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Manager, Payment Resolution (Hospital) PBS-K Full-time Job

3 months ago Customer Services Kentwood   225 views
Job Details

 

Provides education to applicable departments across each the local RHMs (crossing multiple states and regions) that are included in the respective PBS location regarding denials prevention and appeal success rates. 

Manages assigned staff to ensure steady workflow balance and high-quality outcomes anticipating and planning for staffing fluctuations:

  • Interviews, selects and is accountable for the on-going development and evaluation of colleagues within the area of responsibility;
  • Develops colleague work schedules to ensure cost effective staffing that meets customer requirements and financial performance;
  • Establishes, implements and evaluates on-going performance improvement programs, utilizing an interdisciplinary approach;
  • Responsible for the financial and personnel management of assigned areas, and
  • Effectively directs and facilitates a multidisciplinary team to achieve its desired outcomes.

Creates and monitors a culture supportive of personnel by fostering individual motivation, teamwork and high levels of performance and accountability utilizing a participative management style to ensure staff retention. Identifies action plans to improve the quality of services in a cost-efficient manner and facilitates plan implementation.

Maintains professional development and growth through journals, professional local, regional and national affiliations, continuing programs, seminars, and workshops to keep abreast of trends in revenue cycle operations and healthcare in general:

  • Develops and implements an annual plan of personal and professional development.

Serves in a leadership role and promotes positive Human Resource Management skills by fostering teamwork between business and clinical stakeholders and by recruiting, retaining, training, mentoring, developing and managing staff to achieve strategic objectives.

Other duties as needed and assigned by the Director.

Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

MINIMUM QUALIFICATIONS

Must possess a comprehensive knowledge of revenue cycle functions and systems, as normally obtained through a Bachelor’s degree in Business or Healthcare Administration or a related field, and minimum five (5) years of experience within the area of revenue management, specifically with Denials or other management functions related to revenue cycle activities or an equivalent combination of education and experience. Experience in a complex, multi-entity healthcare organization across multiple states and regions, or large complex revenue cycle services preferred.

Exhibits superior management skills that emphasize teambuilding and strong leadership with the ability to provide clear direction to the department.

Customer service background and working knowledge of computer operations and electronic interfaces. Formal software course training is preferred.

Demonstrated ability to interpret 3rd party payer contract requirements and recommend, design and implement procedures for compliance with regulations and standards

Knowledge of APC’s including NCCI and OPPS error edits.

Utilization management knowledge.

Knowledge of and ability to perform medical records review for documentation requirements.

Supervisory experience required

 

 

Company Description
Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 92 hospitals, as well as 106 continuing care locations that include PACE programs, senior living facilities, and home care and hospice services. Its continuing care programs provide nearly 2 million visits annually.