Revenue Cycle Resume Samples
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Revenue Cycle Resume Samples
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BE
B Eichmann
Brain
Eichmann
62438 Greenholt Court
Phoenix
AZ
+1 (555) 292 5201
62438 Greenholt Court
Phoenix
AZ
Phone
p
+1 (555) 292 5201
Experience
Experience
Philadelphia, PA
Revenue Cycle Coordinator
Philadelphia, PA
Leuschke Group
Philadelphia, PA
Revenue Cycle Coordinator
- Work with coding staff to resolve coding related denials
- Partner with clinical leaders, admitting departments and physicians related to securing payment on hospital accounts from third party resources and/or patients
- Responsible for improving and maintaining an efficient revenue for the department
- Monitors high dollar and aging accounts (unbilled, denials, follow-up) in systems for escalation with departments (DNFB, XClaim, Revenue Recover, RTS)
- Develops and maintains efficient working relationships
- In partnership with CBO, follow-up on claim status and appeals including interaction with the payors
- Reviews and ensures departments are reconciling charges on a daily basis
Chicago, IL
Revenue Cycle Mgt Analyst
Chicago, IL
Wuckert-Haley
Chicago, IL
Revenue Cycle Mgt Analyst
- Reporting at CBO monthly operations meetings
- Complies with departmental and company-wide policies and procedures
- Create new reports for the RCM Auditing Dept, Contract Revenue Dept, Billing Dept and Business Systems Dept; train said departments on running reports and troubleshoot future issues or modifications
- Support and Training, by providing ongoing support to the CBO RCM Revenue Cycle Analysts
- Distribute Deposit Report of current month’s deposits, including previous day’s Lockbox and EFT transactions, along with monthly projection of receipts by region
- Responsible for balancing tie outs from billing and patient accounting systems (GPMS, NextGen,
- Monthly Reporting, Analysis, and Trending
present
Houston, TX
Revenue Cycle Optimization Manager
Houston, TX
Jakubowski, Grimes and Mills
present
Houston, TX
Revenue Cycle Optimization Manager
present
- Develop work plans, project tasks and manage projects in accordance with budget
- Provide feedback to management concerning possible problems or areas of improvement
- Perform other duties as assigned by management
- Development of options and recommendations for client improvement
- Provide informed feedback to Optum and client executives including assessments of processes, standards, suggestions and improvements
- Interim management
- Office Process and Performance Assessments
Education
Education
Bachelor’s Degree in Accounting
Bachelor’s Degree in Accounting
University of San Francisco
Bachelor’s Degree in Accounting
Skills
Skills
- Possesses the ability to build trusting relationships with multiple Client Executives at all levels and for numerous unique customers
- Possesses analytical ability sufficient to work in a data-heavy environment and to identify trends in the data
- Possess business acumen with an emphasis on: effective communication (i.e., listening, written and verbal), negotiation, influencing decision makers, business planning, strategy, problem solving, decision making and time management skills
- Policies & Procedures – demonstrates knowledge and understanding of organizational policies, procedures and systems
- Customer Orientation – establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
- Leadership – guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
- Communication – communicates clearly and concisely, verbally and in writing
- Tactical Execution – oversees the development, deployment and direction of complex programs and processes
- Understanding of the market, trends, competition, and key pain points for hospital executives
- Financial Management – applies tools and processes to successfully manage budget
15 Revenue Cycle resume templates
Read our complete resume writing guides
1
Manager of Revenue Cycle Integrity Resume Examples & Samples
- Certified Professional Coder – CPC
- 5 years of billing experience in a physician, ambulatory setting, and/or clinic setting
- Experienced CPT, ICD9-10, and HCPC coding experience
- Experience with professional fee coding systems, charge code mapping, Third Party Billing audits and regulatory compliance
- EMR/EHR Experience – minimum of 2 years’ experience with one or more EMR/EHR software systems
- Healthcare Experience – minimum of 5 years’ experience in the healthcare industry
- Strong knowledge of medical insurance billing and collections including Medicare, Medicaid, Managed Care Products (HMO, PPO, etc.) and other third party guarantor voucher process
- Excellence in solving difficult problems relating to revenue cycle functions, coding, billing and collections relating to clinical documentation and coding errors
- Demonstrated ability to educate Physicians/Clinical Staff on required billing, coding and clinical documentation requirements
- Develop training materials and facilitate staff training on regulatory changes that impact billing and reimbursement
- Strong knowledge of medical insurance billing and collections with CPT, ICD, HCPC coding
- Excellent written and verbal communication skills with all staff levels and backgrounds
2
Xerox Revenue Cycle Consulting Resume Examples & Samples
- Employment Type: * Full-time (preferred) or Project Based depending on client needs and employee preference
- Travel: * Up to 80% travel may be required. Consultants live anywhere in the U.S. (remote) and travel to the project (client site)
- Position Overview: *
- Provide Consulting Services to clients concerning the following: *
3
VP-revenue Cycle Resume Examples & Samples
- 10+ years of experience in hospital finance w/ a particular focus on system-wide initiatives for revenue cycle management and systems
- Strong budgeting skills
- Demonstrable leadership abilities
4
Healthcare Revenue Cycle Senior Manager Resume Examples & Samples
- Ability to lead and develop others
- Strong organizational, time management and analytical skills
- Ability to work overtime as job and peak business deadlines require
- Ability to travel up to 80% as needed (travel can be much less depending on location of office)
- Positive, professional attitude and proactive approach to work
- Ability to work independently on various work assignments as needed
- Minimum of 5 years experience in healthcare revenue cycle and/or finance settings (with consulting experience preferred, but not required)
- Must have a solid reputation and references with previous clients, contacts, co-workers, etc
- Strong organizational, time management and analytical skills – with an entrepreneurial attitude
5
Healthcare Senior Sales Revenue Cycle Resume Examples & Samples
- Aggressive sales and marketing minded disposition
- Organized, with ability to manage campaigns, drive meaningful conversations for our thought leaders and manage the sales process to close
- Ability to think of innovative ways to drive messaging into a focused market
- Ability to sell over $3M in revenue and manage a $7M-$10M pipeline
- Ability to adapt to demand creators and market quickly
6
Consulting Senior Associate Healthcare Revenue Cycle Advisory Services Resume Examples & Samples
- Maintain and develop a high degree of expertise in revenue cycle operations, technical processes, and reports
- Support our management team in executing project work plans, including qualitative and quantitative tasks and analytics, to provide high quality client service delivery
- Act as part of the support team on projects to prioritize work tasks, ensure project milestones and deadlines are met, and ensure work products meet quality standards
- Assist Directors and Managers in scoping and planning multiple projects
- Develop and manage relationships with new and existing clients
- Bachelor's degree in Accounting, Finance, Business or other related field
- 3+ years of Healthcare consulting experience for Hospitals and large Physician groups
- Expertise in Patient Access and/or Patient financial services portions of the Revenue Cycle
- Experience in Denial Management Reporting(Ensure accurate capture of and reporting on denials to allow the organization to understand where and why claims are being denied and focus on how to reduce denied claims over time)
- Proven track record in improving process functions and financial performance
- Experience in leading or working with performance improvement workgroups
- Strong technical and analytical skills, particularly related to analyzing, summarizing and interpreting large data files
- Provide project support and potentially serve as subject matter expertise in utilizing Business Intelligence tools
- Experience in using QlikView software (or similar platform) is a plus
- Willing and able to travel 75%
7
Consulting Manager Healthcare Revenue Cycle Advisory Services Resume Examples & Samples
- Analyze and communicate financial and operational data to clients for decision-making and strategic planning
- Manage and execute project work plans, including qualitative and quantitative tasks and analytics, to provide high quality client service delivery
- Manage and direct support staff on projects to prioritize work tasks, ensure project milestones and deadlines are met, and ensure work products meet quality standards
- Assist Directors in scoping and planning multiple projects
- 5+ years of Healthcare consulting experience for Hospitals and large Physician groups
- Expertise in Patient financial services / Patient Accounting portion of the Revenue Cycle (including, but not limited to: Cash acceleration, Clean Claims, Insurance follow-up, Payment posting, Self Pay and Bad Debts Policy, Denial Management, Detailed mapping of adjustment codes, Revenue leakage)
- Proven track record in improving process and financial performance in revenue cycle operations
- Proven experience in managing client service teams and client relationships
- Working knowledge with query, extract, transformation and load (ETL) from common database platforms (SQL) and experience with ETL tools such as Talend or CSIS is desired
- Ability and willingness to travel nationwide 75%
8
Consulting Manager Healthcare Revenue Cycle Advisory Services Resume Examples & Samples
- 5+ years of Healthcare consulting experience with expertise in Revenue Cycle performance / process improvement in the patient financial services area of Hospitals
- In addition: 2+ years of direct industry experience in revenue cycle management, operational process improvement, implementation/design, data mining and detailed analytics
- Strong expertise in Denial Management Reporting and Resolution
- Understanding of bundling, ICD-10, Value-Based Purchasing, and other Health Care initiatives
9
Director of It-revenue Cycle Resume Examples & Samples
- Required: Bachelor’s degree in computer science or equivalent experience in a related field or equivalent applicable work experience
- Preferred: Master’s Degree in Health Administration and/or Business Administration degree
- Required: Seven or more years of experience in the implementation and support of revenue and access solutions in the ambulatory healthcare environment
- Required: Five or more years of leadership experience in ether the manager or director level
10
Revenue Cycle Auditor Resume Examples & Samples
- Collaborate with leadership to ensure an appropriate risk based approach to internal control audits
- Perform a comprehensive and ongoing evaluation and documentation of operational processes and key internal controls
- Work with departmental management to develop and update internal control documentation(process narratives, risk control matrices, etc.) periodically to include any new key internal controls or processes identified
- Perform audits on an ongoing basis ensuring compliance with applicable regulations and established PRMO policies and procedures
- Develop test plans to verify process effectiveness, accuracy, and completeness for specific internal controls
- Prepare accurate and thorough work papers and audit documentation to support the audit findings
- Identify internal control deficiencies and recommend remediation to strengthen the control environment
- Engage with process owners and managers in the timely remediation of these deficiencies.Identify root-cause of audit issues identified and process anomalies as determined through testing procedures
- Perform routine review of audit outcomes with management of assigned departments
- Effectively present findings in both face-to-face and small group settings with peers and management
- Prepare and present management reports as required
- Identify, as a result of internal control audits performed, additional process improvement opportunities and assist in the redesign of those processes
- Perform proper planning to execute the required test steps by established deadlines with minimal supervision
- Prioritize assignments, apply sample size guidelines appropriately and provide constant and clear feedback to management and the process owners
- Develop and maintain effective working relationships with team members,business process owners, management and other customers
- Review revenue cycle policies and procedures, providing timely and appropriate feedback to departmental management
- Participate in integrated audits, process redesign, and other projects as requested
11
Manager, Msrdp Revenue Cycle Resume Examples & Samples
- Develops strategy based upon MSP Revenue Management Data and Reporting Committee vision and works to achieve goals long term; applies an excellent understanding of physician reimbursement policy and coding methodologies including, but not limited to AMA, CMS and specialty societies, to the physician practice for compliant documentation, coding and billing
- Monitors the government reimbursement policy landscape to ensure that affected Departments are aware of emerging policy issues in order to take advantage of opportunities and identify potential threats that could impact the revenue cycle
- Analyze data and develops an overall approach for trending issues, report findings, applying timely and constructive feedback, continued education and training (as the "content expert") for revenue cycle staff, clinic staff, and billing providers
- Directs and supports auditors assigned to complete professional billing compliance audits, as well as ad hoc audits requested by management; prepares department summaries based upon audit findings and works closely with applicable providers/staff/management for continued performance improvement
- Assists with internal and external audits including notification and reporting results to Director, Department Chair, and/or Department/Division Compliance Officer; works with billing and compliance staff to identify root cause of billing errors and take corrective action (such as Edit Administration Committee requests and staff or provider education)
- Attends and participates in reimbursement and compliance activities and department meetings; facilitates problem resolution sessions where multiple departments and/or clinical or business areas are involved
12
Revenue Cycle Supervisor Resume Examples & Samples
- Maintain current and thorough understanding of dialysis reimbursement and industry norms
- Award-winning education and training across multiple career paths to help you reach your potential
- Minimum of two years’ related supervisory experience strongly preferred
- Intermediate proficiency in MS Word and PowerPoint; advanced proficiency and analytical ability in Excel
13
Senior Revenue Cycle Management Analyst Resume Examples & Samples
- Analyze, and summarize reports and operational data to identify trends and ways to improve operational efficiency, productivity, and financial performance
- Provide reporting data to management and others in oral and written form
- Identify root causes and take appropriate steps
- Perform additional process reviews as directed by the Manager; identify opportunities for improvement and implement changes as directed
- Other duties and responsibilities as assigned including but not limited to
- Attend team meetings, phone conferences, and training as needed
- Know, understand, and follow teammate guidelines, employment policies, and department or company procedures
- Demonstrated experience with electronic billing and accounts receivable systems preferred
- Outstanding project management skills
- Business process redesign experience required
- Advanced computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook required; experience developing spreadsheets and databases required; experience with MS Access preferred, experience with Tableau preferred
- Demonstrated interpersonal, collaborative, and relationship-building skills; ability to interact positively with teammates at various levels across the company
- Demonstrated time management skills and ability to handle multiple priorities with shifting time frames, and meet deadlines; self-starter with high degree of initiative, urgency, and follow through
- Able to work independently and as a member of a team and to foster a positive work environment
- Demonstrated strengths in organizational, follow-through, analytical, reasoning, critical thinking, and problem solving skills
14
Revenue Cycle Report Analyst Resume Examples & Samples
- Creating and generating both volume and revenue cycle reporting
- Experience communicating daily/weekly with both customer and leadership teams
- Strong analytical skills specific to customer revenue cycle and volume activity
- Working knowledge of company products and company function
- Marketing and/or service policies and procedures
- Excellent written and verbal communication as well as telephone skills
- Monthly invoicing and procedure code analysis
15
Revenue Cycle Senior Analyst Resume Examples & Samples
- Provide revenue cycle management services in all areas of revenue cycle operations which includes
- Bachelor's Degree in Business, Finance, or Healthcare
- 5+ years most recent work experience in Revenue Cycle including patient access, financial analysis, patient finance, or consulting in a senior level position
- Intermediate level proficiency with Excel, Word, PowerPoint
- Ability to Travel 25-50%
- Healthcare Consultant
- Intuitive and skilled at problem solving
16
Revenue Cycle Senior Consultant Resume Examples & Samples
- Assess the customer charge master and charging process
- Identify potential performance improvement opportunities or best practices and make recommendations to clients on how to integrate new process/best practice into current workflow
- Provide consulting services to clients in all areas of the healthcare revenue cycle with a focus on the charging process
- Understand clinical coding scenarios for hospital ancillary departments (e.g., Radiology, Laboratory, Pharmacy, Rehab)
- Understand hospital and physician Medicare and Medicaid billing and coding
- Understand governmental and third party reimbursement policies
- Ability to write a monthly newsletter and present quarterly to clients
- Ability to understand complex billing and coding requirements and educate clients on them
- Develop work plans, project tasks and manage projects in accordance with budget
- Document findings, impacts and recommendations within assessment deliverables; responsible for the revenue cycle sections within each deliverable
- Identify client barriers in achieving operational excellence
- Understand client business metrics and results
- Evaluate and analyze client data to understand trends in all areas of the operation
- 5+ years experience with charge master principles and the relationship to coding, billing, compliance in a hospital setting
- Knowledge of CPT/HCPCS coding required
- Knowledge of CMS regulations, HCPCS, ICD-9 and UB Revenue Codes with the ability to effectively interpret, communicate and educate others
- Requires work experience involving an understanding of hospital charging practices and governmental coding requirements; o Solid understanding of revenue cycle workflow in the hospital and ambulatory environment (registration, scheduling, coding, billing, contracting)
- 3+ years of healthcare consulting/management experience or leadership experience in provider organization
- Ability to travel 50-75%
- Master's Degree in Business Administration or related field preferred
- Medical record coding or patient accounting experience preferred
17
Supervisor, Revenue Cycle Resume Examples & Samples
- Supervises daily operations and performs activities of Patient Accounts, including billing, follow-up, denial management, cash application, support services and collection referral
- Proactively reviews payer aging reports and establishes achievable goals for AR reduction and/or cash acceleration. Notifies Senior Leadership of potential systemic issues and high risk/high exposure situations. Recommends solutions for resolving aging receivables
- Minimum of two (2) years progressively responsible experience to ensure familiarity with patient accounting and/or patient registration
- Proficiency in Excel and Microsoft applications
- Must be available to work M - F business hours with some overtime as needed
- Knowledge of basic accounting principles, business administration, and computer systems as normally acquired through completion of two (2) years of college, business or technical school
- Outstanding written and verbal communication skills with the ability to articulate departmental policies and procedures clearly too all levels of staff
- Ability to handle multiple situations simultaneously and to exercise sound judgment
18
Revenue Cycle Optimization Front End Associate Director Resume Examples & Samples
- Bachelor's Degree or equivalent experience required
- Revenue cycle consulting experience, such as revenue cycle outsourcing, interim management or performance improvement
- Prior Revenue Cycle hospital based provider consulting or revenue cycle management experience preferred
19
Healthcare Revenue Cycle Assessment Consultant Resume Examples & Samples
- Owns a specific work stream of the end to end assessment and full due diligence processes at a single potential client site
- Prepares first draft of the benefits based on the high level assessment and full due diligence efforts
- Displays ability to effectively communicate within the Revenue Cycle Solution Design team as well as externally
- Provides operational subject matter expertise in the development of sales materials in preparation for initial and ongoing client conversations
- Attends industry conferences and acts as a subject matter expert for Optum 360
- Presents to small/ moderate sized groups well and has the ability to adjust message to audience (CFO, CEO or VP of Revenue Cycle)
- Exemplifies Optum360 values of integrity, respect, collaboration, innovation, and excellence across all activities
- Enables achievement of Optum360 goals for growth, execution, customers, and people
- Strong proficiency in Microsoft Office Suite including Excel, PowerPoint and Visio
- Revenue Cycles
- Patient Access
- Health Information Management/Revenue Integrity/Coding/Clinical Documentation Improvement
- Patient Business Office
- Advanced degree
20
Healthcare Revenue Cycle / IT System Analyst Resume Examples & Samples
- Troubleshoot a wide range of issues for both Optum360 implemented solutions as well as 3rd party applications being used by our E2E operation teams
- Identify and initiate resolutions to user problems and concerns associated with application (hardware and software)
- Partner with functional teams and interact with E2E operation teams as well as vendors to find solutions for application issues and problems
- Provide standardization and consistency across our solutions
- Responsible for various configuration documents and tools that are used to manage the solutions (i.e DDS, Admin tools, DMS, Workflow config, User provisioning)
- Bachelor's degree in a technical field or equivalent experience
- 3+ years healthcare revenue cycle experience (Patient Access focused)
- 3+ years IT troubleshooting / client support experience
- 1 year SQL experience (basic queries)
- Understands HL7 basics (ADT messages)
- Software development - Programming and scripting languages
- MS Office (Including Word, Excel, PowerPoint)
- Knowledgeable with patient access tools (Insurance verification, Medical necessity check, Patient Estimation, Financial Counseling)
- MedeAnalytics Patient Access Intelligence experience
- IIS log analysis
- Network Topology
- Workstation/Desktop Utilities
- Reporting Tools
- Previous experience in an Agile environment
- Claim knowledge
21
VP, Middle Revenue Cycle, HIM Operations Resume Examples & Samples
- Delivers profitable top line revenue growth by supporting the development and delivery of effective operational performance and services for End to End Revenue Cycle Client
- Contributes to on-going collaboration and dialogue to ensure strategic alignment, set rules-of-the-road for how the Health Information Management functions engage and resolve conflicts and issues
- Leads, directs and develops Health Information Management, Clinical Documentation Improvement and Charge Description Master operational teams; continually assesses skills and acts to improve the talent and effectiveness of the team
- Keeps the organization informed of client needs, product requirements, competitive information, account specific initiatives and other knowledge essential for our business efforts; push the organization to act to deliver capabilities that enable growth
- Integrates operational teams to align with Optum360 and client organizational goals and objectives
- Collaborates with Optum360 executive team to develop strategy for change management based on details of the proposed changes and the effects on clients and other stakeholders
- Leverages effective change management strategies based on details of operational changes and effects on stakeholders
- Leverages effective training programs for employees and clients on new processes and services offered and implemented
- Provides analytical consultation and leadership to Optum360 executive team regarding revenue management operational development, with a focus on effective performance and business growth
- Works with the Services and Technology Solutions teams to develop a business strategy that maximizes value for Optum360
- Oversees the RFP, selection, contracting and implementation process of relevant vendors in collaboration with the appropriate Optum360 executives and local client leadership teams
- Maintain knowledge of applicable laws, regulations and trends
- Develops and manages new and existing client relations, including maintaining customer satisfaction
- 10+ years’ experience in hospital Revenue Cycle Operations
- Experience leading large diverse teams
- Experience effectively facilitating large scale organizational change
- Develop and design operational best practices with desired outcome to improve patient care
- Broad knowledge of modern revenue cycle management, systems, practices and principals
- Expert level knowledge of billing and regulatory compliance practices
- Expert knowledge of Health Information Management, Coding, and Clinical Documentation Improvement regulatory compliance practices
- Proactively questions current practices; ability to identify root cause and corrective actions and drive improvement
- Ability to deal effectively with ambiguity
