Cleveland, OH, USA
Plans, organizes, controls, standardizes and directs UH CBO Insurance collections employees, processes and strategy. Manages day to day operations of the Revenue Cycle billed AR to ensure the efficient and expected cash collection through productive and timely claim submission, follow-up, denials management and appeal activity to ensure expected payment of insurance and/or patient claims for all hospital services billed through the Central Business Office. Remains current for self and staff with governmental and third party billing, follow-up and appeal requirements for compliant billing and follow-up of both inpatient and outpatient claims for all wholly owned facilities. Performs departmental audit review and resolution processes in accordance with organizational requirements for areas of responsibility. Works closely to support RCM Senior leadership to coordinate support and hand offs between Pre-billing/billing, Hospital Financial Counselors, Customer Service, Self-Pay Collections and Physician A/R teams to optimize patient experience and collections. Leadership role responsible for managing secondary billing office vendor relationships and performance designed to optimize net revenue. Works closely with Managed Care, Payers, Finance and Operations to communicate A/R performance and resolve A/R issues and drive process improvement.
The position is responsible for an estimated 70 to 80 FTEs, including 4 supervisors and annual hospital insurance collections of over $1.8B.
Establishes, enforces and ensures standards of performance and behaviors, monitors and analyzes departmental service standards for Insurance Follow up Insurance collections, and responds timely with Customer Service to respond to in-bound patient call activity to ensure our patients receive superior service.
The position is responsible for adhering and creating Insurance Collection policy and guidelines in coordination with RCM Senior Leadership, as well as driving insurance collection strategy, analysis, monitoring payor performance, as well as oversight of Denials, Credit Management and Post Payment Review. Supports in decisions and strategy associated with on line and other technology solutions as well as pre collect, collection and other vendors contracted to optimize patient collections. Ongoing alignment and strategy to coordinate and follow processes implemented by CBO.
Understands and supports internal and external relationships including I.T., Legal, Compliance, Internal Audit as well as vendor relationships to ensure compliant revenue transactions for each of the 7 Core Hospitals (Case, UH Regional, Ahuja, Geauga, Geneva and Conneaut)
*This role may encounter Protected Health Information (PHI) as part of regular responsibilities. UH employees must abide by all requirements to safely and securely maintain PHI for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace
Bachelor’s degree required
Experience & Knowledge:
Special Skills & Equipment Knowledge:
Oracle, Kronos, Soarian, and/or IDX experience preferred
To apply, please visit the following URL:https://www.hospitalcareers.com/job/3691416/manager-patient-accounts/→