Manager of Professional Revenue Cycle Operations (SMG)
Steward Health Care System LLC ("Steward") is a fully integrated, physician-led national health care services organization committed to providing the highest quality of care in the most cost-efficient manner in the communities where out patents live. Steward - the largest privately held health care company in the U.S. - owns and operations 35 community hospitals across nine states, serves over 1,000 distinct communities and employs approximately 40,000 health care professionals. In addition to our hospitals, the Steward provider network includes 4,800 providers, 25 urgent care centers, 87 preferred skilled nursing facilities, substantial behavioral health offerings, over 7,300 hospital beds under management, and approximately 1.5 million full risk covered lies through the company's managed care and health insurance services. The total number of paneled lives within Steward's integrated care network is projected to reach 3 million in 2018.
Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, New Jersey, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.
The Manager of Professional Revenue Cycle Operations will be responsible for daily operations of the accounts receivable and follow-up functions of the Steward Medical Group, professional billing team. The manager is passionate about the mechanics of successful payer collections and seeks innovative solutions with their team to optimize performance. This individual will be highly skilled in the use and understanding of cloud based, medical billing software; knowledgeable of payer rules and payer/provider workflows that result in optimal reimbursement; have an innate interest in analytical research.
- Maintain knowledge of payer rules, regulations and guidelines to ensure ethical and compliant standards and provide continued education for staff as appropriate
- Provide analysis and data driven recommendations to senior management
- Design and implement policies, protocols and systems to improve productivity, efficiency and customer service, as well as, enhance revenue acquisition.
- Monitors and assigns daily workload to the AR team to optimize load-balancing and staff acuity.
- Demonstrate ability to set priorities and manage multiple projects simultaneously
- Develops and implements monitoring mechanisms to track AR claim productivity, identifying and providing additional training where needed.
- Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
- Designs, establishes and maintains an organizational structure and staffing model to accomplish the organization’s goals and objectives in an effective manner; recruits, employs, trains, coaches and evaluates AR staff members.
- Works to assure program compliance with all applicable federal and state rules, regulations and laws related to healthcare billing.
- Conduct regular staff meetings to review productivity metrics, reaffirm weekly/monthly goals, provide coaching/training and ensure work is appropriately prioritized
- Demonstrate excellent communication skills, both written and verbal.
- Bachelors Degree in Health information mgmt., business or health administration.
- 3 years experience in AR management, medical practice revenue cycle, Third Party Payor work, or related health care field.
- 2 years of management experience.
- Intermediate or Advanced knowledge of MS Excel & MS Word required.
- Working knowledge of CPT-4, HCPCS, revenue codes and ICD-9 coding.
- Proficient with Revenue Cycle Management software - athenaNet suite preferred.
- Strong written and oral communication skills.
- Understanding of the organization’s goals and objectives.
- Self-motivated and directed.
- Ability to effectively prioritize and execute tasks in a high-growth, fast paced environment.
- Experience working in a team-oriented, collaborative environment.
- Strong customer-service orientation.
Job Reference #: 1900844