- Excellent communication skills, both written and verbal; acts as champion
- Ability to interact successfully with numerous client organizations
- Effective human resource management abilities including the ability to develop leadership talent
- Ability to ensure a high level of employee and client satisfaction
- Effective organizational, planning, controlling, scheduling and multiple project management ability
- Demonstrated success with management reporting, metrics and goal setting
- Ability to work independently, achieve tight deadlines and take initiative on multiple projects
- Knowledge of and experience with revenue cycle applications
- Experience overseeing for revenue cycle systems in a multi-system setting
- Experience managing Revenue Cycle related technology implementation
22
Revenue Cycle Optimization Associate Director Resume Examples & Samples
- Revenue cycle assessments
- 1+ years’ experience working in hospital revenue cycle department as a director or supervisor (patient access, patient financial services)
- 3+ years of revenue cycle consulting experience, such as revenue cycle outsourcing, interim management or performance improvement
- In-depth knowledge of the complete healthcare revenue cycle
23
Revenue Cycle Senior Analyst Resume Examples & Samples
- Alignment of client processes and Optum technology
- Interim management
- Provide subject matter expertise to clients in all areas of the healthcare revenue cycle which includes
- Minimum of 3 years’ experience in the Healthcare revenue cycle
- Experience and comfort working at all levels of a health care organization
- Ability to lead, direct and motivate others
24
Revenue Cycle Optimization Front End Associate Resume Examples & Samples
- 1+ years of experience developing Quality Assurance plans
- Revenue cycle experience in performance improvement assessment and implementation
- A high degree of self-motivation, versatility and flexibility
25
Revenue Cycle Optimization Associate Resume Examples & Samples
- Revenue cycle assessments for: hospitals, health systems, diagnostic laboratories
- Reimbursement and managed care
- Minimum of 2 years’ experience in revenue cycle management with at least one year in laboratory revenue cycle management
- Expert in MS Word and Excel and Visio
- Knowledge of laboratory and hospital based IT systems
- Ability to travel 70 - 80%
- Expert in Outlook and PowerPoint
26
Senior Hospital Revenue Cycle Workflow Consultant Resume Examples & Samples
- Demonstrates clearly and effectively Optum360s’ RWS application suite benefits and best practice model to ensure integration into the clients processes and systems
- Proactively identifies project concerns, and communicates timely and effectively to the Project Manager, Director of Product Management, and/or Senior Product Consultant
- Oversees Senior Product Consultants and Product Specialists assigned to the client and ensures seamless integrated communication with the client
- Reviews Sales assessment document and any other client information to determine scope of the project and identify and proactively address any potential implementation concerns
- Participates in introduction call, scoping visit, and discovery visit to review current workflow , analyze operational processes, and determine future state best practice workflow and operational processes
- Primary responsibility for completion of the Business Requirement document, and participates in the Project Charter completion and Technical Business Requirement
- Works with cross functional teams across the overall E2E project to ensure alignment and is proactive in identifying process and technology improvements that will support Optum360 SLA’s, both
- Works with Clients and Product to provide business requirements and stories for Product Enhancement Functionality
- Participates in weekly project meetings with member of the deployment team (internal and external) to review the project plan, and evaluate progress; provides input throughout the implementation and post implementation process
- Assists with developing Training for our E2E clients using our technology
- On time successful deployment of RWS applications
- Adherence to Optum360 Best Practice Standard Operating model within deployment or appropriate variance approval
- Client Satisfaction with deployment and configuration of technology
- Achievement of Optum360 SLA’s
- Minimum 10 years in Revenue Cycle Management, with heavy involvement in technology deployment , provider or vendor experience
- Technical knowledge of Revenue Cycle Operations
- Experience managing large scale projects where deadlines are met or ahead of schedule
27
Supervisor, Revenue Cycle Solutions Resume Examples & Samples
- Minimum 2 years of experience working in a medical claims billing environment handling insurance denials/appeals
- Minimum 3-5 years experience in a supervisory or management role in healthcare
- Knowledge of ICD-10, CPT, and HCPCS coding required
- 5+ years experience performing supervisory work or other leadership role
- Experience with managing several aspects of the revenue cycle highly desired
- Working knowledge of managed care, Medi-Cal, and Medicare eligibility, authorization and billing requirements a plus
- Working knowledge of denial reason codes, payor appeal processes, payor contracting, and how to effectively communicate with insurance companies
- Certification in medical billing and/or medical terminology
- Able to interpret various contracts and health plans
- Must have demonstrated ability to work in a highly complex environment, able to communicate with clients (including patients, payors, clinicians and physicians) effectively
- Demonstrated ability to remain professional, even when working through difficult situation
- Demonstrated ability to effectively research and resolve claim payment issues
- Establishes a pleasant environment by using a pleasant tone of voice and maintaining composure at all times
- Demonstrate a concern for needs and expectations of clients and customers
- Encourage teamwork and collaboration to bring about win/win situations for the organization and staff
- Ability to organize work flow and set priorities
- Ability to communicate effectively and diplomatically with clients, physicians, payors, health care business executives and the general public
- Able to analyze and problem solve
- Ability to guide, lead, coach and mentor
- Must have a working knowledge of Microsoft Office programs, including Excel, Word, Access or similar programs
28
Certified Revenue Cycle Associate Resume Examples & Samples
- Minimum coding certification of CPC-H
- Experience is MediTech and XClaim, preferred
- Working knowledge of Microsoft PC applications (Outlook, Word, Excel)
29
Senior Revenue Cycle Coordinator Resume Examples & Samples
- Advanced knowledge of accounting, healthcare, and general office procedures
- Advanced knowledge of the Maryland and DC Reimbursement and regulatory environment so as to ensure compliance with State regulations regarding patient and insurance billing issues
- Advanced knowledge of the HSCRC, DRG and APC payment reimbursement
- Advanced knowledge of common revenue cycle accounts receivable terms, common business practices, and statute of limitations as it pertains to billing, appeals, payer requests, payments, retractions, and EOB’s
- Advanced in Microsoft Office
- Requires strong organizational skills to complete financial applications, insurance verification, billing, and collection processes within acceptable time frames
- Requires solid communication skills to clearly and concisely communicate verbally and in writing with peers, superiors, payers, physicians, ancillary departments, etc
- Ability to adapt to urgent deadlines or rapidly changing priorities and maintain composure in high stress situations
- Requires leadership ability to guide and advise others without having line management authority
- 2-3 years’ experience in accounts receivable
30
Revenue Cycle Coordinator Resume Examples & Samples
- Basic knowledge of accounting, healthcare, and general office procedures, preferred
- Basic knowledge of the Johns Hopkins Health System or other Healthcare related policies and procedures, preferred
- Knowledge of most common revenue cycle accounts receivable terms, common business practices, and statute of limitations as it pertains to billing, appeals, payer requests, payments, retractions, and EOB’s, preferred
- Requires analytical skills to assist in preparing reports monthly or as needed utilizing department software applications
- Requires minimal assistance in completing billing and continual follow up on accounts
- Expected to have prior keyboard and internet navigation knowledge and experience
- Ability to adapt to urgent deadlines and priorities
- Ability to show professionalism when working with management peers and team members
- 0-1 years’ experience in accounts receivable
- Requires ability to understand, interpret, evaluate, and resolve basic customer service issues
- Intermediate knowledge of accounting principles which directly impacts the accounts receivable that may include debit and credit transactions; charge transfers; contractual allowances and adjustments and financial class changes
- Knowledge of medical terminology, preferred
- Moderate understanding knowledge of the Revenue Cycle specific to JHM
- Requires knowledge of common revenue cycle accounts receivable terms, common business practices, and statute of limitations as it pertains to billing, appeals, payer requests, payments, retractions, and EOB’s
- Requires knowledge of billing, collection, and telecommunications software, including LAN-based claims editing applications
- Requires knowledge of Federal regulations and requirements
- Ability to identify and know the different requirements for the various types of insurance plans
- Understands common terms used daily in carrying out tasks
- Intermediate knowledge of Microsoft Office
- Requires intermediate organizational skills to complete financial applications, insurance verification, billing, and collection processes within acceptable time frames
- Requires communication skills to clearly and concisely communicate verbally and in writing with peers, management, payers, physicians, ancillary departments, etc
- Ability to evaluate own workflows and JHHS processes and appropriately recommends process improvements
- Requires continual communication keeping others informed of work flow status updates, trends and/or issues while managing tasks in a timely manner
- Requires the ability to work independently while completing billing and continual follow up on routine and challenging accounts with minimal assistance from management and others
- Ability to problem solve and analyze high dollars claims/cycles and elevate quickly for resolution
- Must have the knowledge and interpersonal skills to be a successful mentor and provide continual constructive feedback to team
31
Associate Revenue Cycle Coordinator Resume Examples & Samples
- The ability to understand, interpret, evaluate, and resolve basic customer service issues, required
- Working knowledge of at least one specific payer’s application, billing, and/or collection processes and/or multiple payer’s insurance verification and pre-certification processes
- Basic knowledge of accounting principles which directly impact the accounts receivable that may include debit and credit transactions; charge transfers; contractual allowances and adjustments and financial class changes
- Basic knowledge of the Maryland and DC Reimbursement and regulatory environment so as to ensure compliance with State regulations regarding patient and insurance billing issues, preferred
- Some knowledge of medical terminology, preferred
- Requires working knowledge of billing, collection, and telecommunications software, including LANbased claims editing applications
- Basic/Beginner knowledge of Microsoft Office
- Requires basic organizational skills to complete financial applications, insurance verification, billing, and collection processes within acceptable time frames
- Requires communication skills to clearly and concisely communicate verbally and in writing with peers, superiors, payers, physicians, ancillary departments, etc
- Proactively keeps others informed of work flow status while managing tasks in a timely manner
- Actively seeks assistance for complex account resolution
- Ability to effectively work with others in conjunction with the Code of Conduct and Service Excellence Guidelines
- Knowledge of accounting, healthcare, and general office procedures, preferred
- Knowledge of the Maryland and DC Reimbursement and regulatory environment so as to ensure compliance with State regulations regarding patient and insurance billing issues, preferred
- Knowledge of the Johns Hopkins Health System or other Healthcare related policies and procedures, preferred
- Understands HCPC and/or CPT coding issues that could impact a claim
- Knowledge of the HSCRC, DRG and APC payment reimbursement
- Requires knowledge of up to date HIPAA and HITECH rules and regulations
- Demonstrates ability to assist in mentoring others in regards to the department’s payers and revenue cycle processes
- Ability to work the receivable of multiple facilities with experience, knowledge, and skills that are transferable to other tasks and assignments
- Requires analytical skills to compile and prepare reports monthly or as needed utilizing department software applications
- Ability to work in multiple billing, insurance verification, and precertification systems simultaneously
- Requires minimal assistance for complex account resolution
- Requires the ability to adapt to urgent deadlines or rapidly changing priorities and maintain composure in high stress situations at all times
- Assists in other staff’s duties in their absences, in addition to routine workload
- Ability to adapt to urgent deadlines and/or rapidly changing priorities while maintaining professionalism in high stress situations
- Ability to show professionalism when communicating with staff and vendors
- 1-2 years’ experience in hospital accounts receivable
32
Epic Revenue Cycle Consultant Resume Examples & Samples
- Understands the rural, remote market and smaller community hospital needs
- End to End Epic implementation, preferably Hospital Connect
- Epic Certifications and experience with version 2015
- Work with CFO and able to work with C-Suite, to the end user level
- Understands and trouble shoots Claims and Denials
- Able to be the translator and intermediary between the Rev Cycle Team and GPH Team
- Have experience working in a hospital business setting and patient access
- Able to provide a Crosswalk of current state to future state by producing a Start/Stop/Continue Grid for the Training Team
- Ability to be the SME to the Trainers and Liaison with the Analyst
- Revenue Cycle General Ledger Mapping, ie - Lawson
- Experience with Supply Mapping
33
Revenue Cycle Business Analyst Resume Examples & Samples
- Gather and document business requirements
- Analyze and interpret data to identify trends, patterns and opportunities for the business and clients
- Communicate analysis and interpretation to appropriate audience
- 2 years of revenue cycle experience
- 1 year of experience in business / finance including analysis experience with a solid understanding of data storage structures
- 1 year of experience with project methodology (requirements, design, development, test and implementation)
- Intermediate level of proficiency with PC based software programs and automated database management systems (Excel, Access, PowerPoint)
- Experience in analysis of hospital accounts receivable, payer trends
- Experience gathering requirements from the client / business and documenting
- Experience in analysis of business process and workflow and providing an evaluation, benchmark and / or process improvement recommendations
- Ability to communicate analysis including trends and opportunities to clients and the business
34
Revenue Cycle Optimization Consultant Resume Examples & Samples
- Improve operational efficiencies throughout the revenue cycle
- Optimize patient access collection of both cash and appropriate information to prevent denials of third-party payments
- Improve processes to ensure measures are taken to authorize care, bill for care and receive timely payment from all responsible parties
- Maximize use of Experian Health solutions to determine sources of reimbursement
- Bachelor’s Degree, or Master’s preferred
- Six years + experience in a health care setting in revenue cycle management
- Experience managing change projects in large enterprises
- Experience in analytics and quality management techniques
- Prior revenue cycle consulting experience strongly preferred
- Excellent documentation and communication skills
- Presentation and training experience a must
35
Revenue Cycle Business Analyst Resume Examples & Samples
- Work well independently but able to contribute in a team environment
- Excellent communication skills both internally and client facing
- Ability to understand authorization requirements and responses
- General knowledge of CPT codes
- Understanding of HIPPA requirements in relation to PHI
- Data modeling and /or SQL queries
- Ability to communicate effectively with internal and external customer
- Experience working with revenue cycle is a plus
- Previous experience with process improvement
- Bachelor’s Degree in related field of Business, Health Information Technology or Statistics
- Ideal candidate would have experience working with hospital IT department to maintain or implement hospital registration of ADT system(s).Experience implementing revenue cycle solution with any vendor
- Experience with more than one hospital system
- 3+ years in hospital experience in areas such as patient access, outpatient registration, insurance verification and authorizations
- Full understanding of hospital revenue cycle and patient access unit workflow
- Equivalent combination of education and experience may be considered
36
Revenue Cycle Senior Director Resume Examples & Samples
- When assigned as project lead, responsible for soliciting client/partner feedback on project progress, performance and success, updates client/partner weekly on progress, problems, and accomplishments
- Communicates issues, opportunities, risk factors and any other applicable information to the client/partner manager and/or manager on an on-going basis
- Experience working in hospital revenue cycle department as a director or supervisor (patient access, patient financial services)
- 8+ years of healthcare consulting/management experience or leadership experience in provider organization
37
VP of Revenue Cycle Resume Examples & Samples
- Leads the development and implementation of revenue cycle strategies to maximize profitability
- Ensures conformity with Compliance requirements throughout revenue cycle
- Delivers a full range of services to clinical and business leaders such as project management, interim project staffing, software application optimization, healthcare reform initiatives, and support analysis
- Works with clinical and business leaders to define needs or problems, gather data and perform analysis to advise or recommend solutions
- Interviews, hires, evaluates, counsels, and recommends the termination of assigned teams
- Develops and maintains positive relationships with clinical and business leaders and provides executive support for the BSWH Revenue Cycle organization
- Participates in the Information Services Leadership Councils
- Bachelor’s degree required, preferably in accounting or equivalent required. Master’s degree in applicable field (CPA and/or MBA) preferred
- Experience of 10+ years in hospital patient accounting or Revenue Cycle within a healthcare environment is required; extensive experience with EPIC billing is preferred
- Significant experience with hospital, physician practice management, and patient accounting systems
- Experience with and ability to manage relationships with up to Executive (C-Suite) level leadership. Specific experience with Clinical Leadership preferred
- Knowledgeable of Revenue Cycle Management operations
- Proven track record of leadership and strong knowledge in revenue cycle operations and industry best practices. Experience in managing complex, large-scale projects in a matrix organization and demonstrated expertise in developing complex systems and performance-based reporting
- In-depth knowledge of Medicare and managed care billing and payment practices, admitting registration requirements, documentation requirements, rate elements, credit and collection practices, and reimbursement techniques. Must be able to analyze payment data through use of multiple financial systems to properly negotiate managed care contract
- Extensive knowledge of coding technology tools and experience with coding services within provider settings
38
Revenue Cycle Improvement Consultant Resume Examples & Samples
- Assists revenue cycle departments in the analytical components of workflow redesign
- Proactively seeks opportunities to identify revenue cycle inefficiencies,
- Research/analyze data, and create solution alternatives
- Implement revenue cycle improvement solutions for BHCS revenue cycle departments
- Monitor the performance of revenue cycle activities utilizing current monitoring tool sets and performance metrics. Create new performance metrics to address and manage new performance issues
- Coordinates revenue cycle department activities including but not limited to charge capture and workflows
- Coordinates revenue cycle improvement activities between BHCS Corporate departments and BHCS facilities
- Facilitates revenue cycle improvement communications across the revenue cycle
- Analyzes and identifies trends in revenue cycle operations. Uses this data to develop and implement process redesign solutions
- Assesses the current capabilities of IT revenue cycle systems and creates innovative revenue cycle IT solutions
39
Member Consultant, Revenue Cycle Solutions Resume Examples & Samples
- Effectively triage and manage member production issues post implementation
- Communicate directly with members in a professional manner to provide a high level of customer satisfaction and timely response
- Identify and assist in implementation of solutions to improve member satisfaction as related to the Product and Support Services
- Support the Dedicated Advisor team by proactively identifying trends and potential solutions to member requests
- Devise creative solutions to accommodate technical challenges faced by the member
- Master the functionality of the Revenue Cycle workflow platforms and develop expertise in product terrain
- Maintain an client-facing documentation of all outstanding tickets to be tracked with the member on a bi-weekly basis through recurring update calls
- Proactively project manage client to quarterly site updates
- Effectively manage multiple and competing priorities
- Provide support during implementations as needed
- Become a part of a consolidated, highly engaged team
- Excellent time management and organizational skills
- Intellectual curiosity, persistence and creativity in problem solving
- Proven experience managing multiple, competing priorities
- Team-oriented but also highly self-sufficient and self-motivated
- Experience working in a team environment
- Must demonstrate strong attention to detail
- Experience in analytic tools (Excel)
- Knowledge of revenue cycle management, PFS & hospital systems a plus
- Experience with SalesForce.com
- Experience in advanced analytic tools (Access, SQL)
- 1 year in direct customer support
40
Revenue Cycle Optimization Associate Resume Examples & Samples
- Provide evaluation and guidance to clients in the healthcare revenue cycle which includes
- 5+ years of experience working with large multi-facility healthcare system
- 5+ years of healthcare revenue cycle management experience as a manager or supervisor
- Solid understanding of revenue cycle workflow (registration, scheduling, coding, billing, contracting)
41
Cerner Revenue Cycle Solution Architect Resume Examples & Samples
- Lead client engagements related to the planning, execution, and organizational activities for KPMG’s Transformation Consulting initiatives in the Healthcare industry
- Support C-Level growth strategy creation, market development identification and transformation execution for the Healthcare industry
- Manage client and KPMG work teams throughout the project lifecycle by leveraging our approaches and frameworks and helping to ensure timely completion of project deliverables and overall project execution
- Support the development of value propositions that tie clinical, operational and financial performance metrics and performance improvement opportunities to the C-Suite agenda
- Help lead proposal development and other new business development activities by leveraging new and existing relationships with client business leaders
- Provide input into engagement decisions including work plan and timeline, project management and resource allocation
- Five years of Cerner Millennium Revenue Cycle Solution Architect management consulting experience in the Healthcare industry, focusing on operations/performance improvement and transformation, workflow redesign, clinical performance improvement, and patient throughput/capacity; operations transformation
- Bachelor’s degree in finance, engineering, information technology, operations analysis, healthcare administration, nursing, or a related field from an accredited college/university; MBA or other graduate degree, e.g., MD, PHD, MSN, MPH, is a plus,
- Demonstrated understanding of healthcare reform and other key industry trends/drivers, such as population health management, demographics, technology, required
- Excellent foundational consulting skills: analytical, written and verbal communication, client presence, facilitation and presentation skills
- Ability to travel at a significant level
42
Back End Revenue Cycle Optimization Senior Associate Resume Examples & Samples
- Bachelor's Degree in Business, Healthcare or related field; or equivalent experience
- 3+ years of healthcare revenue cycle management experience as a manager or supervisor
- 1+ years of experience developing training plans
- Master's Degree in Business Administration, or related field
- Ability to probe, analyze, and articulate complex subject matter to be easily understood
43
Analyst Revenue Cycle PMO Resume Examples & Samples
- Defines and document revenue cycle data sources of truth and data definitions per project
- Populates dashboards, results and benefits realization, track progress, develop, document and ensure adherence to standardized processes and project reporting methodologies
- Accesses data bases to provide analytical support and reporting to revenue cycle teams and/or initiative
- Organizes and formats data for presentation and to assist with analysis
- Validates data provided
- Summarizes data and provides direct commentary or insight into data results
44
Revenue Cycle Optimization Senior Director Resume Examples & Samples
- Assumes responsibility for the success of diligence efforts assigned as project lead; contributes to the success of other projects as necessary
- Provide written communication with client / partners, team members and management the status of assignments on a weekly basis via project documentation (i.e. status update, scope change, etc.)
