- The overall responsibilities for this job are to ensure client satisfaction and retention on current accounts and to help grow existing ones by identification of opportunities for enhancing services offered and ensuring the operational performance standards are met. He/she also directs and manages all activities that relate to creating a culture of quality.
- He/she shall be responsible for leading Billing Operations (Medical Billing & Account Resolution)s daily operations, ensuring optimal productivity, quality, and compliance with healthcare regulations. This role is critical for driving continuous improvement, resolving issues, and enhancing overall operational efficiency. This is to ensure improvements in both team as well as organizational effectiveness, thereby directly impacting the organization’s success.
Key Deliverables
1. Operations Management:
- Daily Oversight: Plan, monitor, and evaluate the daily performance of Associates, ensuring that production targets and quality standards are met.
- Schedule Coordination: Ensure that daily schedules are adhered to; communicate with Superiors and Associate Operations about any challenges that may hinder deadlines.
- Workflow Optimization: Identify operational priorities and workflow challenges; adjust staff assignments to maintain a consistent work flow.
2. Policy Development:
- Process Improvement: Assist in the development and revision of operational policies and procedures to enhance workflow efficiency.
- Client Understanding: Develop a comprehensive understanding of workflows, procedures, and specific requirements for each assigned client.
3. Training and Development:
- Staff Training: Provide training and support to Associates on best practices in billing and accounts receivable processes.
- Performance Reviews: Conduct regular performance evaluations, offering feedback and coaching to promote professional growth.
4. Issue Resolution:
- Query Management: Resolve queries and conduct thorough account reviews to ensure accuracy in billing and collections.
- Denial Management: Demonstrate expertise in denial management, including understanding of Medicare, Medicaid, and ICD and CPT coding, to effectively address and resolve denials.
5. Communication and Reporting:
- Daily Updates: Ensure timely sending of acknowledgment emails regarding daily updates to relevant stakeholders.
- Data Analysis: Analyze data to identify payer issues and challenges; implement solutions to address these concerns.
6. Team Engagement:
- Engagement Initiatives: Foster team engagement and work towards reducing absenteeism and turnover.
- Lead Communication: Serve as the primary contact for internal and external communications related to revenue cycle processes.
7. Performance Management:
- Metrics Tracking: Monitor and report on key performance indicators (KPIs) related to billing, collections, and team performance.
- Escalation Point: Act as the first level of escalation for operational issues, addressing concerns promptly and effectively.
8. Project Involvement:
- Project Participation: Actively participate in project launch sessions to understand current processes and track daily progress during launch periods.
- Feedback Loop: Provide feedback on project performance and suggest enhancements based on team experiences.
Experience & Qualifications: Relevant Years of Experience :
Minimum of 15+ years of experience in Revenue Cycle Management, with at least 8 years in a supervisory or leadership role.
Strong background in medical billing and accounts receivable processes.