Steward Health Care System Manager, Revenue Management in Westwood, Massachusetts
This position is responsible for providing leadership and subject matter expertise relative to forecasting, calculating and capturing all net revenue contractually owed by the payers.
Independently manage and monitor daily work related to identifying net revenue contractually owed.
Experience with a contract management tool to manage contract inventories and simply the reimbursement process by calculating expected payments.
Experience interpreting managed and commercial payer contract language, state/federal payer regulations and how it relates to pricing claims.
Understand the process to identify, research and resolve over/under payments.
Manage the daily operations the revenue integrity unit including productivity, quality, hours-worked, development needs and other aspects of employee/team performance.
Assist in the evaluation and recommendations of programs, procedures for improved operations, modifications to and/or implementation of new procedures.
Identify and work with the director to resolve problems with CBO processes and when appropriate, initiate changes to prevent future problems.
Assist in establishing long and short term unit goals and objectives to support department and corporate strategic plan.
Maintain professional competency, according to department policies, procedures and protocols.
Maintain a repository of knowledge required to train new revenue cycle associates including manuals, tip sheets and other materials.
Maintain strict confidentiality and adheres to all HIPAA guidelines/regulations.
Associate's degree required; Bachelors preferred.
4 years minimum experience in hospital billing with specific payer(s) subject matter expertise.
Demonstrated ability to manage teams or groups of colleagues.
Experience with patient accounting systems, billing/claim submission software required.
Specific XClaim and/or Meditech experience a plus.
Possess ability to investigate, analyze and in coordination with management, resolve departmental issues.
Possess ability to work efficiently and accurately, and to organize and plan work.
Possess flexibility and adaptability to work additional hours and to work under stress.
Ability to establish and maintain effective working relationships and communicate clearly with customers both within and outside of Steward.
Highly detail oriented and well organized; ability to multitask.