AND RESPONSIBILITIES In-depth knowledge of all applications used in Patient Access and Revenue Cycle operations (e.g. EPIC, RTE, Scheduling, etc.). Ensures staffing needs are met while maintaining budgeted staffing levels.
Implements alternative staffing patterns as needs arise. Reviews and process timecards in an accurate and timely manner. Maintains accurate employee attendance files.
Interviews and hires applicants to maintain adequate staffing levels. Provides orientation and training to new hires, completing necessary competency/orientation checklists. Actively seeks and schedules staff development opportunities, including those outside the department that would be beneficial for partners to attend.
Supervises partners and ensures workload is distributed equitably within the work group. Conducts team meetings to apprise staff of changes and to address broader-based program area issues and initiatives. Assist staff with complex work situations.
Performs audits to review partner performance on an ongoing basis to ensure policies and procedures are being followed consistently and that any issues are addressed. Provides timely performance improvement feedback and coaching. Evaluates partners by conducting training assessment and completing employee performance reviews on time.
Monitors and maintains reports and dashboards to monitor productivity on each partner and the Department as a whole. Tracks and measures volume of work assigned to the work group to set goals and monitor trends and shifts in volume, etc. Monitors the accuracy of the data entry of demographic and insurance information and adherence to access and financial policies/procedures.
Develops, recommends and implements policies and procedures for the department. Updates policy and procedure resources as necessary and ensures partners are notified of changes. Enforces established policies and procedures, including work rules, safety procedures, confidentiality standards, CMOS, JCAHO standards and CMS standards.
Monitors accuracy of scheduling functions, provider templates and makes recommendations on template changes to best utilize providers time, while ensuring patient satisfaction. Monitors workqueues and reports to ensure accurate and timely registration, scheduling and claims submission. Coordinates functions within defined work group, works cooperatively with other work group supervisors to ensure smooth and timely processing of third-party claims and timely follow-up with patients.
Maintains a solid understanding and knowledge of payer requirements, registration and scheduling workflows, as well as referral requirements to ensure staff follows established procedures to maximize reimbursement. Reviews and analyzes new government billing regulations/guidelines, new managed care contracts, and industry publications to advise Director, partners, and other department heads of potential issues that could impact billing, reimbursement and compliance.
Ensures that the department follows and adheres to all policies and guidelines regarding the handling of cash and checks, and the posting of payments and adjustments according to Finance. Monitors and reviews precertification and referral authorizations workflows to ensure maximum reimbursement for services. Works collaboratively with counterparts, Patient Financial Services, and other departments on issues relating to patient registration, scheduling, patient flow, insurance verification, referrals and reimbursement issues.
Serves as the knowledge expert and information source for staff. Keeps up to date on insurance, referral, and billing requirements Provides Ancillary Providers with necessary and accurate information related to insurance determination and financial compliance. Assists with application implementation, upgrades, enhancements, and usability testing.
Provides education and training to clinic leadership and partners to ensure financial policies are being adhered to. Reviews registration or authorization related denials and provides education as necessary to reduce write offs. Performs other duties as assigned.
EDUCATION AND/OR EXPERIENCE High school diploma or equivalent preferred. Associates degree in a business or healthcare field required (or an equivalent of experience, certification and years of service). Four years of patient access, revenue cycle or other healthcare experience required, with emphasis in access services, POS collections, registration, scheduling, insurance verifications/authorization, billing, or customer service preferred Two years of prior leadership related experience required.
CERTIFICATION/LICENSURE Healthcare revenue cycle related certification or an equivalently designated certification approved by management required within 1 year. OTHER SKILLS AND ABILITIES Proven ability to work effectively in a team environment. Strong typing/data entry experience.
Strong organizational skills and attention to detail, accuracy and follow-through. Knowledge of medical terminology preferred. LEVEL OF SUPERVISION Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems; employee adherence to annual education and certification requirements SUPERVISES Supervisory responsibilities are conducted in accordance with directives of management, the organization's policies, and applicable laws.
$50,183.24 - $75,274.86 Mercyhealth is an Equal Opportunity Employer . All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status. Mercyhealth offers competitive pay and a comprehensive benefits package including: Medical, Dental, Vision Life & Disability Insurance FSA/HSA Options Generous, accruing paid time off Paid Parental and caregiver leave Career advancement and educational opportunities Tuition and certification reimbursement Certification Reimbursement Well-being Programs Employee Discounts On-Demand Pay Financial Education Annual recognition/awards events Partner appreciation days Family entertainment/attractions discount Community service/improvement opportunities Click here for more details regarding Mercyhealth Careers Benefit Information.
At Mercyhealth, we don’t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin. Mercyhealth has been nationally recognized for our commitment to our people and culture, including: #1 in the nation on AARP's Best Employers for Workers Over 50 One of Working Mother magazine's 100 Best Companies for Working Mothers A Top 50 Company and Top 10 Nonprofit for Executive Women