Senior Manager, Revenue Cycle Vendor Operations

Position: Senior Manager, Revenue Cycle Vendor Operations        

Department: PFS Administration

Schedule: Full Time, Quincy MA

POSITION SUMMARY:

The Senior Manager, Revenue Cycle Vendor Operations will be managing the third-party vendor relationships, identifying process improvements and the billing cycle (the billing, collection, and follow-up) under the direction of the Senior Director Revenue of Cycle Operations, Hospital Billing and Professional Billing. The Senior Manager, Revenue Cycle Vendor Operations will also lead a small team of Revenue Cycle Business Partners and analysts. This Senior Manager will be the primary Revenue Cycle Billing liaison between designated between department(s), the Professional Billing office, third-party vendors, and all other stakeholders. The individual will be responsible for building and maintaining collaborative and productive relationships within the organization, managing revenue cycle projects, and driving performance.  Professional revenue cycle expertise and strong communication skills are required.

JOB REQUIREMENTS

EDUCATION:

Bachelor’s Degree in Business / Healthcare related field (or work experience equivalent).

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

None

EXPERIENCE:

Minimum of 7-10 years related experience required. Requires an extensive knowledge of policies, procedures, systems and equipment relating to revenue cycle operations; of regulations and guidelines pertaining to third-party payers and self-pay patients; of Microsoft Office suite; of supervisory techniques and performance management at a level generally acquired through seven to ten years of experience. Specifically, experience in an academic medical center managing billing functions.  
Epic system experience preferred.
 

KNOWLEDGE, SKILLS & ABILITIES:

• Advanced knowledge of healthcare revenue cycle functions, including coding and billing guidelines, government payer regulations.  Must have CPT coding knowledge.
• Working knowledge of payer reimbursement and rules.
• Experienced in auditing, training and communicating revenue cycle regulations and concepts.
• Excellent interpersonal and communication skills to positively interact with a variety of hospital personnel, including administrative and management staff in a fast paced environment.
• Strong analytical skills.
• Highly skilled experience and knowledge of Windows-based software required, including but not limited to Microsoft Windows, Outlook, Excel and Access.
• Proficient skills to collect, organize and analyze data, produce actionable reports and recommend improvements and solutions.
• Possess effective oral and written skills.
• Ability to interpret and implement regulatory standards.
• Working knowledge of multiple healthcare applications, including but not limited to Epic.
• Possess effective time management skills to permit handling of large workload.

ESSENTIAL RESPONSIBIILITIES/DUTIES:

• Represent the Single Billing Office in the role as a subject matter expert for revenue cycle items related to all department(s) within the Single Billing office (SBO).
• Manages and coordinates the activities of the SBO and Revenue Cycle Associates team teams to achieve departmental goals for cash collection, lowering insurance and patient account receivables, and reducing bad debt. Sets daily goals and targets, motivates and supports staff to meet those targets. Interacts with BMC departments and payer representatives to address account resolution barriers. 
• Works collaboratively with the Professional Billing Office (PBO) to address issues that may cause challenges to meet service levels and KPIs.
• Work collaboratively with PBO, departments, and third party billing vendors to drive organizational efficiencies and alignment and to ensure processes and systems are standardized and optimized for efficient and effective flow of patient accounts
• Identify areas of opportunity to apply process changes and/or technology implementation/updates to optimize performance within the Revenue Cycle SBO department.
• Develops programs, policies, processes and procedures for meeting KPIs and achieving short and long term goals. Documents processes among important internal customers (including but not limited to, Case Management, Patient Access, Registration, Coding, outside vendors), identifies gaps, and recommends changes in policies, processes and procedures to address operational needs and to ensure continuous quality improvement.
• Consistently manages Revenue Cycle-SBO to meet federal, state, and third-party payer regulations and guidelines. 
• Oversees department activities to meet goals by specified target dates. Holds regularly scheduled staff meetings and daily huddles to convey information and motivate staff.
• Develops and maintains productivity and quality measurements and adjusts resources to meet hospital and departmental standards.
• Demonstrates problem-solving solutions and initiates changes as required. Sets daily direction and reviews team assignments with supervisors. Develops, monitors, and uses reporting tools, monthly reports, and analyses for management.  
• Demonstrates ability to identify and resolve interpersonal or professional conflicts when dealing with the BMC community and external customers (vendors, payers and others). Investigates and responds appropriately to all complaints and takes effective actions to resolve issues.
• Responsible for effective fiscal management of department operations. Assists the Senior Director in developing and monitoring budgets. Suggests alternatives to the established budget depending on shifting demands of resources.
• Maintains effective and appropriate staffing and ensures effective hiring processes. Conducts employee disciplinary procedures up to and including termination with appropriate documentation according to Human Resources policy and employee-relations laws and guidelines.
• Ensures on-going training for employees to respond to evolving business and staff needs and challenges. Develops training materials for management of department-specific content.  Establishes and delivers departmental training modules and competencies. Performs a training needs analysis annually to target continuing training needs for Senior Director’s review. Ensures all staff are appropriately trained and have completed annual training as required by BMC (for example, safety and infection control).
• Manage implementation of standards and systems to enhance quality, consistency, efficiency, and timeliness of responsibilities for the enterprise; designing, develop, and monitor performance improvement processes (e.g. quality, accuracy, productivity and timeliness); identify continuous improvement opportunities and manage productivity metrics and efficiencies
• Provide consistent monitoring, reporting, and communication of department-specific trends and overall revenue cycle performance for assigned areas.  
• Establish and maintain a close working relationship with assigned department(s) as well as other stakeholders within the organization.
• Collaborate with the necessary team(s) to prepare standard revenue cycle reports for the assigned department(s).   Review and analyze reports for identification of trends and issues relating to all revenue cycle IT platforms (including but not limited to Epic, NThrive, Medicare FISS, and others.
• Demonstrates professional and focused, written and verbal communication at all times and in all interactions. Compile and distribute meeting minutes and action items.  Continue timely follow up of action items until resolved. 
• Provide general oversight of third party billing vendor(s).  Develop a strong working relationship with assigned vendor Managers.     
• Monitor work queue performance by all parties, including department and third-party vendor.
• Demonstrate proficiency in all aspects of professional revenue cycle operations to achieve increased collections, optimal billing goals, and adherence to compliance rules and regulations.
• Participate in multiple projects simultaneously, while keeping priorities aligned with department and organizational goals.
• Conform to hospital standards of performance and conduct, including those pertaining to patient rights, so that the best possible customer service and patient care may be provided.
• Represents the department at meetings and on committees. Participates in the decision and policy-making process on hospital-wide issues, particularly those which relate to Revenue Cycle operations activities, as assigned. Represents the department and the hospital in a positive manner.
• Preform other duties as required. IND123

Must adhere to all of BMC’s RESPECT behavioral standards.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

Equal Opportunity Employer/Disabled/Veterans