- Documents all deliverables including; scope definition, status reports, analysis documents, user documentation and other applicable project records as appropriate
- Works closely with client / partners and staff to develop client / partner and project risk assessments, implement opportunities, and recommendations regarding business and IT process optimization, profit improvement, internal control and compliance
- Conducts studies or surveys for process change or problem resolution to obtain data required for solution
- When assigned as project lead, responsible for soliciting client / partner feedback on project progress, performance and success, updates client / partner weekly on progress, problems, and accomplishments
- Communicates issues, opportunities, risk factors and any other applicable information to the client / partner manager and / or manager on an on-going basis
- Develop reports and presentations based on project specifications for delivery to client / partners
- Provide strategic guidance to client / partner on Revenue Cycle process improvement
- Lead and focus team efforts in data analysis, data interpretation, process design and formulating conclusions and recommendations
- Minimum 8+ years of healthcare consulting / management experience or leadership experience in provider organization
- Excellent interpersonal, written and oral communication skills
45
Revenue Cycle Optimization Consultant Resume Examples & Samples
- Revenue cycle assessments for hospitals, health systems, and diagnostic laboratories
- Alignment and implementation of client/partner processes and Optum360 technology
- Provide revenue cycle management services to client/partners in all areas of revenue cycle which includes
- Minimum of 3 years’ experience in acute care and/or laboratory revenue cycle management
- Expert in MS Word and Excel and Visio required
- Ability to build effective team in order to accomplish goals
- Ability to adapt to a flexible schedule
- Expert in Outlook and PowerPoint preferred
46
Revenue Cycle Data Analyst Resume Examples & Samples
- Grows expertise in knowledge of KP data systems; actively shares knowledge within and outside the department. Builds queries using one or more tools (e.g. Business Objects, SAS, FOCUS, Crystal, etc.) to extract data from mainframe and server-based data repositories per specifications based on client requests
- Performs intermediate to advanced spreadsheet analyses and database solutions using tools such as Excel and MS Access; develops accurate scorecard and other reporting processes; provides detailed statistical measurement and interpretation; creates cost-benefit/profitability analyses; financial forecasts; and other analyses as required
- Develops financial outcome measurement techniques and suggests appropriate tools for measuring process improvement
- Collects, audits and compiles confidential data, determines statistical significance/variances according to standard criteria
- Develops and maintains indicators of department performance
- Utilizes critical thinking skills with regard to measurement and data; makes recommendations to management based on interpretation of data
- Coordinates data extraction and develops forecast proposals for the annual operating forecast of professional and technical outside expenses, other benefits and hospitalization and tests data validity
- Provides training and direction to other revenue cycle staff as necessary
- Maintains and supports a culture of compliance, ethics and integrity
- Maintains knowledge of policies and procedures and performs in accordance with the Principles of Responsibilities and applicable regulatory requirements, external laws and accreditation standards
- Reports appropriately observed fraud or abuse
- Minimum three (3) years of experience with Epic software
- Minimum four (4) years of experience performing sophisticated data retrieval and analyses
- Demonstrated experience in data extracting, manipulation and/or data management, and interpreting and communicating results/recommendations
- Experience with Epic's Clarity data model is preferred
47
Revenue Cycle Interim Manager Resume Examples & Samples
- 3+ years interim management experience with Revenue Cycle
- Experience leading business offices for physicians, hospitals, or both
- Diverse background with various vendors such as GE, Epic, and/or Cerner
- Excellent interpersonal, organizational, and communication skills
- A strong proficiency in common PC software applications
48
Revenue Cycle Project Manager Resume Examples & Samples
- 3+ years project management experience with Revenue Cycle
- Experience with practice management system replacements
- Diverse background with various vendors such as GE, Epic, Allscripts and/or Cerner
- 3+ years experience working in a Healthcare setting, physician practice, or hospital
- Ability to work on multiple, complex projects with high quality results
49
Revenue Cycle VP Resume Examples & Samples
- Assumes responsibility for the success of projects assigned as project lead; contributes to the success of other projects as necessary
- Provide written communication with client/partners, team members and management the status of assignments on a weekly basis via project documentation (i.e. status update, scope change, etc.)
- Works closely with client/partners and staff to develop client/partner and project risk assessments, implement opportunities, and recommendations regarding business and IT process optimization, profit improvement, internal control, and compliance
- Interact with other departments to ensure a high level of client/partner satisfaction through successful execution of projects
- Provide strategic guidance to client/partner on Revenue Cycle process improvement
- Demonstrates the highest levels of professional conduct and ethical behavior
- Works collaboratively with client/partners to exceed expectations; able to overcome major obstacles preventing project success; able to convert a negative client/partner experience to a positive relationship
- Demonstrates ability to generate new concepts for innovative products and services; creates business case to move from idea stage to execution and launch; able to market and position products and services to create competitive advantage for Optum360 platform
- Able to build, manage and maintain a robust sales pipeline that drives growth
- Demonstrates strong ability to lead a consulting practice; creates and executes measurable business, financial and marketing plans to generate profit for the firm; leads efforts to develop value-add resources/materials to support client/partner initiatives
- Develops an understanding of external market and industry trends; knows key client/partners of Optum360, can identify key competitors, able to describe major political and economic market forces that influence our business; aware of social, technological, legal and environmental changes that impact our organization
- Leads collaboration efforts across organizational boundaries; identifies strategic opportunities to leverage the knowledge of multiple business segments within OptumInsight; builds strong partnerships with peers; optimizes networks to develop and sell projects and ideas across the organization; able to build consensus to drive results
- Role model for the mission, vision and values of Optum360 consulting platform
- Bachelor's degree from a four-year college or university required
- Minimum of 10 years’ experience in related role including extensive knowledge of coding technology tools
- Minimum of 10 years’ of healthcare experience
- Direct experience working in a hospital environment (such as a former Director, Manager or Supervisor of department) or similar experience in consulting experience (relevant experience includes revenue cycle, compliance/quality, clinical departments/units
- Demonstrated performance in strategic/operational analysis and planning, analytical techniques
- Demonstrated ability to bring projects/initiatives to completion
- Advanced knowledge of at least one practice management system and/or EMR system. Experience with one or several of these vendors is a plus: GEHC, Allscripts, SMS, Cerner, McKesson, Epic, Meditech or other similar system
- Advanced knowledge of Microsoft Office (e.g. Word, Project, Excel, PowerPoint, Visio.)
- 10 years’ experience providing leadership and management direction in a healthcare environment
50
Revenue Cycle Resume Examples & Samples
- Requires an understanding of multiple systems and processes that impact revenue cycle performance and capabilities
- Possesses the ability to build trusting relationships with multiple Client Executives at all levels and for numerous unique customers
- Possesses analytical ability sufficient to work in a data-heavy environment and to identify trends in the data
- Demonstrated experience of the entire acute care hospital revenue cycle processes is required
- Three (3) to five (5) years Management in a Revenue Cycle or Acute Health Care
51
Revenue Cycle Operations Director Resume Examples & Samples
- Advanced knowledge of healthcare A/R, collections, insurance, and appeals
- Advanced understanding of Compliance Guidelines
- Advanced knowledge of the hospital based operations related to the revenue cycle including Health Information Management, Patient Access, Clinical Quality/case Management, Management Information Systems, Accounting and Finance
- Intermediate Microsoft Office (Word and Excel)
- Ability to provide advanced customer service
- Ability to train, mentor and coach staff
- 4 year college degree in Business Administration, Finance, or Health Administration or equivalent experience
- 5-7 years experience managing in multi-facility business office
52
Revenue Cycle Resume Examples & Samples
- Organization – proactively prioritizes needs and effectively manages resources
- Communication – communicates clearly and concisely, verbally and in writing
- Leadership – guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
- Customer Orientation – establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
- Tactical Execution – oversees the development, deployment and direction of complex programs and processes
- Policies & Procedures – demonstrates knowledge and understanding of organizational policies, procedures and systems
- Financial Management – applies tools and processes to successfully manage budget
- Minimum 2 years related supervisory experience required
- Minimum 3 years of managed care and denials experience
53
Reg Director of Revenue Cycle Resume Examples & Samples
- Routinely performs site visits to each facility and SSC as assigned to provide support, review processes, provide feedback, and identify areas of opportunity
- Provides comprehensive site visit reports to Facility, CFO, and SSC
- Works collaboratively with the Shared Services Center to understand impact of Patient Access performance on the entire revenue cycle
- Serves as on-the-ground support for the Service Center at the facility and hosts onsite leadership meetings as needed to address noted issues
- Demonstrated ability to manage the day to day operations of multiple mid-sized – large hospitals providing a more diverse and complex offering of services to the community it serves. (100-500 beds)
- Able to work independently to efficiently and effectively manage all functions within the Patient Access and SSC departments
- Maintains knowledge of Revenue Cycle ensuring a high productivity and proficiency standards of performance are achieved at all times
- Monitors Front End and back end performance and KPI’s on a routine basis, including but not limited to
- Accuracy – 98% or greater if software applicable
- Alert/Unbilled days - <3 days
- Estimate Utilization – 98% or better if applicable
- Front end denial rate - < 2%
- CIQ/BARTT requests- >3 days
- EDUCATION, SKILLS & EXPERIENCE
- Administrative Skills
54
Director Bsmg Revenue Cycle Resume Examples & Samples
- Previous management experience in a large, multispecialty billing environment is required. Management experience with business office with a minimum of 35 FTE’s is required
- Experience working with enterprise level practice management systems is required
- Working knowledge of physician practice operations specifically as it related to patient access and time-of-service (TOS) revenue cycle functions
- A Bachelor’s degree is required; Bachelor’s degree in Business or MBA degree is a plus. Equivalent combination of education and experience will be considered
55
Revenue Cycle Regulations Manager Resume Examples & Samples
- The ideal candidate will be detail oriented, highly organized and able to read, comprehend, summarize and manage the implementation of complex Federal and State regulations and regulatory changes
- Candidate must have the ability and experience to understand how regulatory changes impact the healthcare revenue cycle at all points, and use good judgment, analytical skills, and experience in decision making related to interpretation and dissemination of regulatory information
- Candidate must possess excellent written and verbal communication skills, and be able to produce error-free work product demonstrating a high-level of detailed understanding with minimal or no supervision
- Must be able to handle heavy workload requiring the production of time-sensitive work product, and adapt to a high growth, rapidly changing environment
- Applicants may be requested to provide writing samples
- 5-7 years of healthcare revenue cycle experience with focus on payer compliance
- 2-3 years hospital operations or hospital clinical experience preferred
- Demonstrated knowledge and experience in health care industry with specific focus on regulatory/billing procedures and compliance, with particular focus on Medicare and Medicaid
- Intermediate to advanced PC skills with Microsoft Office suite (Excel, Access, Word, PowerPoint)
- 5 or more years of change management experience, which may include program, project, or process experience managing multifaceted projects and teams, including onsite and virtual, through all stages of assessment, identification and communication of impacts and operational changes
- Lead experience in managing projects from development to execution, including tracking and reporting of milestones
- Proven track record of developing and training staff effectively in a collaborative and cross-functional environment
- Well-developed analytical, problem solving and communication skills to include analysis expertise and ability to translate regulatory requirements into operations
- Ability to interact and communicate with staff independently at all levels, including management, and the capacity to manage competing priorities in a dynamic environment
- Must be able to work in sitting position, use computer for extended periods and answer telephone
56
VP, Revenue Cycle Optimization Resume Examples & Samples
- Prepare final client status reports and create presentations to clients and engagement staff that demonstrate full command of factual material
- Manage day-to-day client relationships including primary ownership for client executive team
- Develop reports and presentations based on project specifications for delivery to client/partners
- Lead and focus team efforts in data analysis, data interpretation, process design, and formulating conclusions and recommendations
- Minimum 8+ years of healthcare consulting/management experience or leadership experience in provider organization
- Solid understanding of revenue cycle workflow in the hospital and ambulatory environment (registration, scheduling, coding, billing, contracting)
- Prior Revenue Cycle hospital based provider consulting experience
57
Revenue Cycle Management Pre-authorization Clinician Resume Examples & Samples
- Possesses excellent customer service skills that include written and verbal communication
- Ability to critically think, problem solve and make independent decisions
- Ability to prioritize and manage multiple tasks with efficiency
- Advanced conflict resolution skills
- Ability to conduct research regarding payer pre-authorization guidelines and applicable regulatory processes related to the pre-authorization process
- Must possess a valid nursing license (Registered or Practical/Vocational). RN PREFERRED. LPN IS MIN REQUIREMENTS
- Minimum of 3-5 years as a pre-authorization or utilization review nurse in a payer or acute care setting; preferably medical-surgical or critical care/ED
- Ability to travel approximately 10% of the time; either to client &/or Conifer office sites
58
Revenue Cycle Representative Resume Examples & Samples
- Analyze and verify patient demographic, insurance eligibility and financial information/responsibility for accurate claim submission and reimbursement
- Resolve patient billing account concerns in order to obtain appropriate reimbursement and patient satisfaction in partnership with PFS management, UIHC Patient Representatives and UIHC Clinical Teams
- Initiate action regarding the management and adjudication of patient account billing and all other customer concerns and inquiries
- Document, correct and assure the accurate information is in the patient billing system
- Establish payment arrangements, counsel and coordinator available financial assistance with patient as necessary
- Verify eligibility of benefits, patient liability and non-covered exceptions; confirm all steps necessary have been taken to adjudicate claims and billing while providing outstanding customer service
- Resolves statement edits to ensure correct and timely billing occurs
- Contacts appropriate third party payers in order to verify eligibility of benefits, patient liability, non-covered exceptions
- Be expected to maintain a high-level of accuracy to meet productivity and quality requirements
- Take payments and set up payment plans for patients
- Communicate with providers, payers, patients, internal departments, co-workers and Coordinator’s to resolve issues
- Maintain extensive knowledge and expertise based around payer regulations/policies, financial classifications and financial assistance programs
- Build and maintain solid working relationships with clinical staff, referral sources, insurance companies, medical providers and public
- * Please note: Five (5) professional references will be required at a later step during the hiring process
- 6 months or more of related customer service experience in a professional, financial or health care related environment
- Strong attention to detail and proven ability to gather and analyze data and keep accurate records
- Proficiency with computer software applications, i.e. Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable programs and an ability to quickly learn and apply new systems knowledge
- Demonstrated ability to handle complex and ambiguous situations with minimal supervision
- Effective communication skills (written and verbal), active listening skills and the ability to maintain professionalism while handling difficult situations with callers or customers
- Successful history collaborating in a fast-paced team environment
- Experience handling difficult callers, customers and patients
- Familiarity with medical terminology
- Knowledge of Health Insurance Portability and Accountability Act (HIPAA) laws
- Knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs
- Experience identifying opportunities for improvement and making recommendations and suggestions
- Experience with multiple technology platforms such as Epic, Cirius ACD, and/or GE
- Ability to drive results and foster accountability throughout the team and organization
59
Lead Consultant, Revenue Cycle Solutions Resume Examples & Samples
- Present research briefings and educational sessions to clients
- Review and approve support documentation, work plans, and other deliverables
- Participate in new product and service conceptualization and planning -Identify cross sell opportunities and support sales proces
- Manage, guide, and coach Project Consultant(s)
- Willingness to travel 70-80% (valid Driver’s License)
- Experience working at The Advisory Board Company
- Master’s degree in business, health care administration or other health care-related field
- Proven ability to prioritize across multiple projects and relationships
- Possess intellectual curiosity, persistence and creativity in problem solving
60
Revenue Cycle Optimization Manager Resume Examples & Samples
- Develop reports and presentations based on project specifications for delivery to clients
- Perform statistical quality assurance review and program validation for each project
- Provide analytical and data support for case studies and business proposals
- Interact with other departments to ensure a high level of client satisfaction through successful execution of projects
- Leverage skills to support creation of product improvements and new product offerings targeted at the sales and market research community requirements Business
- Office Process and Performance Assessments
- Business Office Centralization
- Business Office Structure and Alignment Optimization
- Efficiency and Productivity Improvement programs
- Workflow Technology Modification and Optimization
- Billing Editor and Billing Tool Modification and Optimization
- Billing, Claim Follow Up and Cahs Posting Methodology Implementation and Improvement
- Policy, Procedure, Job Description and Staff Training Optimization
- Provide direction, coordination and leadership to clients in all areas of the healthcare Back End Revenue Cycle may include
- Patient, Government and Commercial Payer Billing
- Claim Follow Up and Collections
- Cash Posting, Credit Balance and Underpayment Review
- Patient / Customer Service
- Decision support and analytics
- Managed care contracting
- Utilize internal Optum360 resources to properly accomplish and deliver measurable results in the Back End Revenue Cycle and Patient Financial Services
- Transformation Staff and Analytics Team
- Optum360 Consulting
- Optum360 Technology implementation teams
- Optum360 Project Management Office
- Optum360 Human Capital, Compliance and Legal
- Evaluate and utilize external vendors where internal Optum360 solutions gaps are present
- Identify client accomplishments barriers in achieving operational excellence
- Development of options and recommendations for client improvement
- Understand and represent Optum technology and services and how they will improve client operations
- Assist in Optum360 growth process as requested
- Must meet minimum performance standards
- Willingness to learn new skills and desire to advance upward in the consulting organization
- Provide feedback to management concerning possible problems or areas of improvement
- Perform other duties as assigned by management
- Minimum 5 years experience in the healthcare revenue cycle
- Minimum 2 years healthcare consulting experience
- Ability to lead, motivate, influence, probe, analyze, synthesize and articulate complex subject matter so it can be easily understood
- Ability to work in an Office environment
- Ability to travel 75+% as necessary to accomplish assign tasks and goals
61
Revenue Cycle Representative Resume Examples & Samples
- Respond to patient/visitors/family requests and directs to the appropriate areas in a timely manner
- Verify insurance benefits to determine if insurance will reimburse UIHC for services provided and ensure that insurance data entered is accurate and complete
- Determine insurance company and financial status classification; enter information accurately and completely into the Billing system and be expected to maintain a high-level of accuracy to meet productivity and quality requirements
- Confirm co-pay amount and collect from patient as appropriate for the visit and practice safe cash handling procedures to ensure batches reconcile at end of shift
- Determine priority of work and work collaboratively with clinical staff in processing of paperwork, lab requests, patient requests, etc
- * Please note: Five (5) professional references will be required at a later step during the hiring
- Bachelor’s degree; or equivalent combination of education and experience
- Demonstrated ability to follow policies and procedures while escalating issues as needed
- Demonstrated ability to maintain or improve established productivity and quality requirements
- Experience with multiple technology platforms such as GE, Cirius ACD, and/or Epic
- Maintain current awareness of industry trends and continually strive for improvement with both technical and professional skills
62
Revenue Cycle VP-telecommute Resume Examples & Samples
- Assists business development teams, sales and client/partner managers on proposals and calls when necessary as requested by management
- Designs and delivers effective presentations to peers and client/partners. Designs and facilitates effective project team and/or client/partner meetings leading to desired outcomes
- Delivers effective presentations to client/partner executive (C-suite) level; facilitates complex, high-risk group dynamics, conflicts and concerns to promote win-win client/partner outcomes; able to deliver compelling, complex and/or difficult messages effectively
- Displays understanding and effectively applies problem solving and decision making skills; able to diagnose problems accurately; skilled at data analysis leading to meaningful insights
- Adept at growing and maintaining strategic client/partner relationships; accurately identifies client/partner needs, gains client/partner consensus on proposed solutions; provides meaningful, value-add client/partner advice and guidance; able to move client/partners to action; used as a trusted advisor by client/partners
- Demonstrates emotional resilience in stressful situations; maintains a positive attitude when dealing with resistance or setbacks; actively supports organizational change agendas
- Works collaboratively with others; constructively manages conflict; maintains open channels of communication
- Bachelor's degree from a four-year college or university
- Minimum of 10 years of experience in related role including extensive knowledge of coding technology tools
- Minimum of 10 years of healthcare experience
- Presentation skills, including development and delivery of PowerPoint presentations to audiences of various sizes
- Demonstrated complex problem solving skills that have led to actionable recommendations or outcomes
- Demonstrated management, teamwork, and interpersonal skills against difficult due dates and timelines
- Advanced knowledge of at least one practice management system and/or EMR system; experience with one or several of these vendors is a plus: GEHC, Allscripts, SMS, Cerner, McKesson, Epic, Meditech or other similar system
- Advanced knowledge of Microsoft Office (e.g. Word, Project, Excel, PowerPoint, Visio)
- Revenue Cycle Management operational knowledge
- Master’s degree
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Revenue Cycle Representative Resume Examples & Samples
- Basic Experience is defined as uses basic understanding of the field to perform job duties; may need some guidance on job duties; applies learning to recommend options to address unusual situations
- Working Experience is defined as successfully completes diverse tasks of the job; applies and enhances knowledge and skill in both usual and unusual issues; needs minimal guidance in addressing unusual situations
- 1-3 years relevant experience in a medical/dental business office with financial counseling, cash collection, knowledge of insurance claim processing requirements/adjudication experience and strong customer service skills including the following skillsets
