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Patient Financial Engagement Manager – (Remote)         

Remote, Remote
Job Purpose:
This position is responsible for managing multiple aspects of the Revenue Cycle department functions while ensuring the activities of the Revenue Cycle team are conducted in a manner that is consistent with overall department processes and are in compliance with Federal, State, and Payer regulations, guidelines and requirements. 

This individual will develop employee benchmarks by monitoring team progress and address issues as they arise. Supervises, trains, coaches, and mentors employees. Maintains internal and external customer satisfaction by providing problem-solving resources; managing staff.

Job Overview:
  • Liaison between Sales and Revenue Cycle regarding all billing communication
  • Single point of contact for external customers (ordering physicians, practices, hospitals and payers)
  • Accountable for overseeing activity to address existing and emerging issues/trends and inform upper management of assessed levels of risk
  • Develop and improve procedures to ensure accurate, efficient, and scalable Revenue Cycle processes
  • Manage billing policies and implement as appropriate (Hold Harmless, Prompt Pay Discount, Financial Assistance Policy, Payment Plans, Self-Pay, etc.)
  • Ensure employees can articulate information in a manner that patients, guarantors and/or family members comprehend the financial responsibilities
  • Patient engagement with heavy focus on patient possible out of pocket expenses and benefit verification including Medicare, Medicaid, PPOs, HMOs, Advantage plans, IPAs and managed healthcare programs
  • Identify insurance requirements upfront (letter of medical necessity, pre-auth requirements)
  • Strong focus on one call resolution
  • Interact with payers on behalf of patients regarding denials
  • Review Negotiations and Single Case Agreements
  • Track Medicare, global code and consolidated billing errors
  • Credential new hires and monitor terminations to eliminate employee access
  • Main contact for Collection agency regarding delinquent account reporting and set protocols
  • Coaches/counsels direct reports to maximize performance, job progression and leads positive change
  • Meet regularly with team to set expectations, assist in monitoring of the teams’ training, productivity, schedules, reviews and customer service standards (KPI’s and SLA’s)
  • Present weekly updates on Revenue Cycle department’s accomplishments and challenges to department Vice President
  • Daily reconciliation of team/online credit card payments
  • Ensure accuracy of all patient statements prior to authorizing release
  • Review and coordinate Medicare CERT audits
  • Formulate project planning strategies/integrations between multiple systems
  • Prepare and administer monthly billing and performance reports to present to upper management
  • Recommends and executes initiatives to enhance current programs, develop new programs, or shorten process cycle time to meet or exceed productivity goals
  • Effective utilization and management of budgets for the Revenue Cycle department
  • Facilitate escalated calls as needed while maintaining a high level of professionalism and integrity
  • Approves monthly patient and payer refunds due to overpayment, claim reprocessing, etc.
  • Track incoming and outbound calls, average handling times, time in queues, abandoned rates, call hold times, escalation rates, customer satisfaction rates
  • Oversee bi-weekly timecard management
  • Initiate contact with patients paid direct by payer for services rendered
  • Forecast growth and make staffing recommendations to Management
  • Coordinate and oversee the interviewing of all potential candidates for the Revenue Cycle department
  • Consistently build employee morale, motivation, and loyalty and foster a team-like environment
  • Work as intermediary between Supervisor(s) and Human Resources to resolve personnel issues as they arise
  • Adhere to all HIPAA protocols and health insurance guidelines and regulations
  • Stay updated on changes to insurance network contracts and fee schedules

Performance Factors:
  • Fast Paced Work Environment: The employee moves swiftly from one task to another by multi-tasking and utilizing time management.
 
  • Cross Functionality:  Coordinate inter-department workflows and processes with management and applicable departments within the Company.
 
  • Communication & Contact: The employee communicates effectively both verbally and in writing with superiors, peers, and individuals inside and outside the Company.
 
  • Relationship with Others & Attitude: The employee works effectively and relates well with others including superiors, peers, and individuals inside and outside the Company. The employee exhibits a professional manner in dealing with others and works to maintain constructive working relationships.
 
  • Self-Motivation & Initiative: Must be a self-starter and demonstrate the ability to work independently by making appropriate decisions according to the organizational and departmental guidelines that fall within the scope of the position. 
 
  • Project Planning: The employee asks questions concerning projects and assigned tasks. The employee volunteers to take on additional responsibilities to meet the needs of the department.

Knowledge, Skills, and Abilities:
  • Ability to work independently
  • Maintain strict confidentiality of all personal health sensitive information
  • Ability to multi-task and prioritize workload
  • Excellent written and verbal communication skills
  • Knowledge of Medical Terminology
  • Ability to read and interpret Explanation of Benefits statements
  • Ability to relate with and communicate with all levels of management
  • Ability to maintain a high degree of professionalism and integrity
  • Possess strong and effective customer service skills telephonically to include proper grammar with a positive and friendly demeanor
  • Display excellent judgment at all times
  • Absolute attention to detail and follow-up
  • Must be a team player, be flexible, and be a good listener with a high level of patience
  • Maintain strict confidentiality in all aspects of the job role
  • Ability to work in a fast-paced, deadline-oriented environment
  • Strong organizational and time management skills


Required Education & Work Experience:
  • High School Diploma or equivalent
  • Two to 5 years supervisory experience

Preferred Education & Work Experience:
  • Bachelor’s Degree or equivalent practical experience
  • Two to Four years Revenue Cycle experience

 

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