Position Summary
The Manager of Revenue Cycle Operations is responsible for the collection of patient balances for services provided within the hospital and in the ambulatory setting for Hunterdon Health. This position is an integral part of the Revenue Cycle Operations and the patient experience. The Manager and their team facilitates the collection of patient financial obligations while providing excellent customer service consistent with the vision and values of Hunterdon Health and their service to patients and the community.
Primary Position Responsibilities
Develops and maintains expertise and knowledge of local, state and federal regulations regarding the collection of patient responsibility. Implements required processes to ensure Hunterdon Health remains in compliance with all local, state, and federal regulations including regulations and compliance with Medicare and Medicaid rules. Develops and maintains expertise and knowledge of collection systems – Affinity, NextGen and any other billing systems utilized by the health system.Manages the plans, programs and processes related to the collection of patient accounts.Writes, plans and implements reimbursement policies, credit limit policies, collection policies, and customer service protocols. Evaluates and assesses the effectiveness of each and, as needed, implements continuous improvement to all.Develops and implements standard industry metrics and measures the performance of the operations including the ongoing review of collection and credit reports, and patient statements. Develops management reports which outline Hunterdon’s actual performance versus industry benchmarks. Identifies and develop improvement plans and processes where the health system is underperforming against the benchmarks. Reports on a weekly, biweekly, monthly, quarterly, annual basis on all key metrics to the Director, SBO and Chief Revenue OfficerHires, trains, and manages the staffing, workload and resources to achieve the collection and customer service goals of the departmentEnsures a customer support staff that effectively communicates with patients on their patient responsibility, integration of insurances, and conveys the available programs to assist with their financial obligations.Ensures the Accounts Receivable processes are effective and meet the established performance metrics and collection timeframes of the health system.Meets frequently with staff for communication, training and coaching of staff; as well as, meets regularly with peers on the CBO leadership team to ensure workflows between collections, accounts receivables, and customer service are maximized to achieve the goals and expectations of the entire organization.Manages departmental vendor relationships to optimize cash collections and patient experience including, but not limited to ensuring contract language and performance expectations are clearly defined and that there are established performance metrics that are tracked and reported to management and the vendor. Addresses any vendor deficiencies. Administers and oversees Hunterdon’s charitable care program and any discount programs consistent with Hunterdon’s established charity policies.Performs special projects as assigned.
Qualifications
- Minimum Education:
- Required:
- College Degree or higher with a concentration in Finance, Accounting, Business or Healthcare administration required.
Minimum Years of Experience:
- Required:
- Minimum of 5 years’ experience managing and supervising in billing, accounts receivable, customer service areas in hospital and/or physician billing offices required
- Minimum of 5 years’ experience in collections, customer service, and third-party reimbursement required
Preferred:
- Knowledge and experience with risk management practices for accounts receivable and collections
- License, Registry or Certification:
- Required: none
- Preferred: Revenue Cycle Certifications preferred
Knowledge, Skills and/or Abilities:
Required:
- Knowledge of collection principles and procedures
- Knowledge and experience of governmental payor and private insurance contracts and billing rules
- Knowledge and experience of local, state, and federal government compliance requirements regarding patient billing
- Knowledge of finance and accounting
- Knowledge of healthcare industry and trends
- Knowledge and experience working with third party collection agencies and vendors
- Knowledge and experience working with charity care policies and procedures and required documentation
- Strong customer service and convincing skills including demonstrated communication and interpersonal skills – verbal and written
- Prior experience with industry benchmarking, creating performance metrics and tracking methods
- Demonstrated analytical experience in data analysis including gathering, synthesizing and using data effective; report writing; and developing executive/management reports
- Demonstrated organization, management and problem-solving skills
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