- Experience with electronic health record/patient accounting system
- Experience in a dental practice
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Supervisor Msrdp Revenue Cycle Resume Examples & Samples
- Reviews and analyzes information, identifies problems, recommends solutions and/or writes reports for management or other personnel
- Ensure timely revenue cycle work queue metrics are achieved by their direct reports; assigns workload to meet production requirements; compiles, analyzes and reports status and issues involving all aspects of assigned area; makes recommendations to management to reflect changes by reviewing management reports and other data, identifies conflicts and writes resolutions
- Monitor charge entry and charge capture quality control thru routine staff and process auditing; ensure charge reconciliation monitoring occurs by Team Leaders
- Maintains performance standards by counseling employees, performing appraisals and providing required training; assists with quality control testing and reporting
- Ensures departmental policies and procedures are properly followed; develops and revises policies and procedures as needed; maintains written procedures for workflow by writing or updating procedures as needed; communicates and educates all applicable information to appropriate personnel and affiliated facilities as required
- Completes special projects and participates in project groups and tasks force teams
- Other Duties: Performs other duties as assigned
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Revenue Cycle Senior Director Resume Examples & Samples
- Direct experience working in hospital or provider setting, including: claims/billing, registration/scheduling, case management, health information management, IT, clinical units/departments, quality, compliance, etc
- Workflow redesign and/or performance improvement projects specific to revenue cycle and/or clinical units
- Experience with Change Management planning and execution
- Minimum of 8 years of healthcare experience
- Prior Consulting or Revenue Cycle Management Experience Required
- Experience and proficiency in business writing, and highest level of proficiency in presentation skills
- Bachelor's degree from a four-year College or university; or one to four years related experience and/or training; or equivalent combination of education and experience
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Revenue Cycle Senior Consultant Resume Examples & Samples
- Assess the customer Denial Management data and workflow
- Complete a root cause analysis and identify potential performance improvement opportunities or best practices and make recommendations to clients on how to integrate new process/best practice into current workflow
- Denial Management turn around / redesign
- Interim Management
- Provide consulting services to clients in all areas of the healthcare revenue cycle with a focus on Denial Management and Prevention
- 5+ years’ experience with charge master principles and the relationship to coding, billing, compliance in a hospital setting
- Knowledge of Denial Management and Prevention best practices
- Ability to complete a root-cause analysis for both technical and clinical denials
- Requires work experience involving an understanding of Denial Management practices
- Master's Degree in Business Administration of related field
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Revenue Cycle Consultant Resume Examples & Samples
- Ability to complete a root cause analysis for both technical and clinical denials
- Evaluate and analyze client data to understand trends
- Collaborate with client revenue cycle team and other departments in order to facilitate resolution of process issues and implement world-class solutions
- Provide informed feedback to Optum and client executives including assessments of processes, standards, suggestions and improvements
- Assist in the sales process as requested
- Provide interim staffing services as required
- Ability to probe, analyze, synthesize and articulate complex subject matter so it can be easily understood
- Excellent interpersonal, written, and oral communication skills
- Previous consulting experience
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Revenue Cycle Senior Consultant Resume Examples & Samples
- Interim management/staffing
- Knowledge of CPT/HCPCS coding
- Requires work experience involving an understanding of hospital charging practices and governmental coding requirements
- Medical record coding or patient accounting experience
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Revenue Cycle Optimization Senior Analyst Resume Examples & Samples
- Revenue cycle process improvement
- Revenue cycle improvement / redesign
- Provide revenue cycle services to client/partners in all areas of revenue cycle which includes
- Experience and comfort working at all levels of a health care organization. Ability to probe, analyze, synthesize and articulate complex subject matter so it can be easily understood
- Knowledge of hospital based IT systems
- Ability to travel 80% of the time
- Experience with laboratory revenue cycle systems
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Assistant VP / Revenue Cycle Resume Examples & Samples
- Responsible for coordination of gross charge capture monitoring for multiple hospital patient accounting system planned conversions including collaboration with multidisciplinary teams to identify and mitigate conversion risk related to gross revenue
- Oversees the preparation and assembly of monitoring reports for compliance of project implementation
- Completes project management and leads optimization efforts across the Revenue Integrity Department long-term
- Collaboration with all aspects of Revenue Cycle stakeholder groups including coding, registration, billing, case management, denial management, and charge capture specialists to enhance and optimize existing revenue cycle practices
- Assist Revenue Integrity team in validating procedures, items and/or services are documented, captured, billed, and paid according to the terms of regulators and payers
- Identify, correct and optimize the processes and systems that lead to lost revenue opportunities and put in place a process to validate accuracy of existing net revenues
- Provides revenue and statistical data analyses and works with staff to optimize facility revenue and reimbursement
- Provides regular and structured organizational awareness and education to key stakeholders
- Performs reviews, research and other duties independently or as requested by the Vice President or Senior Vice President
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Revenue Cycle Appellate Resume Examples & Samples
- Serves as a resource to non-clinical personnel
- Provides CRC leadership with sound solutions related to process improvement
- Assist in development of policy and procedures as business needs dictate
- Assists Law Department with any medical necessity reviews as capacity allows up to and including attending mediation hearings, other litigation forums, etc
- Demonstrates proficiency in the application of medical necessity criteria, currently InterQual®
- Possesses excellent written, verbal and professional letter writing skills
- Critical thinker, able to make decisions regarding medical necessity independently
- Demonstrates knowledge of managed care contracts including reimbursement matrixes and terms
- Ability to conduct research regarding State/Federal appellate guidelines and applicable regulatory processes related to the appellate process
- Ability to conduct research regarding off-label use of medications
- Must possess a valid nursing license (Registered or Practical/Vocational)
- Minimum of 5 years recent acute care experience with the last 2 years in a facility environment
- Medical-surgical/critical care experience preferred
- Minimum of 2 years UR/Case Management experience within the last 2 years
- Managed care payor experience a plus either in Utilization Review, Case Management or Appeals
- Patient Accounting experience a plus
- Previous classroom led instruction on InterQual® products (Acute Adult, Peds, Outpatient and Behavioral Health) preferred
- Ability to lift 15-20lbs
- Ability to travel approximately 10% of the time; either to facility sites, National Insurance Center (NIC) sites, Headquarters or other designated sites
- Ability to sit and work at a computer for a prolonged period of time conducting medical necessity reviews
- Characteristic of typical office environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc
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Revenue Cycle Coordinator Resume Examples & Samples
- Outstanding attention to detail and proven ability to gather and analyze data and make recommendations
- Proficient in the use of Microsoft Office Suite with strong Excel skills or comparable programs and the ability to learn and apply new software knowledge quickly
- Experience (typically one year or more) in a high-volume customer service environment that demonstrates an ability to manage difficult conversations and resolve conflicts; ability to influence (without authority), and experience with escalation techniques
- Demonstrated skills in time management and managing multiple priorities
- 1+ year experience in medical claims processing, healthcare revenue cycle or medical coding
- Advanced knowledge of medical terminology and health care billing
- Demonstrated ability to prioritize and coordinate inquiries and concerns of customers: patients, staff, administration and public
- Experience as a team leader or supervisor
- Experience identifying opportunities for improvements in processes, procedures and reporting
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Uwmc Hb Revenue Cycle Program Operations Analyst Resume Examples & Samples
- Analyze hospital / professional revenue cycle processes and procedures with a focus on optimizing the use of Epic functionality to ensure the highest level of revenue is recognized through compliant practices and guidelines
- Participate in determining the priority, usage and implementation plan for new features and functionality during new version upgrades
- Proactively review and evaluate system updates and participate in the upgrade implementation; including analysis, design, testing, communication and implementation of these updates
- Partner with HIM / Coding, Peer Systems, Charge Capture and Clinics / Departments to ensure timely billing resulting in clean claims and reduced late charges and denials
- Define and document customer requirements
- Proactively monitor and maintain systems
- Perform problem resolution
- Develop and maintain QA documentation
- Identify error patterns and recommend training or revised workflows
- Provide regular status reporting
- Work with all required (intradepartmental & interdepartmental) personnel to define and manage changes to system and/or functional workflows
- Perform analysis and troubleshooting for application issues
- Provide regular status to management, customers, and stakeholders
- Maintain issue tracking tools to manage operational issues to feed regular status reports
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Senior Revenue Cycle Data Analyst Resume Examples & Samples
- Be a valuable contributor to the project team
- Provide analytical support to the consulting team
- Interpret data, analyze results using statistical techniques and provide ongoing reports
- Develop and implement databases, data collection systems, data analytics and other strategies that optimize statistical efficiency and quality
- Maintain communication with team and key stakeholders
- Is a critical thinker
- Has proven analytical skills
- Is able to communicate effectively across roles and levels within the organization
- Demonstrates painstaking attention to detail
- Is innovate and effective at visual communication
- Has experience working in the revenue cycle area
- 4 year degree or equivalent experience
- Proven working experience as a data analyst or business data analyst
- Minimum of 2-3 years of experience in a business office setting
- Strong knowledge of and experience with reporting packages (Business Objects etc) and databases (SQL etc)
- Knowledge of statistics and experience using statistical packages for analyzing datasets (Excel, SPSS, SAS etc)
- Ability to work independently when appropriate
- Interested in continually learning and growing
- Innovative and creative
- Flexible and versatile
- Prior experience identifying data trends and issues
- Knowledge of MS Project
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Revenue Cycle Assistant Manager Resume Examples & Samples
- Ensure team follows documented policies and procedures, including SOX narratives, and conduct SOX control activities, as appropriate
- Make recommendations to Manager on changes to existing tools, policies and procedures to facilitate achievement of department goals
- Review daily, weekly, and monthly key metrics to identify trends or areas of focus; work with Manager to develop, document, and implement action plans to address issues
- Maintain current and thorough understanding of dialysis reimbursement and industry norms; monitor trends, escalate issues, concerns, and changes
- Monitor work of Registration Representatives to ensure patient records are established timely and accurately and maintained properly
- Commitment to DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment, and Fun
- Provide support for department initiatives as needed
- Provide support to Finance, ROPs, and Clinical partners
- Other duties
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VP-revenue Cycle Resume Examples & Samples
- 10+ years of progressive management experience
- 5+ years of healthcare industry experience
- Experience with Medicare, Medicaid and Managed Care regulatory, billing, compliance, contracting and reimbursement issues
- Government and Third Party payer billing and compliance audits experience
- 2 years of EMR experience
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Director of Revenue Cycle Management Resume Examples & Samples
- Provide direction to the Claim Scrubber/Submission Team, Acquisition Integration Team, System Set-Up and Maintenance Team, and Payor Specialist Team
- Bachelor’s degree in related area required; Master’s degree preferred
- Minimum of seven (7) years’ experience in managing complex operational and support functions required; experience in Healthcare, Consulting, Information Technology, or Insurance industries preferred
- Minimum of four (4) years’ management consulting experience in healthcare revenue cycle preferred
- Commitment to and role model of DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians, and/or vendors (Village Service Partners) in everyday performance and interactions
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Business Analyst, Healthcare Revenue Cycle Resume Examples & Samples
- At least 5 years prior business analyst, implementation, or client/payer-side (payer or hospital/health system) experience in healthcare revenue cycle management software and technology
- Healthcare revenue cycle experience
- Understanding of HL7 and X12 message/file formats and transactions
- Effective communication and relationship building skills
- Self-motivated, autonomous
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Revenue Cycle Coordinator Resume Examples & Samples
- Licensure/Certification/Registration: None
- Education:Bachelors preferred; may substitute experience
- Experience: 3-5 years in a computerized office setting, healthcare billing experience required
- Special qualifications: Must be able to successfully complete established competencies for the position within designated probationary period. Must have good communication skills, computer skills (Microsoft Office suite), project management skills,. Must have the ability to organize, prioritize, and coordinate multiple projects simultaneously; presentation and training skills
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Middle Revenue Cycle Optimization Associate Director Resume Examples & Samples
- Assess the impact of new technologies on specific workflow and identify the associated education needs, system remediation needs and workflow redesign
- Identify potential performance improvement opportunities or best practices and make recommendations to clients on how to integrate new process / best practice into current workflow
- Bachelor's degree from a four - year College or university; or one to four years related experience and / or training; or equivalent combination of education and experience
- 1+ years of experience working in hospital revenue cycle department as a director or supervisor (patient access, patient financial services)
- In - depth knowledge of the complete healthcare revenue cycle
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Revenue Cycle Representative Resume Examples & Samples
- Resolve claims from an assigned work-queue to ensure that all claims are worked within the timely filling/appeal guidelines
- Determine if appropriate payment has been made by various entities; and/or work with patients and insurance companies, government entities (such as Centers for Medicare and Medicaid Services) to obtain correct payments; and/or appeal claim payments/denials
- Perform denial management, research, obtain proper documentation to support resolution of overpayment; resolving credit balances and to resolve outstanding accounts receivable by interacting with third-party entities via websites, telephone, or written inquiries
- Identify & report undesirable trends and reimbursement modeling errors or underlying causes of incorrect payment; review allowed variances from third party payers
- Identify trends and/or work processes for potential process improvements
- Review and analyze report data to provide status updates to leadership
- Communicate changes in payor policies and denial trends; escalates claim payment delays as appropriate
- Related customer service experience (typically 6 months or more) in a professional, financial, health care or medical related environment
- Strong attention to detail with a proven ability to gather and analyze data and keep accurate records
- Experience maintaining professionalism while handling difficult situations with callers or customers
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Revenue Cycle Representative Resume Examples & Samples
- Contact patients and insurance companies by phone to resolve credit/collections for payment acquisition, pre-authorization and to resolve patient account inquiries
- Contact inpatients within 48 hours of admission and discharge to comply with Centers for Medicare and Medicaid Services requirements for patients to receive, understand and sign receipt of Medicare Discharge Rights letter
- Work with court system to provide time sensitive documents and ensure that deadline dates are met and that UIHC is in compliance
- Maintain extensive working knowledge and expertise based around payer regulations/policies, financial classifications and financial assistance programs
- 6 months of customer service experience in a professional, financial, health care or medical related environment
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Senior Revenue Cycle System Analyst Resume Examples & Samples
- Ensure that the solution is designed leveraging Cerner recommendations
- Maintain knowledge of Cerner Patient Accounting, staying current on and utilizing the latest functionality and content on projects
- Conduct recurring and ad-hoc meetings with stakeholders from Patient Financial Services
- Review escalated requests
- Review, prioritize and work open application issues
- Manage relationship with Cerner Application Management Services (AMS) and act as liaison for AMS with end users
- Drive meaningful initiatives to improve KPIs
- Create ad hoc queries/reports
- Strong interpersonal communication and client presentation skills
- Ability to build and maintain relationships with partners and vendors
- Strong Healthcare industry experience
- 1 years of Experience with Cerner Patient Accounting or other revenue cycle solutions
- Must live in or be willing to relocate to San Diego, CA and, if not previously experienced in Cerner Patient Accounting, to travel to Kansas City, MO for 12 weeks for certification courses
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Revenue Cycle Consultant Resume Examples & Samples
- Ensures business needs are understood and Cerner’s information technology strategies are enhancing client objectives
- Follows Cerner policies, upholds professional standards, and performs all work in a manner respectful of others
- Strong presentation and facilitation skills
- Ability to work off-hours when required Willingness to learn autonomously when needed
- Agile
- 5+ years of healthcare experience in Cerner RevCycle design and build, or workflow (ex: RevCycle, Case Management, HIM, hospital business office, healthcare administration)
- Ability to travel nationwide (80% +) required
- Reside in or ability to relocate to the Kansas City area
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Revenue Cycle Consulting Architect Resume Examples & Samples
- Understand and consult on departmental and service line workflows, including associated Revenue Cycle roles and operational/process metrics
- Ensure the solutions are designed leveraging Cerner recommendations
- Provide expert knowledge, implementation strategy, and workflow design within scope
- Successfully use analytics to drive end-user adoption
- Understand client value metrics for the project
- Maintain knowledge of the solution, staying current on IP development and utilizes latest functionality and content on projects
- Work with client leadership team to create consistent communication across revenue cycle projects
- Work with engagement management for project planning / phasing, scoping and timeline projection
- Ensure Change Management processes are in place for success implementation
- Build relationship with Client and Project team leaders
- Able to manage multiple projects and deadlines
- Basic computer skills, including Microsoft Office suite
- Bachelor’s degree or equivalent in experience
- 1+ year of experience in project management
- 3+ year of experience leading a full Revenue Cycle solution implementation across all venues (Cerner preferred)
- Ability to travel up to 80%
- Does not require relocation as long as you live in a major US city
- 3+ years of experience in healthcare consulting
- Previous experience working with Cerner Revenue Cycle Solutions
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Revenue Cycle Consulting Executive Resume Examples & Samples
- Resource Management experience required
- Ability to build relationships at the CXO level
- Experience managing a small team of people with disparate focuses
- Confident presenter and communicator
- 10+ years’ healthcare project management and/or related healthcare consulting
- 3-5 years' experience in healthcare information technology (HCIT)
- Experience in Healthcare Revenue Cycle/Financial Management
- Ability to travel up to 80% nationwide
- Must reside near a major international airport or be willing to relocate to Kansas City, MO
- PMP and/or Six Sigma certification
- Cerner and healthcare IT industry knowledge
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Revenue Cycle Senior Business Analyst Resume Examples & Samples
- Work under the direction of the Manager to provide application solutions for assigned business areas
- Possess functional knowledge of assigned application technology
- Interact with business users to understand new business requirements and enhancement requests
- Serve liaison role between application technology vendors, internal IS groups, and business users
- Translate business requirements into product-specific designs and configuration, detailed requirement specifications and use cases
- Deliver functional specifications, design documents, business process workflow and related documentation for new development projects and/or enhancement and modification requests to be used by Systems Analyst
- Interact with Systems Analysts during the software build and/or configuration process and testing process
- Perform functional application configuration and configure /run reports at user request
- Design and execute functional, integration, and regression test plans for new application functionality, product releases and enhancement and regulatory modifications using business scenarios and use cases
- Ensure programs meet business specifications
- Demonstrate new functionality to business users seeking inputs on future direction
- Review vendor provided documentation and user manuals needed to support the product
- Directly interface with business users by responding to support calls escalated by the Service Desk
- Participate in user focus groups and requirements workshops, vendor training and demonstrations
- Assist in supporting activations and rollouts
- Consistent efforts to deliver quality solutions as per agreed scope
- Customer focus and close alignment with the customers’ business objectives
- Ensure efforts to continually improve domain knowledge
- Ensure the quality of the deliverables as per the defined defects standards
- Document issues with resolutions and share with team members to improve team productivity
- Provide data to generate team performance metrics
- Knowledge transfer with other team members to improve overall team education level
- Take complete ownership for the assigned task and timely inform the progress of the project / task to all stakeholders
- Adherence to the defined standards
- Take initiative and drives to bring to logical conclusion; proactive approach
- Provide accurate and timely information and escalates when there are issues
- Actively participate in meetings and make valuable contribution
- BA or BS degree preferred and/or other relevant combination of training and experience
- 0-2 years Industry experience preferred
- 2-5 years practical experience in providing technical support and maintenance in assigned product preferred
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Engagement Lead Revenue Cycle Solutions Resume Examples & Samples
- Developing new Revenue Cycle solutions that drive client value and generate a replicable
- Managing client and internal expectations of solution scope and delivery objectives
- Communicating all of the requirements and commitments to the client, project team and CST
- Minimum of five - seven years’ progressively responsible healthcare experience including a solid
- The ability and willingness to travel to customer locations throughout the US approximately up to
- 60% of the time
- Strong Organizational skills
- Integration of Clinical Software systems with Revenue Cycle Systems
- Five years project management experience
- Excellent listening and inquiry skills
- Problem resolution and creativity in solution development
- Customer political sensitivity and awareness
- Self-assessment and development skills and ability to work independently
- Microsoft Office (Excel, Word, PowerPoint, Project)
- You have the unrestricted legal right work to work in the US
- Willing to submit to a drug test
- Willing to submit to a background investigation, including for example, verification of your past
- Extensive knowledge of multiple Revenue Cycle applications
- GE Healthcare Revenue Cycle Solutions applications (IDX Flowcast products and their
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Revenue Cycle Associate Resume Examples & Samples
