments, Directors, Supervisors, and staff. Works closely with Executive Directors, Managers, Supervisors, Managed Care Liaisons, and Intake Coordinators to ensure that billing information is accurately captured and applied appropriately to Patient Account Representatives.
This leader ensures that all Home Health and Hospice work flows includes all aspects of the revenue cycle for Post Acute billing which includes being billed on an HB platform in Epic. Understanding, support, and process improvement implementation of Registration, Precertification, Coding, Charge Capture, Claims Submission, Insurance Payment Posting, Account Resolution, Patient Statements, Customer Service and Bad Debt Collections functionality and vendor relationships for all Wellstar Post Acute services. In addition, oversight over the preparation and distribution of Revenue Cycle Key Performance Indicators (KPIs) to key leaders and stake holders within the system including AVPs, VPs, SVPs and EVPs.
Duties and expectations for each segment include communicating trends and action plans to Senior Leadership. Enforces organizational policies and procedures to ensure quality account resolution workflows, appropriate staff productivity and quality expectations are managed, appropriate cost controls and effective operations are in place. Assists Senior Leadership with any departmental tasks and requests, as needed. The Mgr. Revenue Cycle Post Acute is responsible for the team's daily work flow, questions and general team assignments; analyzing, problem-solving, coaching, team-building, hiring, interviewing, supervising, training, counseling and disciplinary actions
The Mgr. Post Acute will assist with documenting and implementing action plans for strategic initiatives, including those that affect monthly/quarterly/year-end financial closes. Deploy resources in accordance with detailed action plans. Additionally, the Mgr. Revenue Cycle Post Acute is expected to collaborate with Post Acute Operational Leadership, attend on site monthly meetings, round and partner with operational leaders to improve workflows and identify efficiencies, and report month-end financial results with solutions for improvement.




Core Responsibilities and Essential Functions:



Primary Responsibilities
* Ensures staff follow-up on claims promptly, and is held accountable for aged receivables
* Oversees any special projects.
* Responsible for JOC attendance and manages payer escalation calls as needed to resolve aged receivables and denials
* Conducts regular staff meetings to discuss new or modified procedures.
* Reviews and monitors staff time and attendance, production and quality.
* Ensures Wellstar policies and procedures are current, up to date, documented and published, and being followed.
* Approves adjustments per the policy
* Assumes responsibility for identifying and resolving issues quickly and effectively
* Set productivity and quality standards with help from Senior Leadership and holds staff accountable.
* Responsible for staff training, education and corrective action documentation.
* Appropriately administer employee recognition.
* Completes performance evaluations on time.
* Review, analyze and interpret monthly/weekly reports to make informed managerial decisions to reach all KPI goals.
Secondary Responsibilities
* Communicate recommendations or findings to Senior Revenue Cycle Leadership and Post Acute Senior Leadership
* Assist in mentoring and educating for succession planning and team excellence.
* Works with Managed Care department and designated Payer Representatives to resolve Aged AR or issues.
* Monitor market and/or payer changes for payment rules.
* Establish and maintain working relationships with physicians, operational leaders, and post acute team.
* Maintain standards in use of systems and applications for consistent follow-up account management.
* Identify and brings to management attention any opportunities for system or process improvements.
* Approve and manage tracking of sick/vacation requests in accordance with department policy.
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.




Required Minimum Education:

• High School Diploma General


• Bachelors Business Administration/Management-Preferred

Required Minimum License(s) and Certification(s):



All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s):





Required Minimum Experience:



Minimum 3 years Post Acute (Home Health & Hospice) billing/collection experience or AR experience in a large business office, Knowledge of Post Acute intake, clinical, and revenue cycle workflows, Medicare and Medicaid regulations for billing Required and
Proficiency in Microsoft Office products with Excel pivot table and V lookup experience Required and
Minimum 1 year Previous management, leadership, coaching, or mentoring experience in post acute billing and follow up Required or
Minimum 5 years Post Acute revenue cycle billing and collections experience in lieu of degree Required




Required Minimum Skills:



Broad proven practical experience in Post Acute billing, follow up, and customer service High
Knowledge of overall revenue cycle activities High
Knowledge of state and federal regulations as they pertain to collection processes and procedures High
Knowledge of and skill in the use of computers and related systems and software Medium
Knowledge of Managed Care contracts and various payment methodologies used and billing requirements. High
Skill in motivating and directing the work and activities of staff with the ability to effectively delegate Medium
Ability to establish and maintain a cohesive work team and efficiently work under pressure. Medium
Demonstrates a commitment to continuous learning and operationalize that learning Medium
Ability to deal effectively with constant changes and be a change agent High
Ability to deal with difficult people and /or difficult situations effectively Medium Apply Now