- Reconcile Athena postings to deposits in bank
- Transfer payments to and from the various Steward vendors
- Work manager holds in Athena related to claims
- Resolve customer service complaints
- Resolve Unpostables in Athena
- Upload remits for posting in Athena
- Sort and direct correspondence
- Work closely with Finance to reconcile receipts
- Resolve issues assigned thru Footprints from other departments within SMG
- Maintains strict confidentiality and adheres to all HIPAA guidelines/regulations
- 2-3 years experience with medical billing/collection; physician billing experience preferred
- Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus
- Experience with patient accounting systems and billing/claim submission software; specific Athena Health experience a plus
- Ability to utilize basic Microsoft Office programs - Excel experience a plus
- Highly detail oriented and well organized
- Ability to read, understand and follow oral and written instructions
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Mckesson Revenue Cycle Architect Resume Examples & Samples
- McKesson Star – Registration
- McKesson Practice Point Plus
- Claims Administrator / EC2000
- 3M APR DRG Grouper
- 3M Coding Reference Software
- Manage process improvements effectively; leveraging existing implemented applications to achieve better performance and outcomes
- Review and design workflow for multiple components of domain
- Share knowledge and proactively identify issues with client or within teams that need to be addressed
- Document all work as part of client deliverables, consistently using a professional documentation approach throughout span of engagement and beyond, resulting in high quality materials for internal and external usage
- Monitor industry trends and identifies policies or requirements to ensure applications fit with government and industry directions for technology. Then consult with clients on the requirements and oversee the direction of the architecture
- Maintain a deep knowledge of the application(s); stay at the forefront of knowledge around the application(s)
- Escalate incidents according to procedures and convert incidents to change requests as needed
- Bachelor’s degree in healthcare, information technology, business or related filed strongly preferred
- 3 years experience in Mckesson RevCycle solution
- Experience with physician facing and/or revenue cycle solutions
- Previous Integration Architect experience
- Must be willing and able to learn the Cerner RevCycle solution
- Proven ability to reach across solution and organizational boundaries to deliver result
- Experience with McKesson RevCycle solutions such as Registration, PPM Physican Billing and Claims Administrator EC2000, to include Vista/KB query language
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VP Revenue Cycle Management Resume Examples & Samples
- Bachelor’s Degree in a related field (e.g., management science, operations management, business, etc.), or an equivalent combination of education and experience, required
- 15 or more years of relevant experience, including experience in call center management, collections, quality control and process improvement
- Strong leadership skills, with the ability to influence with and without formal authority
- Detail-orientation, comfort juggling dynamic and complex work
- Highly analytical, with the ability to operate at both strategic and tactical levels as required
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Revenue Cycle Consulting Architect Resume Examples & Samples
- Bachelor’s degree or equivalent experience
- 3+ year of experience leading a full Revenue Cycle solution implementation across all venues
- Ability to travel 80-100%
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Revenue Cycle Senior Director Resume Examples & Samples
- Assists business development teams, sales and client / partner managers on proposals and calls when necessary as requested by management
- When assigned as project lead, responsible for soliciting client / partner feedback on project progress, performance and success, updates client/partner weekly on progress, problems, and accomplishments
- Interact with other departments to ensure a high level of client / partner satisfaction through successful execution of projects
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Revenue Cycle Engagement Leader Resume Examples & Samples
- Financial Management experience required
- Resource Management experienced required
- Has fully participated in all project engagement phases
- Proficient in Microsoft Office Application, including MS Project
- Ability to build relationships at the CFO level
- 2+ years of successful project management experience
- Ability to travel 80% nationwide
- 1-2 years of experience leading Revenue Cycle implementation
- Previous experience working with Cerner Millennium Revenue Cycle Solutions
- Certified Revenue Cycle Representative distinction
- Healthcare knowledge/experience
- Experience leading Healthcare/IT and/or HCIT projects
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Revenue Cycle Resume Examples & Samples
- Facilitate communications between ITWorks, AMS and Revenue Cycle departments
- Participate in project implementations, system upgrades and quality assurance processes
- Actively participates in project activities. Analyzes data requirements for system upgrades
- Place a high priority on serving all customers, lead user group meetings to establish client relationship
- Interact with AMS, end-users and business unit owners to understand business needs
- Work with all team members to achieve goals, identify and resolve issues, overcoming challenges
- Assist with system functional and user acceptance testing. Create and/or participate in unit and integrated testing. Obtain approval and signoff from stakeholders
- Identify and initiate resolutions to user problems and concerns associated with Revcycle solutions and recommend corrective and preventive action to team lead/manager
- Develop training materials to assist the help desk with first tier troubleshooting and issue resolution
- Plan and implement upgrade requirements on a timely basis
- Participate in the Incident management process. Proactively work to resolve incidents and meet service requests. Document relevant data on requests and resolutions in agreed upon timeframes
- Participate in the change management process, with proper work plan, test plan, back out plan and peer review
- Bachelor's degree in healthcare, information technology, business or related field strongly preferred
- 2 years of experience in information systems, healthcare, project management, or business
- 1 year of experience with Cerner Patient Accounting or other hospital revenue cycle solutions
- Experience with Cerner Millennium solutions to include CCL reporting query language, Cerner Patient Accounting and willingness to learn additional revenue-cycle related Cerner solutions such as Registration, Scheduling, and Health Information Management
- Must be able to work flexible hours as needed
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Revenue Cycle Mgmt Associate Resume Examples & Samples
- Process and track Automated Clearing House (ACH) notification, return items, online lockbox decision tools, return checks, field collector payments, return and fee reports
- Perform out outbound C&I collections calls on accounts with balances <$5,000 (excluding high risk or managed accounts) and outside collection agency work
- Process financial account transactions to ensure accurate account billing, balances, revenue and General Ledger (G/L) accuracy (bankruptcy, disputes, sales tax, debit/credit adjustments, deposit maintenance, suspends, vouchers, G/L activities, final bill disputes, customer directed payments, collection agency manual payments, bank issued, HEAP and cross system payments)
- NOTE: Exceptions in RCM are commonly referred to as “WFM”, “Queues”
- Sound knowledge of internal customer, financial and operational systems
- Ability to create and update excel or system files/reports
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Communityworks Revenue Cycle Consultant Resume Examples & Samples
- Experience participating in multiple phases of a system implementation
- Strong client facing presentation and facilitation skills (may be demonstrated through teaching client or associate classes or presentations)
- Ability to work overtime and “off” hours as necessary
- Bachelor's degree or equivalent experience in Healthcare, Sciences, or Information Systems
- Healthcare IT or Financial industry experience
- Experience with financial reporting
- Must reside in or be willing to relocate to Kansas City, MO
- Technical or healthcare background
- One or more years’ experience working with the Millennium suite of solutions
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Supervisor of Revenue Cycle Management Resume Examples & Samples
- Responsible for managing day-to-day operations of the department including staff supervision and issue resolution, individual productivity, and overall transaction processing
- Identifies and responds to staff needs for support and training through side-by-side work review and informal and formal feedback sessions
- Provide financial and demographic analysis regarding program participants
- Works closely with operational partners to develop strategies for promoting charity care programs
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Project Consultant, Revenue Cycle Solutions Resume Examples & Samples
- Serve a key role in analyzing client operations and data
- Develop presentation and report deliverables, and present recommendations
- Facilitate client calls and in person meetings at the client site
- Maintain and share business and technical expertise with clients
- Assist in providing on-site and off-site assessments and consulting services for a portfolio of clients
- Identify potential issues that will impede success and recommend corrective action
- 1+ Year of Professional Experience
- Experiencing analyzing large data sets using Excel advanced functionality
- Previous work experience, education, or demonstrated interest in the health care field
- Demonstrated ability in client relationship management and project management
- Willingness to travel 60-80% domestically
- Valid Driver’s License
- Experience working with Access and Excel
- Proven ability to present effectively to multiple audiences
- Ability to manage projects independently
- Ability to drill down to the root cause of issues and be creative in problem solving
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Sunrise Revenue Cycle Management Resume Examples & Samples
- On track for a Bachelor's Degree in Business or Healthcare Management or a related discipline
- 0+ GPA preferred
- Microsoft Office experience specially PowerPoint & Excel
- Comfortable working with a remote team
- Entrepreneurial mind-set wanted
- Salesforce & Sharepoint experience preferred, but not required
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Revenue Cycle Coordinator Resume Examples & Samples
- Strong analytical skills with an outstanding attention to detail and proven ability to gather and analyze data, make recommendations or implement changes based on data analysis
- Proficient in the use of Microsoft Office Suite with an Extensive level proficiency with Excel or comparable programs and the ability to learn and apply new software knowledge quickly
- Demonstrated ability to manage difficult conversations; an ability to influence (without authority), and experience with escalation techniques
- Self-motivated with initiative to seek out additional responsibilities, tasks and projects
- Knowledge of medical terminology and health care billing
- Demonstrated ability to prioritize and coordinate inquiries or concerns from patients, staff, administration and public
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Revenue Cycle Representative Resume Examples & Samples
- Review accounts and initiate pre-certification, pre-authorization, referral forms and other requirements related to managed care; route to appropriate departments as needed
- Manages reception area; including greeting patients, check-in for pediatric admissions
- Provide financial counseling via phone and/or in-person based on the patient’s liability and ability to pay
- Advise patients and/or family members about their healthcare accounts, collect appropriate self-pay balances, establish payment arrangements and link patients to the available funding sources such as: Medicaid, Healthcare Marketplace, Payment Plans and Uncompensated Care
- Basic knowledge of Health Insurance Portability and Accountability Act (HIPAA) laws
- Basic knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs
- Working experience with multiple technology platforms such as Epic, Cirius ACD, and/or GE
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Revenue Cycle Project Manager Resume Examples & Samples
- Management of medium to large concurrent initiatives which support the strategic goals of the organization. This includes management and follow-up of deliverables as well as open items
- Successfully managing projects with interdisciplinary teams to meet project milestones and achieve performance expectations
- Demonstrate strong communication skills both written and oral to team members and management
- Work with business partners to influence direction and actively align project goals with Conifer strategic objectives
- Manage to identified KPI’s and success indicators for the project
- Provide guidance and mentorship to other team members
- Experience in managing multiple Project Managers and staff
- Experience in interacting with the most senior executives of clients in a very clear, cogent, and professional manner
- Experience with deploying multiple Revenue Cycle Management (RCM) solutions across an organization that have data-sharing and operational inter-dependencies that must be managed across multiple vendors
- Experience in business process improvement methodologies: Lean, Six Sigma, etc
- Experience in building scorecards and tracking tools to monitor both project success and operational metric-based performance
- Experience in developing and delivering communication plans and vehicles across multiple stakeholder groups (internal and external)
- Ability to quickly understand and navigate the internal Conifer business units to align the efforts of key staff to the betterment of the effort
- Experience in working within a hospital or physician business environment
- 4-6 years of experience leading multi-project program level efforts that span client stakeholders, including internal senior leadership, partners/vendors, and external influencers
- Solid knowledge of all MS Office Products, including MS Project
- Prior working experience with Cerner Millennium revenue cycle EMR system preferred, but not required
- Prior working experience with revenue cycle EMR systems (i.e. Epic, GE IDX, Cerner, Athena) required
- Ability to multi-task in a fast paced, fluid work environment
- Demonstrated high level of written and verbal communication skills working with subordinates, peers, clients and members of senior management
- Very organized and detail oriented
- Expert knowledge of project management theory and practice. The ideal candidate must be able to select methodologies, standards and tools and make effective use of experts in these areas
- Proficient in Microsoft Office tools (Word, Excel Pivot tables, Visio, MS Project, MS Sharepoint and PowerPoint)
- Analytical problem solving skills to review, identify and resolve operational issues that would impact the implementation cycle and potentially delay an established go-live date
- Ability to identify client policy/procedural issues that must be addressed to ensure a successful implementation Demonstrated ability to think ‘out of the box’ and make adjustments to meet the needs of the client
- Nationwide travel varies between 0-60%, depending upon project phase
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Revenue Cycle Analytics Intern Resume Examples & Samples
- Contributing to a designated project or initiative to meet a KP business objective
- Report development and analytics
- Project management - planning, execution, and measurement
- Learning new applications needed to complete assignments or support the execution of business objectives
- Job shadowing in other functional areas
- Performing additional duties as required
- The union and the company are currently investigating the bargaining unit status of this position. If it is determined that this is a bargaining unit position, bargaining unit status (seniority dates, dues payments etc.) will be applied on a retroactive basis based on the employment commencement date
- Pursuing a bachelor's degree or have graduated with a Bachelor's degree from an accredited Colorado university within the last year
- Desired majors: Computer Science, Math/Statistics, Business Administration or related
- Proven ability to build effective working relationships as well as strong interpersonal skills
- Ability to learn quickly and experience producing high quality work in short periods of time
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Cerner Revenue Cycle Consultant Resume Examples & Samples
- This position requires 5+ years of Cerner Revenue Cycle Consulting experience
- Provide expert Cerner Revenue Cycle services
- Cerner Patient Accounting experience preferred
- Must have experience with 3 implementations of Cerner Millennium Revenue Cycle
- 5+ years experience with Cerner Millennium optimization, implementation or support
- Applicant must possess excellent understanding of Cerner Revenue Cycle, in the hospital environment
- May require long periods of standing
- Bachelor's degree preferred or equivalent experience
- Project Management/Leadership skills
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Revenue Cycle Auditor Resume Examples & Samples
- Performs duties independently and proactively with a high level of accuracy and timeliness
- Excellent oral and written communication and interpersonal skills and demonstrated ability to effectively and collaboratively work with team members and various levels of staff and management
- Demonstrated ability to successfully manage multiple priorities concurrently
- Maintains high integrity, builds credibility and favorable relationships with customers
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Senior Soarian Revenue Cycle Consultant Resume Examples & Samples
- Applies Cerner's consulting methodology and guides continued client optimization
- Understands and consults on entire service line/department workflow, including all associated roles and operational/process metrics
- Articulates regulatory impact on service line/department
- Establishes trusted relationships with all levels and service lines/department inside the client organization(s) and within Cerner project team
- Works in accordance with corporate and organizational security policies and procedures. Understands personal role in safeguarding corporate and client assets
- Takes appropriate action to prevent and report any compromises of security within scope of role
- 10+ years of healthcare experience in Soarian RevCycle design and build, or workflow (ex: RevCycle, Case Management, HIM, hospital business office, healthcare administration)
- Ability to travel nationwide 80-100% required
- Must reside near a major international airport or be willing to relocate to Malvern, PA area
- RHIA, CRCR or other Revenue Cycle credentials
- Experience with Microsoft Office products
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Revenue Cycle Application Consultant Resume Examples & Samples
- Demonstrates broad solution knowledge
- Develops and maintains solution expertise
- Serves as the onsite point of contact for issue resolution and triage for supported applications
- Responds to client inquiries via telephone, email or chat sessions
- Utilizes effective oral and written communication skills to facilitate discussions and decision making
- Articulates the end-user requirements and proposed solutions to clarify and control expectations and achieve user acceptance of the application
- Identifies, develops, and utilizes appropriate forums to solicit input and provide feedback to support the design, education, implementation, evaluation, and modification of the application
- Participates in design, build and testing for application specific projects as needed
- Leverages internal and external resources and tools to deliver problem identification and resolution
- Maintains client relationship through direct onsite contact
- Complies with standards for change control and work plans. Insures appropriate communication and documentation is completed in order to support application quality programs and application development
- Works in accordance with corporate and organizational security policies and procedures
- Understands their role in safeguarding corporate and client assets. Takes appropriate action to prevent and report any compromises of security within scope of role
- Demonstrated ability to work within a team environment and with diverse groups and difficult clients
- Ability to learn and apply new skills and concepts quickly
- Ability to sit and view computer monitors or other monitoring devices for a prolonged period of time
- Prolonged use of a computer and basic computer skills, including Microsoft Office suite
- Ability to work on a flexible schedule and overtime and/or irregular hours when needed
- Must be able to travel up to 10%
- Must reside in the greater Glens Falls, NY area
- Associate’s Degree required or equivalent experience
- 1+ years of experience in healthcare, sciences, or information systems; with emphasis in information systems
- Experience with Cerner Revenue Cycle Solutions (including Scheduling / Registration, HIM, Charge Services and/or Revenue Cycle)
- 1+ year of experience with database tools, application development, or health information standards
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Revenue Cycle Management Associate Resume Examples & Samples
- Basic account updates, field orders and outbound calls based on account parameters (Service application Management, payment agreements, applications, medical emergency cut-ins, connects/disconnects, protections, account riders, meter reads, leave on for landlord, payments, long term estimates, report lists, contacts, program enrollment, borderline billing, non-qualifying letters and Unable To Complete)
- Research, reconcile and resolve customer, agency, internal clients/billing owners/partners, banks inquires including account research, billing and adjustments (customer and billing owner inquiries, payments in suspense, payment investigations, crediting fees, removing cash only status, transferring payment amounts, duplicate bills, prepare documentation statements/correspondence, transferring balances, customer refunds, collection agency reports, discharges, suspends, DSS, government services website, claims backup, DSS agencies, bank, billing, collection vendors, internal billing owners, life support, cross system inquiries and energy suppliers)
- Perform and coordinate revenue loss mitigation activities such as pole cuts, field collections, gas safety compliance, consumption on inactive accounts, stopped meter, theft and other loss activities
- Communicate with external customers, business partners, vendors and other employees
- Advanced use of computer software (Email, MS Office Suite) and office technologies
- High School Diploma or Equivalent
- AND
- Must Pass Prescreening testing (CAT Test)
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Revenue Cycle Assessment Consultant Resume Examples & Samples
- Operations and/or consulting for pre-bill clean claim requirements, billing, collections, payment management
- General back office metrics, productivity standards and workflow
- Understanding the root cause linkage of back end claim issues and the originating cause of the issue (e.g. payment delays, returned mail and bad debt caused by incorrect information capture and quality checks during registration),
- Government (e.g. Medicaid, Medicare), commercial and self-pay payers
- Back end experience as described above is required
- Identifies opportunity areas and contributes to the development of benefit estimates and financial models for potential clients
- Manages timelines and project plans for the completion of the assessment and full due diligence process
- Serves as the key data contact for a potential client, including reviewing the data request with the client, fielding questions regarding the request and posing any necessary questions back to the client in order to validate the integrity of the data
- Acquires and processes client data necessary for high level assessment and full due diligence efforts. Demonstrates ability to analyze large volumes of data in order to produce useable results to meet evaluation objectives
- Collaborates with other functional units (optimization, finance, human capital, technology and compliance) to ensure timely reviews and contributions of final documents
- Assists with pre-onsite planning and logistics (e.g. flight, hotel, and rental car logistics)
- Contributes to Revenue Cycle Solution Design methodology development and other functional assignments as assigned
- Demonstrates creativity to design approach and problem solving skills
- Supports innovation execution for strategic organization initiatives
- Presents to small / moderate sized groups well and has the ability to adjust message to audience (CFO, CEO or VP of Revenue Cycle)
- Ability to condense large amounts of data into succinct, executive level Presentations
- General Revenue Cycle knowledge across Patient Access, Health Information Management / Revenue Integrity / Coding / Clinical Documentation Improvement
- Industry or consulting experience
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Revenue Cycle Coordinator Resume Examples & Samples
- Supervise work of Adult, Psychiatry and Children’s Hospital Admissions teams and serve as a payor expert and technical resource. Develop new and current staff through training to improve revenue cycle knowledge; work with staff to suggest additional options to resolve patient account inquiries
- Oversee and review employee’s work to determine if appropriate actions have been taken with regard to receipt of correct reimbursement
- Supports patient care by resolving hospital pre-certification and pre-authorization issues with physicians, radiologists, radiology technologists, and ancillary staff; improving and maintaining quality assurance program for department functions
- Perform trend analysis of self-pay accounts and financially unsecured accounts, to identify additional collection opportunities
- Manage and monitor timeliness and accuracy of self-pay accounts receivable functions, in adherence to UI Health Care and governmental policies
- Investigate transactions to clear up confusion regarding improper medical billing in order to maximize reimbursement and minimize inappropriate self-pay billings
- Audit and monitor routine follow up activities of unpaid self-pay accounts and financially unsecured accounts. Set performance measurements/standards to enhance collections and take leadership in resolving problematic accounts
- Partner with clinical leaders, admitting departments and physicians related to securing payment on hospital accounts from third party resources and/or patients
- Implement new processes developed by management to ensure processes are operating effectively and efficiently; make recommendations based on analysis of data
- Develop and monitor employee performance goals to enure compliance. Perform an array of QA checks and productivity audits; identify and resolve undesirable trends and reimbursement errors; prepare reports to assure quality and productivity requirements are being met
- Communicates with clinic management and staff regarding insurance carrier contractual and regulatory requirements
- Keep current on industry knowledge, skills and certifications to serve as a resource to employees and to conduct job duties
- 1-3 years’ experience in a high-volume customer service environment that demonstrates an ability to manage difficult conversations with patients or family members, an ability to influence (without authority), and experience with escalation techniques
- Proficiency with Microsoft Office Suite with strong Excel skills or comparable programs and the ability to learn and apply new software knowledge quickly
- Prioritization, time management and organizational skills; experienced in the management of multiple priorities that enable the ability to coordinate inquiries and concerns of customers: patients, staff, administration and public
- Experience training and/or mentoring new employees or team members
- Demonstrated ability to appropriately maintain confidentiality
- Knowledge of insurance authorizations, referrals and eligibility processes
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M HIS Revenue Cycle Solution Sales Executive Resume Examples & Samples
- Bachelor's degree or higher from an accredited institution
- Minimum of three (3) years of combined experience selling and/or delivering/implementing complex technology solutions, across multiple hospital departments
- Minimum of three (3) years of experience with one or all of the following: CDI workflow, HIM Operations, IP & OP Revenue Cycle, and the regulatory environments
- Masters in Healthcare Administration or Masters in Business Administration from an accredited university
- Proven ability to identify and communicate with “C level” decision makers
- Excellent organization, presentation, and communication skills
- Working knowledge of 3M HIS products
- Coding and/or CDI certification(s)
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Revenue Cycle Management Operations Analyst Resume Examples & Samples
- Analyzes data and statistics, including physician productivity and compensation, to identify trends and variances
- Provides analysis and data to support the PSA’s strategic planning, growth, and development efforts
- Prepares accurate financial and/or statistical reports for internal and external use by governmental agencies, financial institutions, or third-party agencies
- Renders assistance to department Directors, Managers, and Service Line Administrators in preparing and reviewing data and systems
- Supports clinical practices with the preparation of revenue cycle performance reports
- Assists with the development of operational strategic analysis in support of clinical and business operations. Reviews and prioritize requests for financial analysis or reports
- Participates on teams, committees, and special projects both internal and external to the organization. Supports senior management and performs other assignments
- Coordinates with the PSA’s Physician Practices, Patient Accounting and Finance on business related issues and best practices
- Provides crucial insight into business operations through analyses of practice operations, review of performance benchmarking, and assisting in business forecasting
- Assists with the preparation of the annual budget related to the revenue, payments and adjustments for the PSA and prepares schedules and analyzes data for comparison and changes
- Responsible for maintaining systems for trending specialty and provider performance within the revenue cycle and audits key data fields to ensure accurate data and reports
- Physician enterprise operational reports design, preparation and maintenance preferred
- Knowledge of physician group practice financials, reports, and tools
- Strong customer service and analytical skills
- Knowledge of Revenue Cycle processes
- Ability to collaborate with operational teams and understand the business of the service lines
- Aptitude for conflict resolution, and problem-solving
- Interpersonal skills necessary to establish and maintain effective working relationships with physicians and all levels of personnel, both internal and external to the PSA
- Skill in the use of complex mathematical and statistical techniques to assess financial and statistical scenarios
- Demonstrates competency in design, preparation of spreadsheets, and other reporting tools
- Ability to utilize discretion and independent judgment to support the financial goals of the organization
- Able to communicate information in a clear, concise, and easy to understand manner for use by internal and external groups
- Ability to balance multiple tasks with changing priorities; organization skills
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Revenue Cycle Mgt Analyst Resume Examples & Samples
- Maintain SOX controls for tie outs, including documentation to be provided to auditors as requested
- Cash Reconciliation & Specialist Projects
- Assist CBOs with complex projects regarding payer issues
- Attend committees to maintain company Control Group Numbers for cash reconciliation purposes in Accounting
- Create new reports for the RCM Auditing Dept, Contract Revenue Dept, Billing Dept and Business Systems Dept; train said departments on running reports and troubleshoot future issues or modifications
- Create and distribute assigned weekly, monthly, and quarterly Management reports for RCM, CLS, Business Systems and Billing Departments
- Provide Auditing with documentation as requested
- Ad-hoc reporting and analysis for management team as requested
- Analyze A/R, collection, reimbursement trends and RCM performance. Provide feedback to RCM leadership as assigned, which may include but is not limited to
- Reporting at CBO monthly operations meetings
- Identification of root causes obtained through analysis and communicate findings as appropriate
- Support and Training, by providing ongoing support to the CBO RCM Revenue Cycle Analysts
- Monitor and respond on a timely basis to report requests and other inquiries directed to the Corporate PA Reporting icon
- Assist Analyst, RCM III (Sr. RCM Analysts) with training of CBO RCM Revenue Cycle Analysts
- Assist and attend Monthly/Annual CBO RCM Revenue Cycle Analyst meeting
- Assist with Disaster Recovery procedures, including cutover testing annually
- Responsible for submitting and testing service request changes to I.S. as requested by the CBOs
- Perform testing on changes as directed by Information Systems
- Act as Corporate RCM liaison to Information Systems
- Performs other job-related duties within the job scope as requested by Vice President of Revenue Cycle Management
- Reads and complies with established policies and procedures
- Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations
- RCM experience
- Advanced knowledge and/or familiarity in Word, Excel, Access, Power Point, Brio, Crystal, GPMS, Medsuite, Monarch, Cognos and Master Database
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Revenue Cycle Management Analyst Resume Examples & Samples
- Responsible for balancing tie outs from billing and patient accounting systems (GPMS, NextGen,
- Medsuite, OBR, Availity) to Financial Database and/or Cognos on a weekly and monthly basis
- Work closely with Finance and IS FDB/Cognos Team to maintain controls and the schedules for tie outs and resolve any conflicting data in a timely manner
- Monitor daily cash report provided by team and provide back-up for issues with banks
- Monitor and trend miscellaneous payments posted throughout the company and assist CBOs with reconciliation
- Monthly Reporting, Analysis, and Trending
- Create monthly OBR, Availity, GPMS, Medsuite and/or NextGen reports for coding educators
- Assist with completing CBO Report Cards
- Provide back-up coverage for the Analysts and assist Analyst, RCM III (Sr. RCM Analysts) with projects and assigned reports as needed
- Create new reports to be used in the CBOs and provide training
- Create, maintain and distribute monthly staffing matrices to RCM leadership to determine necessary staffing to support operations
- Contribute on committees as needed
- Maintain strict confidentiality in accordance with HIPAA regulations and Company policy
- Any patient private health information (PHI) must not be divulged on any account except for payers that need the information in order to process the claim for payment
- Maintains constant awareness of potential safety hazards insuring necessary safety precautions
- Associate's degree (A. A.) or equivalent from two-year College or technical school (Bachelor’s preferred); or three or more years related experience and/or training; or equivalent combination of education and experience
- Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to write speeches and articles for publication that conform to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors
- Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables
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Revenue Cycle Precertification Clinician Resume Examples & Samples
- Ability to work independently and self-regulate in compliance with deadlines
- Proficiency in the application of applicable nationally and payer authorization criteria
- Minimum Intermediate Microsoft Office (Excel and Word) skill
- Ability to interact intelligently and professionally with other clinical and non-clinical partners
- Ability to communicate effectively at all levels
- Ability to sit and work at a computer for a prolonged period of time conducting pre-service medical necessity reviews
- Characteristic of typical Call Center environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc
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Revenue Cycle Coordinator Resume Examples & Samples
- Responsible for improving and maintaining an efficient revenue for the department
- Maintain accurate and up-to-date knowledge of managed care programs, government and indigent payers
- Responsible for coordinating the work related to the department's accounts receivable work files
- Ensure appeals are made within filing deadline
- Communicate with representatives from managed care companies, government and indigent programs to resolve and prevent denials
- Work with coding staff to resolve coding related denials
- Track and communicates trends in claim denials
- Actively improve collections from hospital patients deemed as self-pay
- Work with clinic staff to ensure accurate financial information is obtained
- Provide training as needed to improve revenue cycle operations
- Special project coordination and management
- Proactively assists others as needed
- Extensive experience working with insurance companies
- Experience with GE Centricity, Enterprise Task Manager (ETM), and Cerner EMR
- Demonstrated strong problem solving & decision making skills
- Demonstrated ability to manage and motivate change
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Revenue Cycle Sys Analyst Resume Examples & Samples
- Assists users and IT personnel with training and development of user documentation
- Evaluates, designs, builds, tests, and implements custom or vendor supplied software and develops system-wide reports to support information management needs
- Maintains production systems to ensure reliable performance
- Prepares complete unit, system, and integrated test plans and test methodologies
- Implements and follows internal Information Technology break/fix and change management processes
- Master’s degree in Business Administration, Computer Science, or Project Management with experience implementing and maintaining complex systems in a healthcare environment is desirable
- Ability to communicate effectively, both verbally and in writing
- Working knowledge of one or more programming languages/reporting systems, including RPG, COBOL, Java, XML, SQL, Crystal Reports, Hyperion, SAS, Cerner CCL
- Knowledge of SQL databases and general knowledge of data structures
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Supervisor of Revenue Cycle Management Resume Examples & Samples
- Supervises and leads the day-to-day activities of assigned group of AR Representatives and Payment Posters
- Ensures production and quality control standards are met by reviewing management reports
- Assigns workload to meet production requirements by evaluating production reports
- Maintains performance standards by counseling employees, performing appraisals and providing required training
- Ensures departmental policies and procedures are followed. Additionally, develops and revises policies and procedures as needed
- High school diploma or equivalent and five (5) years of healthcare supervisory experience such as, but not limited to clinic supervision, accounts receivables and payables or revenue cycle business operations
- Two (2) plus years of experience in Payment Applications
- Certified Professional Coder (CPC) a plus
- Intermediate Microsoft Office
- Work requires computer skills
- Ability to apply arithmetic, mathematical reasoning and analyze data and/or report information
- Proven success in a fast paced, changing environment
- Effective oral, written and interpersonal communication skills
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Senior Revenue Cycle Consultant Resume Examples & Samples
- Work with clients to understand business and back office requirements
- Define service scope (statement of work) and corresponding labor estimates to complete assignments
- Demonstrates ability to estimate and manage work assignments to budget
- Provide lead technical support in business development opportunities
- Assist in research of new technologies and trends that might impact our clients and make appropriate recommendations
- Team leadership, direction, and engagement supervision of Consultants. Assist client with compliance areas associated with back office service
- Manage assigned client service engagements
- Execute assigned tasks relating to the client’s back office services or as assigned by the Consulting Manager
- Communicate advice and answer questions of client staff relating to client’s back office services
- Provide training or assistance to client staff relating to client’s back office services
- Perform emergency on-site or remote support as needed as requested by client or other consultants when urgent issues arise
- Pursue advancement in technical back office service capabilities as well as advancement in “soft skill” competencies
- Mentor other consultants and assist them with client management
- Revenue Cycle operations experience (Hospital/SNF/Behavioral Health) (include knowledge in pre-authorization, pre-admission processes, denials management, claims adjudication, etc.)
- Revenue cycle business process optimization experience (includes knowledge of edits, denials, holds, reimbursement, etc.)
- Revenue Cycle Data Analysis Knowledge of key performance indicators for Revenue Cycle and national benchmarks
- Deep knowledge of facility coding and billing processes
- Revenue cycle information systems knowledge
- Provider education experience
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VP, Revenue Cycle Resume Examples & Samples
- Provide leadership and administrative direction to Patient Financial Services, Patient Access, and supporting staff. An inherent element of this responsibility is the mentoring, development and encouragement of these individuals in alignment with the organizations Core Values
- Responsible for day to day oversight of the revenue cycle services agreement and periodic reconciliation of the net benefit
- Responsible for establishing open communication lines to ensure all relevant information is received from or passed to the appropriate staff members in a timely manner
- Ensure employees are hired, trained and evaluated according to the standards set forth by Human Resources and sound management principles
- Incorporate the values and standards of Beaumont Health System into all business staff development practices and all departmentally directed activities
- Maintains direct oversight of all aspects of third party vendors as it relates to A/R operations and technology Quality / Cost
- Maintain appropriate internal control safeguards over A/R records and collection of cash. Maintain compliance standards for providing accurate information on all facility of health system billings
- Plan, coordinate, and prepare year-end audits with public accounting firms and third party auditors as they relate to A/R operations
- Ensure compliance with relevant regulations, standards and directives from regulatory agencies and third-party payors
- Responsible for overseeing and enhancing the development of data collection analysis and reporting processes for the executive management of the revenue cycle at all system facilities, including information integrity validation and interpretation
- Oversee the financial interface between and performance analysis of the patient financial services functions and fiscal services functions
- Bachelor's Degree in Management Accounting, Finance, Management Engineering
- MBA or other appropriate advanced degree strongly preferred
- Evidence of continuing additional education and coursework
- Broad knowledge of revenue cycle aspects including patient scheduling, pre-registration, central registration, financial counseling, , billing, credit and collections
- Broad and deep knowledge of accounts receivables management (tracking receivable levels, days of cash, cash management, days in A/R and aging)
- Broad knowledge of financial forecasting, cost center salary and direct expense analysis, month end financial reporting
- Understanding of a central business office function
- Strong understanding and comprehension of process management
- Human relations skills including one-one leadership, team leadership, and leadership within the larger organization with multiple departments and constituencies
- Approximately 10 years of progressive experience is desirable with 5 years at the supervisory/management level
- Experience in a major systems conversion, preferred
- Experience with responsibility for large groups (at least 250+) of employees
- Hands on experience in various areas of patient access, registration, billing, credit and collection, cash management
- Multi hospital experience strongly preferred
- High energy level, proactive and responsive
- Energizes self and others
- Works collaboratively with others
- Enjoys leading a team and playing a role as a team member
- Manages by the use of facts and measurable analysis
- Ability to maintain ambiguity and confidentiality
- Comfortable with large and complex organizations and various cultures and bureaucracies
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Revenue Cycle Associate Resume Examples & Samples
- Prepares and submits clean claims to insurance companies either electronically or by paper in an accurate, timely and compliant manner
- Collects and verifies all documentation necessary for timely billing of patient accounts, including requesting and collecting medical records and other documents ensuring the acceptance of the claim
- Works all reports related to billing, such as work-lists, hold reports, and rejection reports to ensure claims are submitted timely and accurately, per billing guidelines
- Processes claims for secondary insurance carriers, attaching all required documentation to ensure claims are filed to appropriate payers
- Understands all payer guidelines related to claim submission; is knowledgeable and proficient with payer websites and other useful resources pertaining to the billing function
- Focuses daily on complying with policies, processes and department guidelines for billing and claim edit resolution
- 2-3 years experience with medical billing/collection; hospital billing experience preferred
- Experience with patient accounting systems and billing/claim submission software; specific XClaim and/or Meditech experience a plus
- Medical billing and coding certification a plus
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Revenue Cycle Associate Athenahealth Professional Team Resume Examples & Samples
- Various aspects of medical billing; claim creation, claim submission, payment posting for insurance and patient balances in the athenaNet system
- Obtain supporting documentation (medical records, EOB's, remits, authorizations, referrals), from the multiple systems
- Monitor insurance denials by running reports and contacting insurance companies to resolve and recover denied claims
- Monitor aging reports for timely follow-up on unpaid claims
- Retroactive review of registration data to aid in the assurance of clean claim submittal
- Accurately document actions taken within patient account
- Serve as resource for problem solving issues related to registration, demographic and insurance errors
- Work payer correspondence including support tickets, emails, and phone message from internal and external contacts
- Work collaboratively with Coding, Provider Enrollment, and Cash Posting as well as coworkers, Team Leads, Managers and practice staff to resolve claim and account issues
- Adhere to HIPAA guidelines regarding confidentiality relating to the release of financial and medical information
- Follow state, federal, insurance and organization guidelines
- 1-3 years experience with medical billing/collection; professional billing experience preferred
- Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices
- Experience with athenaNet patient accounting systems and billing/claim submission software
- Knowledge of revenue cycle and/or business office procedures
- Knowledge of third party payer guidelines and procedures
- Experience with insurance claim follow-up, denial & appeal processes
- Experience with eligibility, registration and authorizations
- Ability to utilize basic Microsoft Office programs
- Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of Steward
- Attention to detail & possess strong verbal and written communication skills
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Revenue Cycle Project & Data Analytics Manager Resume Examples & Samples
- Managing a team of analysts and associates that are focused on meeting project goals and milestones
- Crafting and delivering upon ROI-based goals that meet athena’s needs and contribute to the development of your team
- Establishing, monitoring and improving quality and effectiveness metrics
- Continually evaluating and optimizing team structure to streamline process and ensure engagement including hiring, feedback and appraisal processes
- Implementing and improving processes, policies and procedures to ensure the efficiency and effectiveness of the operational process and the product ‘s posting functionality
- SQL proficiency
- Understanding of the needs of our clients and how attainment of our goals will meet those needs
- Focus on quality of service as our driving principle
- Understanding the business need to set and attain ever more challenging goals
- Understanding of, and dedication to, continuous improvement of our processes and ourselves to support athena’s mission
- Eagerness to participate in change-oriented endeavors geared toward expanding our capabilities
- Willingness to vary job responsibilities as required to meet the needs of our clients
- Desire to learn as much as possible about our core systems
- Monitoring and managing metrics, ensuring that performance is trending in accordance with monthly goals and analyzing variances to identify improvements in quality and efficiency
- Supporting and automating existing operational processes, add streamlined controls and reporting to facilitate expansion of team capacity, scope and influence
- Managing internal and external stakeholder relationships through clear communication, reporting, and setting clear expectations
- Analyzing trends and resolve root-cause issues by working externally with vendors, payers, as well as coordinating with key leaders internally at athenahealth
- Mastery of all Microsoft Office applications, including Outlook, Word, Excel and Powerpoint
- Proficiency with Visio
- Dedication to the corporate mission to become the most trusted and effective business service to health care providers in the world
- Commitment to athenahealth’s social mission to improve the quality of healthcare for all
- Commitment to athenahealth’s Corporate Compliance Code, including escalation of all compliance issues through the chain of command and to the company’s Compliance Officer and/or General Counsel
- Unconditional support of athenahealth’s cultural mission to be a community of teachers, learners and winners
- Belief in the primacy of the group over the individual – that “super-performers” are those who most help the performance of those around them rather than those who produce the most themselves
- Creating a virtuous circle of learning and innovation through fostering his/her innate curiosity and desire to: 1) master his/her job, 2) innovate in his/her area of responsibility, whatever its scope and 3) teach other athenistas about what s/he has learned
- Demonstrate unconditional positive regard for the personal worth (distinct from a particular individual’s actions) of all other athenistas, and act accordingly
- Fueled by the passionate desire to make his/her role and athenahealth a terrific success, every athenahealth employee will do what it takes to get the job done, including sometimes working unpredictable, long hours to perform a diverse array of tasks
- High level understanding of the three major services lines and of the organization’s responsibility for delivering on them
- Understanding of the Balanced Scorecard and each department’s responsibilities under it
- Excellent communication skills (particularly listening and speaking); highly articulate; makes arguments in a compelling manner, explain complex processes and data flow in a way that’s understandable by non-technical stakeholders
- Maniacal attention to detail
- Willing/excited to work in a fast-paced, but sometimes intense, rapidly expanding company
- Strong computer literacy and/or the comfort, ability and desire to advance technically
- Data driven decision making experience and/or experience with SQL
- The comfort, ability and desire to advance technically
- Coaches and empowers team to deliver results and gain internal and external stakeholder buy-in
- Experience working in agile project
- Understands project requirements, coordinates with resources and directs projects in the right direction and in a timely manner
- Passion to teach
- General understanding of how systems function and how system logic operates
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Healthcare Revenue Cycle Resume Examples & Samples
- Be the “face of IT support” to our Service Operations team
- Act as a liaison between Operations System Admin and Optum360 E2E Support team
- Obtain, interpret and analyze operation issues/problems/requirements
- Be able to perform application walk-throughs from service operation perspective for Optum360 functional teams
- Identify and initiate resolutions to user problems and concerns associated with application
- Submit and manage requests to Partner IT when information/changes are needed
- Bachelor's degree in related field Or equivalent experience
- MS Office (Including Word, Excel - to include pivot tables, VLookups, Formulas etc., PowerPoint)
- SQL experience (basic queries)
- Willingness and ability to travel 25% of the time regionally as well as between multiple offices in the Long Island, NY area
- Knowledge of Optum360 Revenue Cycle tools and solutions
- Knowledge of Optum360 Revenue Cycle tools and solutions such as: Electronic Financial Records (eFR – workflow/follow-up tool similar to Artiva), Claims Administrator (CA – commercial claim scrubber tool similar to SSI), Medicare Real Time (MRT – claim scrubber tool for Medicare claims)
- Able to work in a dynamic environment
- Able to self-prioritize tasks
- Able to work independently and as part of a large team
- 837 and 835 formats experience
- HL7 preferable
- Knowledge of Citrix or Terminal Services configurations and troubleshooting
- Familiarity with system / application monitoring tools
- Reporting Tools experience
- Network Topologies experience
- Desktop utilities experience
- Excellent verbal and written communication skills are required to represent UHG in a positive fashion to our clients
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VP, Revenue Cycle Services Resume Examples & Samples
- Provides executive oversight for delivery teams engaged with members, in both inpatient and outpatient/professional environments, to drive successful outcomes and positive member results
- Acts as a “senior Advisory Board voice and presence” for member senior executive team, providing executive level reports and updates
- Coordinates with Revenue Cycle Partner for cohesive delivery and sales initiatives
- Identifies upsell opportunities within current consulting engagements; drives opportunities to close through necessary analysis, coordination and communication
- Provides direction for project teams working on engagements, including but not limited to, setting engagement strategy, assigning tasks to be completed, reviewing material and providing constructive feedback to consulting teams to drive to successful engagements
- Promotes and enhances staff development at all levels through coaching and in-service education creation and delivery
- Ability to function as part of the consulting team, driving progress through, but not limited to, leading discussions, white boarding sessions, storyboarding sessions and organizational interviews
- Drive cohesive, thorough and accurate recommendations for member organizations through thoughtful analysis of data
- Lead consultative meetings with member organizations
- Ensure accurate and timely collection of at-risk fees through the management of successful completion and delivery of results for member organizations
- Ensure accurate and appropriate adherence to contractual terms; communicate effectively with Revenue Cycle Consulting and Marketing leadership around instances of inappropriate scoping and/or scope creep
- Positively represent Revenue Cycle Consulting, and the Advisory Board, through industry meetings and conferences
- Maintains and enhances positive communication between departments within the Advisory Board
- Performs other related duties incidental to the work described herein
- Masters degree in health administration, or other related field is preferred
- Six to ten years’ experience, at a senior level, either managing physician practices or, preferably, healthcare system physician group practices with a sizeable employed physician base
- Six to ten years’ experience, leading an in-patient hospital finance division, preferably at the VP Revenue Cycle or Chief Financial Officer level; Academic Medical center experience is a plus
- Proven to have successfully grown and developed an employed physician model within a health system
- Experience working in a physician-led, integrated healthcare delivery organization a plus
- Proven experience developing and implementing operating plans, analyzing financial and quality data; experience in developing and/or operating management service organizations is beneficial
- Knowledge of various physician compensation plans, incentives and contracting arrangements
- Strong knowledge of ICD9, ICD10, CPT and HCPCS
- Strong knowledge of payer requirements, including Medicare and Medicaid
- Strong PC and Office software skills
127
Revenue Cycle Associate / Senior Analyst Resume Examples & Samples
- Interim management (as applicable)
- 2+ years of experience in revenue cycle management
- Knowledge of the complete healthcare revenue cycle
128
Soarian Revenue Cycle Consultant Resume Examples & Samples
- Articulates the impact of Cerner solutions on future state workflow, role and service line/department
- Performs other responsibilities as needed
- Facilitates current state, future state and gap analysis
- Ability to work off-hours when required
- Willingness to learn autonomously when needed
- 3-5 years of healthcare experience in Soarian RevCycle design and build, or workflow (ex: RevCycle, Case Management, HIM, hospital business office, healthcare administration)
- Must reside near a major international airport or be willing to relocate to Malvern, PA
129
Senior Revenue Cycle Application Consultant Resume Examples & Samples
- Understand and consult on Cerner Patient Accounting and overall revenue cycle workflow, including all associated roles and operational/process metrics
- Provide expert domain knowledge, implementation approach, and workflow design within scope
- Articulate regulatory impacts
- Understand client key revenue cycle metrics
- Discuss status of Open/Pending projects
- Must live or be willing to relocate to the San Diego, CA area
- Bachelor's degree or equivalent experience in health care related revenue cycle positions
- Minimum of one year of experience with Cerner Patient Accounting
- Revenue Cycle build experience
- Experience with revenue cycle applications in a healthcare environment
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MS Revenue Cycle Consultant Resume Examples & Samples
- Healthcare/hospital environment experience is preferred
- Project Management experience is preferred
- Maintain regular communication with client, vendor, team members and team leaders regarding project issues, risks, and needs
- Required to use computer for long periods of time
131
Revenue Cycle Optimization Associate Resume Examples & Samples
- Knowledge of HL7 standards
- Familiarity with Electronic Medical Record systems
- Ability to travel 50-60%
- 1+ years in laboratory revenue cycle management
132
Revenue Cycle System Analyst Resume Examples & Samples
- Supports and maintains existing applications and performs system analysis and troubleshooting to resolve end-user issues and technical problems
- Performs root cause analysis of data and workflow issues and participates in cross-application solution design (system and/or workflow based)
- Researches, configures, tests and implements new functionality and applications to support revenue cycle processes and accurate, complete and efficient data flow
- Creates thorough system design and build documentation
- Grows expertise in KPHealthConnect (Epic) end to end data flow and Kaiser Permanente revenue cycle processes
- Collaborates with Revenue Cycle management, KP HealthConnect clinicals support team, Medical Group, Vendors, National and Regional teams, KPIT and other internal KP departments
- Performs analysis of reports relating to financial data completeness and accuracy
- May participate in multiple projects at once
- Minimum two (2) years of relevant work experience, in areas such as (but not limited to) project management, system analysis, data analysis, health care administration, science, engineering, education, information technology, business or finance
- Experience with Epic Systems software a plus
- Demonstrated working knowledge of medical terminology
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Manager, Healthcare Revenue Cycle Management Resume Examples & Samples
- Bachelors degree in business related field, or equivalent work experience
- 8+ years experience in related field
- 5% travel
- Manages department operations and supervises professional employees, frontline supervisors and/or business support staff
- Participates in the development of policies and procedures to achieve specific goals
- Decisions have a short term impact on work processes, outcomes, and customers
- Interacts with subordinates, peer customers and suppliers at various management levels may interact with senior management
- Interactions normally involves resolution of issues related to operations and/or projects
- Gains consensus from various parties involved
- Role is responsible for the shipped unbilled revenue and ensuring timely billing of healthcare claims, patient collections teams and 3rd party vendor relationships related to patient liability
- Role will lead a team of about 20 people with 6 direct reports
- Role works collaboratively with order entry and order processing teams to improve quality, speed of payment and collecting on aging AR for unbilled and patient responsibilities
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Hospital Revenue Cycle Admin Assistant Resume Examples & Samples
- Ability to fully support 6 – 10 leaders’ priorities to completion
- Strong organizational and multi-tasking skills
- Proactive problem solving
- Display professionalism and flexibility in a fast paced, ever-changing environment
- Ability to interact effectively with all levels of staff and management is essential
- Ability to maintain strict confidentiality is required
- Intermediate MS Office required (Outlook, Excel, Word, PowerPoint, Visio, SharePoint)
- 3 – 5 years corporate office experience
135
Revenue Cycle Optimization Resume Examples & Samples
- Revenue cycle assessments for hospitals, health systems and diagnostic laboratories
- Alignment of client / partner processes and Optum360 technology
- Provide revenue cycle management services to client / partners in all areas of revenue cycle which includes
- Minimum of 3 years of experience in acute care and/or laboratory revenue cycle management
- Basic knowledge of at least one practice management system and/or EMR system. Experience with one or several of these vendors is a plus: Siemens, GEHC, Allscripts, SMS, Cerner, McKesson, Epic, Meditech or other similar HIS/LIS/EMR systems
- Working knowledge of laboratory and hospital based IT systems
- Ability to maintain the highest level of confidentiality
- Expert in MS Word and Excel and Visio required, expert in Outlook and PowerPoint
- Familiarity with payer to provider or patient to provider transaction sets (such as 270/271, 837/835, 276/277)
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Senior Director of Revenue Cycle Operations Resume Examples & Samples
- The Senior Director is responsible for achievement of client service level agreement targets including Cash, A/R, Denial, and Bad Debt targets
- Development and oversight of operational plans
- Collaborates with the client as appropriate to improve operational performance for RCM services
- Provides leadership and input into the architecture, detail design and development of the business office organization
- Oversees the deployment of company operating model (TOPs) and philosophy
- Provides input on the refinement of service level agreements with customer leaders and representatives; responsible for market and area satisfaction with overall performance
- Contributes to the development and implementation of strategic direction for the Revenue Cycle process for supported facilities
- Performs staff reviews and prepares performance documents for direct reports
- Promotes employee engagement and satisfaction
- Assist Optum360 with designing Best in Class RCM Operating Model
- College education or equivalent experience managing large scale operation
- Experience leading large organizations (must be 8 or more sites)
- At least 10+ years of revenue cycle management experience with five or more years of leadership; healthcare provider service background preferred
- Must have broad experience with RCM operations, people leadership, and transition / change management
- Industry knowledge is required
- Must be proficient in packaging PowerPoint presentations summarizing outcomes
- PC skills - skilled in Microsoft Office applications and others as required
- Experience with MS4, SSI or Cerne
- Ability to communicate long term goals and lead leadership team in development and implementation of performance improvement initiatives
- Strong and engaging leadership qualities
- Project management - administers using tools and processes to identify and communicate project goals, schedules, responsibilities, progress and performance
- Experience in healthcare billing and collection or similar service environments preferred
- Managed Care financial and operational experience a plus
- Experience with organizational start-ups, mergers, acquisitions, operational consolidation and shared services a plus
- Consulting experience in areas of business transformation, finance reengineering, shared services, change management and project management a plus
- Health Plan Operations is a plus
137
Revenue Cycle Representative Resume Examples & Samples
- Verify eligibility of insurance benefits, patient liability, non-covered exceptions: confirm all steps necessary have been taken to adjudicate claims and billing to maximize reimbursement
- Analyze and resolve system generated and user defined work queues to ensure clean and timely claim submission and reduce claim denials
- Maintain extensive working knowledge and expertise based around payor regulations/policies, financial classifications and financial assistance programs
- *Please note: Five (5) professional references will be required at a later step during the hiring process
- Minimum 6 months revenue cycle, health Insurance or related customer/patient focused service experience
- Experience maintaining professionalism while handling difficult situations
- Knowledge of healthcare billing (healthcare revenue cycle) and/or insurance, and/or federal and state assistance programs
138
Revenue Cycle Representative Resume Examples & Samples
- Assist in monitoring utilization services to assure cost effective use of medical resources through processing prior authorizations
- Initiate authorization requests for outpatient and inpatient services services in accordance with prior authorization requirements. Route to appropriate staff when needed
- Communicate with patients and/or referring physicians on non-covered benefits or exam coverage issues
- Contact patients, insurance companies, credit/collections for payment acquisition, pre-authorization and to resolve patient account inquiries
- Provide financial counseling to patients and families; and/or determine if appropriate payment has been made by various entities; and/or work with patients and insurance companies to obtain correct payments; and/or appeal claim payments and/or denials
139
Revenue Cycle & Analytics Senior Consultant Resume Examples & Samples
- Participate in setting engagement objectives and scope
- Develop work plans for components of an engagement
- Coordinate activities between work streams
- Provide guidance to junior practitioners as they manage large, confidential and complex data sets
- Facilitate client interviews and client meetings
- Develop process flows depicting pain points in the business process
- Conduct detailed analyses to draw conclusions, and develop pertinent and insightful recommendations
- Design deliverable content to reflect the engagement contract
- Present findings and recommendations to client leadership
- Mentor junior staff
- Bachelor’s degree from accredited university
- Minimum of 5 years of professional experience in revenue cycle operations in a health care provider, consulting, or technology vendor environment
- Demonstrates consistent career progression with increasing levels of responsibility
- Performed above expectations in previous professional roles
- Excellent knowledge of Big Data Analytics, Enterprise Healthcare Revenue Cycle and billing operations, patient financial processes
- Deep knowledge of data analytics platform integration for electronic healthcare medical record databases such as Epic and Cerner
- Working knowledge of SEO, HTML, CSS, SQL, PuTTY, Salesforce, JIRA and Clarizen
- Competent in Microsoft suite of Business Software, specifically Excel and PowerPoint
- Possess strong Data & Analytic skills
- Willingness and ability to travel 100%
- Must live within commuting distance to one of Deloitte’s consulting offices
140
Business Analyst of Revenue Cycle Resume Examples & Samples
- Demonstrates the ability to effectively prioritize tasks with limited direction
- Performs qualitative and quantitative data analyses, and builds presentations to communicate the results of analysis to leadership and partners
- Exhibits the ability to gather business problems, identify the root causes through claim-level deep dives and data analytics, help to define potential solutions, design experiments to test potential solutions, conduct the ROI assessment, and implement the solutions if justified
- Exercises good judgment within department and company defined procedures and practices to determine appropriate action
- Collaborates with PRT and stakeholders, and drives the adoption of new process changes
- Ensures that new processes are documented and that changes are communicated to all affected parties
- Generates innovative solutions by approaching problems with curiosity and open mindedness, using existing information to its fullest potential
- Assists on various projects, meets deadlines, and handles multiple priorities in a fast-paced, ever changing and evolving business environment with shifting time frames
- Attends team meetings, phone conferences, and training as scheduled or needed
- Provides guidance and training to other PRT Teammates
- Assists in the development and maintenance of best demonstrated practices
- Travel required: up to 25%
- Bachelor’s degree from accredited university (or minimum of 3 years of related experience)
- Certification and/or experience in process improvement and/or project management
- Prior health care reimbursement / revenue cycle experience
- Proficiency with MS Word, Excel, PowerPoint, and Outlook (MS Access highly desired)
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Revenue Cycle Coordinator Resume Examples & Samples
- Participates in revenue cycle/billing, denial management/follow-up, Patient Access Services, HIM, lab, authorization/referral processing, and other hospital-based work teams
- Works with management, clinical and other hospital departments, and the patient accounting staff to improve processes, increase accuracy, create efficiencies, resolve related issues, and achieve the overall goals of the department
- Performs XClaim and Revenue Recover training in Revenue Cycle Systems for new users and monitors departmental clean-up of worklists
- Reviews and ensures departments are reconciling charges on a daily basis
- In partnership with CBO, follow-up on claim status and appeals including interaction with the payors
- Develops and maintains efficient working relationships
- Recognizes the importance of team efforts and partners with others to achieve positive outcomes
- Is responsible for ongoing development of his/her work skills through the use of available resources (i.e.: in-services, formal educational programs, other work groups and on-the-job training)
- Demonstrates an understanding of relative Hospital and all-departmental policies and procedures including safety issues
- Possesses awareness of programs/services provided by Hospital and where they are located
- Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers
- Maintains a professional appearance and demeanor
- Strives to prevent/resolve customer concerns to the customer's satisfaction
- Preferred: Minimum 5 years supervisory experience in a healthcare setting
- Strong interpersonal/public relations skills and the ability to work effectively with a wide range of customers in a diverse environment
- Knowledge of CPT, HCPCS, and ICD-9-CM coding
- Ability to establish priorities effectively
142
Director of Revenue Cycle Shared Services Resume Examples & Samples
- Manage the day - to - day operations of the charge department
- Manage the day - to - day operations of the payment department
- Manage the day - to - day operations of the cash management department
- Manage the day - to - day operations of the patient call center
- Research new technologies that can improve the overall efficiency of each area as well as eliminate risk to the department
- Develops functional, strategy, plans, and production priorities
- Identifies and resolves technical, operational and organizational problems outside own team across the department
- Ensure that each functional area is meeting all SLAs and client expectations
- Track and eliminate all backlog for each functional area
- Plan, hire, and train staff to ensure success of each area
- Ensures key performance metrics for all clients are at or better than industry standards
- Ensures that each functional team understands new and existing client delivery expectations and metrics
- Reviews all key client processes that have been documented for the Service Delivery Team and ensures understanding across all functional areas
- Working knowledge of best practices for each functional area in the Shared Services Department
- Working knowledge of improving workflow and operations through the use of technology
- Working knowledge of Revenue Cycle Management processes and key performance metrics
- Proven track record in following standard policies and procedures with a constant focus on improving processes
- Proven track record of re - engineering processes / workflows to ensure operating efficiencies are maximized
- Proven track record to utilize tools and technology effectively
- Strong organizational skills and an ability to meet assigned deadlines without supervision
- Understanding of business reporting packages such as crystal reports and cognos
- Strong presentation skills for multi - level audiences
- 3 - 5 years of experience in managing and leading people and teams in a Professional Revenue Cycle Management Setting
- 5 - 10 years of experience in revenue cycle services in charges, payments, cash management and /or patient call center
- BS / BA in Business Administration or Healthcare Administration
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Healthcare Revenue Cycle Management Consulting Senior Manager Resume Examples & Samples
- Develop management plans to migrate out clients into a leading practice environment
- Strong financial acumen; ability to develop budges, forecast revenue, develop early warning signs and adapt the organization to achieve financial targets
- Solid financial acumen and financial analysis and diagnosis skills
- Strong executive level relationship building skills
- Ability to create and deliver high-impact communications to senior audiences (written and oral) and facilitate complex discussions
144
Revenue Cycle Representative Resume Examples & Samples
- Contact insurance companies for credit/collections and/or investigation on payments to resolve patient accounts
- Manually post payments/denials/contracted discount to patient account and research when the Explanation of Benefits (EOB) provides or does not provide all necessary information
- Work to identify correct facility (UIHC, UI Dental School, etc) of account to apply payment to the unapplied clearing account in a timely manner
- Research and resolve overpayments and ensure that proper documentation is forwarded to the Credit Team for final resolution
- Assist with Remittance edits; research and identify each payment on the edit and determine appropriate placement in the Epic Patient Accounting System
- Be expected to complete deadlines in support of week-end, month-end and year-end accounting activities
- Communicate with internal departments, co-workers and Coordinator’s to resolve issues
- Experience using EPIC
145
Meditech Revenue Cycle Consultant Resume Examples & Samples
- MEDITECH Revenue Cycle experience is required
- Candidate must have strong knowledge of Claims Builder
- Classify problems as system, training, or process and recommend appropriate corrections
- Assistance with other tasks as necessary
- On occasion, may be required to lift and/or carry up to 25 lbs
146
Director Information Technology Revenue Cycle Management Applications Resume Examples & Samples
- Develops strategic and technical business plans
- Develops budgets, resource utilization plans, allocations and contingency availability plans
- Manages resource utilization and expenditures. Identifies best practices and makes recommendations
- Directs systems functions and technical support
- Monitors, reviews and adjusts work plans to meet requirements
- Secures and allocates resources
- Manages staff; provides guidance, evaluates performance and recommends training
- Manages vendor relationships; evaluates performance, provides feedback and resolves conflicts
- Develops and administers systems area policies and procedures
- Provides quality information systems customer service to user community
- Acts as advisor and consultant to project sponsors and executives
- Provides project status updates and resolves issues to meet project deliverables and deadlines
- Produces management reports and conducts executive presentations
- A minimum of 7 years of functionally related experience, including at least 4 years of progressive management experience
- Strong communication, leadership, team building and project management skills required
- Additional experience managing large complex enterprise projects preferred
- Experience leading and aligning enterprise hospital, professional, and specialty revenue cycle billing functions and projects that ensures the health systems efficient and effective use of the Epic portfolio (e.g. billing, collections, claims, and remittance), statements, legacy, and related third-party applications
- Demonstrated understanding of healthcare revenue cycle operating drivers, metrics, business concepts and industry strategies
- Experienced in building collaborative models of consulting with operational leaders, revenue producing areas, and revenue cycle operations
- Experience in developing successful operational service models, work production standards, and Service Level Agreements (SLA)
- Relevant Epic certifications, information technology or professional certifications highly desirable
147
Strategist Revenue Cycle Resume Examples & Samples
- Acts as the subject matter expert for specific healthcare revenue cycle roles, venues, markets and/or segments
- Understand and articulate the current competitive landscape
- Recommends development priorities, leveraging quantitative and qualitative analysis
- Performs analysis of solution needs and defines scope of capabilities
- Communicates existing and emerging solution functionality to Client
- Ensures alignment of client goals and strategies with current IP capabilities and roadmap
- Collaborates across solution groups on similar functionality to ensure common process and seamless integration
- Protects innovation through the patent process
- Support Cerner Implementation and Consulting processes
- Obtains feedback on quality of solutions
- Demonstrated excellence in written and verbal communication: including speaking at conferences as well as with C-suite executives
- Bachelor's Degree (or the equivalent) with emphasis in related field; or equivalent experience
- Experience in healthcare revenue cycle
- Related industry certifications (CHFP, CRCR, CRCE, CRCP, PMP, etc.)
- 5-7 years of experience managing a revenue cycle practice in a provider organization, or related consulting or IT solution provider experience
148
Revenue Cycle System Analyst Resume Examples & Samples
- Develops system design, including functional specifications, and implements strategies based upon the analysis of specific operational needs
- Provides day-to-day operations support to customers as required
- Coordinates efforts between stakeholders from multiple areas in order to gather requirements, develop technical specifications, and test enhancements and other changes to these systems
- Identifies data integrity issues and analyzes data and process flows for process improvement opportunities
- Performs data analysis in order to extract requirements, identify data inaccuracies, and ensure accurate processing and reporting
- Identifies policies and requirements that drive a specific solution
- Works effectively on project teams and meets deadlines in accordance to project manager's expectations
- Works with stakeholders to build, test and maintain integration points with revenue cycle and clinical solutions
- Provides ongoing 24x7 application support and troubleshoot problems when they arise
- Work with all stakeholders to evaluate, approve and deliver requested system changes
- Follows MCHS policy and procedures regarding confidentiality and privacy of all related work activity, and in compliance with IT standards and regulatory practice (i.e., HIPAA)
- 3+ years of Cerner Millenium experience desired
- Prior experience with patient financial services, patient access, and/or health information systems preferred
- Ability to manage large scale projects and software deliveries
- Ability to work effectively on team projects
- Strong analytical, interpersonal, customer service, communication, and problem solving skills
- General knowledge of HL7 ADT Transactions
- Solid skills working with PC and multiple software applications including Microsoft Word, Excel, Access and Visio
149
Senior Director of Revenue Cycle Operations Resume Examples & Samples
- Experience leading large organizations (must be 5 or more sites)
- Experience in healthcare billing and collection or similar service environments
- Experience with organizational start-ups, mergers, acquisitions, operational consolidation and shared services
150
Epic Revenue Cycle Application Manager Resume Examples & Samples
- Maintain the scope, schedule and quality of the project in the Revenue Cycle area
- Work closely with the service lines and other project managers to coordinate activities and workflow
- Ensure that the Revenue Cycle business community is engaged in the success of the project
- Assist the application Analysts in their respective areas
- Review the progress of the project on an on-going basis with the service lines and the PMO
- Help review revenue cycle optimization opportunities prior to, during, and after go-lives
151
Revenue Cycle Coordinator Resume Examples & Samples
- Supervise work of Pre-Authorization team and serve as a payor expert and technical resource. Develop new and current staff through training to improve revenue cycle knowledge; work with staff to suggest additional options to resolve patient account inquiries
- Manage and monitor timeliness and accuracy of radiology and procedure preauthorization functions, in adherence to UI Health Care and governmental policies
- Provides administrative support to licensed health professionals to gather and enter pertinent information, supporting Medical Management functions for physician peer review
- Supports patient care by resolving pre-authorization issues with physicians, radiologists, radiology technologists, and ancillary staff; improving and maintaining quality assurance program for department functions
- Develop and monitor employee performance goals to enure compliance. Perform QA checks and productivity audits; identify and resolve undesirable trends and reimbursement errors; prepare reports to assure quality and productivity requirements are being met
- Experience in a medical setting and/or emergency room setting
152
Director of Revenue Cycle Management Resume Examples & Samples
- Direct all of our efforts surrounding outstanding and aged accounts receivable, reimbursement and refund posting, lockbox correspondence and reconciliation with 3rd party vendors and collection agencies
- Manage Inbound Call Center to provide world-class service within prescribed department KPI’s
- Manage Outbound Call Center for all initiatives and collection targets within prescribed department KPI’s
- Manage vendors utilized for billing claims to insurances outside of the United States
- Act as liason between USACS and external collection agencies performing work on USACS accounts
- Prepare older USACS debt for sale to external agencies
- Work closely with Athena healthcare to drive occupational efficiencies to optimize net revenue while reducing expenses
- Optimize and analyze all RCM reporting for each entity on a monthly basis
- Ensure compliance throughout entire RCM Operation
- Work closely with Director of Continuous Improvement to constantly improve the efficiency and effectiveness of the organization
- Communicates with other departmental managers to ensure smooth transition of inventory between departments
- Develops & maintains key performance indicators for departments and uses them to measure & improve departmental results
- Monitors, analyzes, and recommends improvements to the workflow systems and procedures
- Analyzes financial reports for clients, identifying trends and communicating such to USACS leaders and clients
- Manages and coordinates personnel including delegating tasks and ensuring a uniform workflow
- Ensures that employees are adhering to company and departmental policies & procedures
- Accounts for and administers human resource matters including: recruiting, hiring, terminating, wage and salary administration, career development, corrective action counseling, performance evaluations and time records
- Implements business and department strategies set forth by senior management
- Participates on committees and takes ownership of Continuous Improvement efforts as needed
- Gains familiarity of the day-to-day operations of the team, department, and company
- Performs and assists with other duties as needed
- At least 8 - 10 years of progressive management experience in healthcare revenue cycle services, especially accounts receivable, payment application and reimbursement
- Demonstrated experience with all major payors within healthcare revenue cycle, including Medicare, Medicaid, Commercial, Blues, Workers Comp and Self Pay
- Demonstrated experience in overseeing a 60+ employee team of revenue cycle associates
- Familiarity with several revenue cycle software solutions
- Operational knowledge of both Inbound and Outbound Call Centers, with some working knowledge of 1st party and 3rd party debt collection laws and practices
- Familiarity with call campaign development, utilization of debt scoring and the capabilities of automated dialing equipment
- BI Reporting and Information Technology experience in a high-volume processing environment a plus
- Thorough knowledge and ability to gain new knowledge of business principles, practices and procedures required to effectively administer, analyze, draw conclusions and make recommendations regarding department operations
- Knowledge of and skill in using personal computers in a Windows environment with an emphasis on spread- sheet applications and graphs, word processing, and basic presentation software applications
- Knowledge and understanding of a broad scope of functions within the medical insurance industry
- Ability to effectively manage staff to ensure productivity that accomplishes the needs of the department and, at the same time, fosters employee growth and involvement in the required day-to-day operations of the department
- Ability to effectively communicate with coworkers to coordinate department operations with other departments to ensure that business requirements are satisfied
- Ability to perform mathematical calculations in order to accurately analyze and complete reports and budgets
- Ability to use sound judgment and problem solving skills to identify and analyze employee and departmental problems and to recommend the proper course of action
- Ability to organize and prioritize job tasks and requirements
- Ability to pay close attention to detail
- Ability to effectively perform in a multi-task work environment
- Knowledge and understanding of the performance impactors horizontally throughout departments
- Ability to exhibit leadership by demonstrating a commitment to teamwork, supporting alignment with company and department goals and objectives, assisting others to develop their knowledge of the company and department, adapting to change in a positive manner that exemplifies commitment, and working proactively with minimal supervision
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VP of Revenue Cycle Management Resume Examples & Samples
- Organize, design and develop the appropriate organization structure for the
- Extensive knowledge in HIPAA privacy and security regulations
- Thorough knowledge of Medicare, Medicaid, Commercial and 3rd Party Payor billing practices
- Strategic decision making on best collection practices
- Strong managerial acumen in setting corporate directions and aligning strategic goals around business plans
- Familiarity with medical contracts and contract review
- Strong background in financial management and knowledgeable of federal and state laws and requirements relating to healthcare management
- Skilled at managing multiple projects and grasping new concepts
- Knowledge of healthcare industry and medical terminology
- Excellent internal and external customer service skills
- Effective communicator at all levels in the organization, with strong oral, written and persuasive skills
- Advanced proficiency in Microsoft Office with Excel skills
- Bachelor’s degree in health care administration, business or other related field, OR equivalent required
- Extensive experience working in a multi-location healthcare environment
- Minimum of 10 years experience in health care management such as but not limited to clinic management, patient management, accounts receivables and payables, and marketing and public relations
- Strong managerial competencies in the areas of leadership and Team development, managerial coaching and mentoring and situational assessment skills and with proven track record in building and developing high performing Teams
- A change agent capable of guiding the Team in initiating / implementing management initiatives with the view of leading and guiding the organization towards the future
- Strong ethics and a high level of personal and professional integrity
154
Director of Revenue Cycle Resume Examples & Samples
- Oversee revenue cycle operations of an assigned geography to ensure the successful management of receivables and effective and efficient function of the revenue cycle
- Provide strategic leadership of short- and long-term goals through the use of thoughtful techniques in the communication of the company’s mission and core values as a means to implement positive change and/or create organizational structure within the assigned business unit(s)
- Direct and control the broad activities of the business unit(s) through the interpretation, application and implementation of company-wide policies and processes appropriate to the functional area(s)
- Ensure that budgets and schedules are within company requirements with significant organizational responsibility for the overall control of planning, staffing, budgeting, expense priority management, and recommendation and implementation changes of current methods
- Maintain current knowledge of all applicable laws and regulations; ensuring operations of the assigned functional area(s) maintain necessary compliance
- Review current policies and procedures within the assigned functional area(s); providing recommendations for improvement as necessary
- Provide appropriate training for the team(s) to ensure the maximum efficacy and efficiency of operations within the assigned functional area(s)
- Assist with various projects as assigned
155
Auditor, Revenue Cycle Audit Resume Examples & Samples
- Assist the Revenue Cycle Health Service Division and other UPMC areas in responding to billing inquiries/complaints which require a coding, charge description master or billing compliance understanding
- Assume ownership responsibility for non-clinical billing holds assigned to Audit Team, ensuring that all claim holds are worked accurately and timely. Identify trends and opportunities for improvement for non-clinical claim holds
- Complete Insufficient Documentation and CHP PFG Diagnosis Verification Request Queue(s)
- Ensure timely resolution regarding completed Diagnosis Verification Requests as outlined in the Revenue Cycle policies and procedures. Identify trends and opportunities for improvement in the diagnosis code review process
- Identifies potential or actual risk areas related to billing in response to audit findings regarding internal and external audits. Assists with corrective action plans and communicates pertinent findings to appropriate UPMC areas
- Lead Revenue Cycle Audit Team Coding Reviews focusing on modifier, CPT and diagnosis coding issues captured on the Clinical Billng Log. As applicable, work with HIM and Hospital Departments to resolve
- Lead and/or support Revenue Cycle self-audits to ensure compliance of all revenue cycle protocols, which may include auditing the following: acounts receivable, registration, referrals, scheduling, cash collections, denials and productivity
- Lead investigation efforts associated with cases received via the HIPAA reporting tool and/or assigned from management, maintaining documentation of each case file, determining if breach notification is required and initiating any required notices
- Maintain Non Audit Plus Service Account. Enter Non Centralized Audits into the department databases. Review and distribute Centralized Audits when necessary. Verify Third Party Audit Payer Responsibility has been met per Third Party Chart Audit Process. Complete necessary documentation, post collection status code, prepare audit bill, UPMC Confidentiality Agreement and UPMC Insurance Audit Settlement Review Sheets
- Maintain Third Party Auditor Calendar and Contact List making sure all information is current including Medical Record view access
- Maintain the Identity Theft Log. Review inquiries, identify root cause i.e., charge posting error, registration error, EMPI error. Work with departments to correct accounts and charges. Complete OCPC Investigation Form when necessary for management review. Provide trending of Identify Theft volumes and outcomes by location
- Provide training and support to coworkers on appropriate tools and techniques related to Audits, Billing Holds, Identity Thefts, DVR's and External Back-End Billing Office HIPAA related issues
- Support and contribute to UPMC core values and guiding principles and abide by all UPMC departmental policies, procedures and goals in the process of performing all job responsibilities. Incorporates acts of dignity and respect in daily interactions
- High School or equivalent and four years of healthcare revenue cycle experience including two years previous billing audit experience, or six years of related experience required
- Analytical problem solving skills and the ability to coordinate the work of others and communicate effectively with all levels of management required
- Knowledge of medical terminology, ICD-10 and CPT coding
- Knowledge of HMO, POS, PPO, Medicare, SNP, CHP and Medicaid plans
- Detail oriented with excellent organizational, interpersonal and communication skills
- Must be able to establish priorities, effectively problem solve, and communicate in a positive professional manner at all times
- Knowledge of MS Office products
- Ability to maintain designated quality and production standards
156
Supervisor, Revenue Cycle Operations Resume Examples & Samples
- Can supervise the operations and processes of any given function within the Revenue Operations department (insurance collection team, cash posters, inbound/outbound collection, credit/returns) to maximize productivity, effectiveness, and quality
- Provide operational support for department; address and resolve escalated questions and issues
- Segregation of duties
- Safeguarding of data
- Regulatory compliance (HIPAA, EMTALA, PHI, Stark, Sarbanes‐Oxley)
- Governmental reporting ( e.g., cost reporting, IRS reporting, Medicare/Medicaid,CHAMPUS)
- Ratio analysis (e.g. days in accounts receivable, days in accounts payable
- Manage all teammate employment activity such as hiring, promoting, job performance, evaluations, and disciplinary actions with appropriate approvals as required
- O Address teammate relations issues appropriately and escalate as necessary
- Associate's degree in related area strongly preferred; Bachelor's degree in Business, Accounting, or other related area preferred
157
Revenue Cycle Mgmt-internship Resume Examples & Samples
- Conduct research related to ESI and its clients
- Collaborate with other functional areas on various projects as needed
- Knowledge of the PBM or healthcare industry preferred
- Dates of Internship are May 15th-Aug 4th, 2017
158
MGR Revenue Cycle Resume Examples & Samples
- Develops and leads the business strategy and processes for billing and collections
- Develops and leads customer communication strategy and policy for billing and collections
- Establishes and maintains policies and procedures to ensure compliance with the order to collections cycle
- Develops key performance indicators (KPIs) to monitor performance and assess revenue leakage; ensures research, analysis and reporting to facilitate revenue capture
- Facilitates business process reviews to improve quality, efficiency and effectiveness of revenue cycle operations; tests, implements and evaluates enhancements
- Analyzes invoicing and statement costs and develops cost reduction initiatives
- Manages the collection functions and performance as executed by internal resources and/or external vendors
- Manages billing and collections operations and accounting teams
- Partners with sales tax department and business in the management of sales tax process, including process improvement
- Partners with customer relationship teams to ensure the billing and payment customer communications meet/exceed customer expectations
- Completes other projects/tasks as assigned by manager
- Master’s degree strongly preferred
- 5-7 years of billing, collections, accounting, or related experience required
- Supervisory and project management experience required
- Data mining experience with business intelligence or database applications (e.g., Access, Cognos) required
- Certified Public Accountant (CPA), or actuarial professional designation preferred
- Knowledge of internal audit and accounting principles and practices
- Critical thinking, problem solving and decision making skills
- Qualitative and quantitative analytical skills
- Good computer skills with Microsoft Office Applications (Word, Excel, Outlook, PowerPoint)
- Knowledge of database applications, management and querying tools (e.g., Access, Cognos, JD Edwards)
- Project management and process improvement knowledge and skills
- Supervisory and performance management knowledge and skills
- Excellent verbal and written communication skills, including public speaking and presentation
- Ability to effectively present information and respond to questions
- Knowledge of database management, project management, call center operation, accounts receivable and customer service management
- Ability to collect data, establish facts, and draw valid conclusions
- Ability to read and interpret general business procedures
- Ability to deliver and create high level reporting and analyze data for management
- Close visual acuity to perform detail oriented activities at distances close to the eyes, as well as visual acuity to perform activities at or within arm’s reach with skill, control, and accuracy, such as preparing and analyzing data, viewing computer screen and expansive reading
159
Mgr Revenue Cycle IV / FC Resume Examples & Samples
- Manages front-end registration and insurance verification operations
- Bachelor’s Degree in Finance or Accounting, required
- Minimum of five (5) years experience in healthcare finance administration, two of which are in an admitting or business office function, including one (1) year supervisory experience
- Advanced knowledge of related hardware/software and hospital registration/ billing systems, required
- Strong interpersonal and communication skills
160
VP, Revenue Cycle Resume Examples & Samples
- Includes being visible, communicating, holding other executives and groups accountable and celebrating successes. Develop a strong vision for the future of healthcare revenue cycle infrastructure and processes while driving consensus among stakeholders
- Deliver on established imperatives, communicating issues in a timely way, brainstorming and creatively identifying alternative methods
- Proficient with all healthcare payer models including private pay, government and contracted programs. Direct knowledge of all processes related to registration, admissions, coding, billing and collections. Has led groups whose efforts resulted in increases of clean claim rates, accelerated cash collections and reductions in cost-to-collection ratios
- Analyze and report on large data sets. Understand the contractual structure and terms of the partnership. Interfaces and collaborates with Cerner finance and HR regarding deal mix, budgets and penalties
- Understands information technology architecture, usability, processing and reporting capabilities. Deep expertise of government program guidelines, HCPCS, ICD, CPT, Revenue Codes, DRG, payment methodologies, managed care operations for both hospital and physicians billing
- Demonstrated ability to compile and analyze data, strong decision making capabilities that support the organizations objectives
- Demonstrated ability to work on multiple initiatives at a time performing cost/benefit analysis, evaluating solutions, and driving consensus among stakeholders
- Knowledge of patient accounting information systems applications, customer call center applications, data interfaces and system integration required to effectively support day to day billing and collection processes
- Operationally demonstrating success leading large, complex revenue cycle organizations, including oversight of CDI and case management
- Lead large organizations during periods of significant, positive change championing continuous improvement
- When necessary be involved in managing and improving fundamental operations and processes
- Motivating and influencing disparate teams to embrace new practices that enhance operations
- Confidently interacting, collaborating and presenting at all levels of a health care delivery organization to corporate officers
- Develop and implement revenue cycle policies and procedures
- Implement continuous process improvements utilizing quality assessment and education of staff to monitor the accuracy, efficiency and productivity of revenue cycle staff
- Partner with the Adventist Health compliance office to ensure adherence of all Medicare/Medicaid and governmental rules and regulations
- Responsible for overseeing the appeal process of all third-party denials for hospital services to include, but not limited to medical necessity and administrative denials for purpose of obtaining payment and eliminating denials
- Maintain and update all managed care contracts in Contract Management system and oversees maintenance of all contract files
- Responsible and oversees all coding, documentation, health information management and release of information, and clinical documentation specialist activities and operations
- Must currently reside or be willing to relocate to the greater Sacramento, California area
- Bachelor’s degree or equivalent industry experience
- 10+ years of experience in Revenue Cycle/Financial Management in an executive level role (i.e. VP, CFO etc.) for a healthcare system or organization
- Prior health care operations executive, consulting, project management, and/or installed client relationship experience
- Experience in Revenue Cycle health care information technology (HCIT)
- Certification in related field (ex: CRCR – Certified Revenue Cycle Representative)
- Cerner Revenue Cycle Solution experience
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Fvc-revenue Cycle Supervisor Resume Examples & Samples
- Oversee diverse revenue cycle activities to maximize the efficacy and efficiency of operations within the assigned function(s)
- Serve as an SME to cross-divisional teams in the resolution of diverse issues; ensuring applicable knowledge and comprehension of processes within the assigned function(s)
- Provide direct supervision of the assigned team(s) through ongoing leadership and guidance; partnering with Human Resources on employee matters
- May support new site implementation, enrollment and evaluation of various systems as assigned
- Assist with various projects as assigned by a direct supervisor
- Strong computer skills with demonstrated proficiency in word processing, spreadsheet and email applications
162
Revenue Cycle Consultant Resume Examples & Samples
- Demonstrated ability to work within a team environment
- Demonstrated ability to work with diverse groups and difficult clients
- Good communication skills; written and verbal
- Ability to work irregular hours and weekends when needed
- Ability to work on multiple projects simultaneously
- Must live in or be willing to relocate to Springfield, MO area
- Associate's Degree or equivalent work experience
- Background in healthcare revenue cycle or revenue cycle information systems
- Experience with database tools, application development, and health information standards preferred
- Soarian Financials experience; including Provider Accounting and CRDT
- Cerner Millennium experience; including Cerner Practice Management/Revenue Cycle
163
Revenue Cycle Data Analyst Resume Examples & Samples
- Conducts analysis of revenue cycle data trends to determine issues and root causes
- Coordinates with Billing and Follow-up Managers to develop action plans to address identified issues
- Prepares reports to reflect trends in revenue cycle data and prepares presentation for managers and executive level reviews
- Performs in depth analysis on accounts appearing on our issues log to determine cause of variance. Maintains a tracking process for payor issues as well as assists with the resolutions
- Assist with tracking the success of appeals
- Responsible to review, validate and update our payor issues logs prior to our next meeting with a specific payor
- Assists in the development of productivity standards and tracking to provide management with real time information on the job performance of staff
164
Revenue Cycle Integrity Coordinator Resume Examples & Samples
- Interview users, stakeholders, and sponsors to assess departmental needs to create Business, functional and technical requirements documents
- Develop documentation of test plans, technical documentation, release notes, end-user guides, training programs and/or other materials as necessary
- Analyze and document client's business requirements and processes; communicate requirements to technical personnel by constructing basic conceptual data and process models, including process
165
AVP, Revenue Cycle Operations Resume Examples & Samples
- Monitoring and tracking accounts receivable performance, daily, weekly and monthly in the areas of cash collections, aging trends, monthly bad debt write-off, contractual and other adjustment's, departmental productivity and customer satisfaction
- Measurement of key performance indicators and metrics which parallel industry standards and achieving improvement in high impact areas such as cash flow, net revenue and reduction of bad debt expense
- Monitors and ensures that vendor performance stays within the boundaries of the statement of work, performance does not deteriorate and quality measurements within acceptable levels
- Assists with establishing goals and objectives that support strategic plans of Ardent Health Services
- Monitors the annual department operating and capital budgets
- Manages Daily operations of assigned departments
- Manages performance of staff
- Supports the mission statement, policies and procedures of Ardent Health Services
- Achieves ongoing compliance with all regulatory agencies
- Communicates effectively with all levels in the organization as well as external customers
- Selects personnel for hire and promotion at the managerial level as well as teaching and managing up or out staff unable to achieve desired outcomes
- Responds proactively to employee needs and concerns
- Facilitates consensus among divergent groups
- Minimizes staff turnover
- Recognizes and rewards employee's accomplishments
- Assists in development of competency plans and provides opportunities for learning
- Provides continuous feedback on Business Office performance and related corrections to processes, people and technology
- Keeps current with emerging industry issues and provides timely guidance to management staff
- Utilizes resources efficiently and effectively
- Participates in performance improvement activities
166
Revenue Cycle Consultant Resume Examples & Samples
- Responsible for the preparation of recurring standard and special ad hoc reports to summarize Revenue Cycle results and facilitate data analysis of Radiology Revenue Cycle functions, including Scheduling, Precertification, Preregistration, Patient Registration, Billing Functions and payor denials, as well as departmental and staff productivity metrics for each area
- Responsible for the daily/weekly/monthly charge reconciliation between systems
- Develops and maintains excellent working relationships with members of the Department of Radiology and Penn Medicine Administration. Handles the coordination of revenue cycle projects and activities at the direction or by request of Revenue Cycle Director
- Assists in the development of training programs to increase knowledge of relationship between scheduling, reception, charge behavior, billing flow, and reimbursement
- Provides technical and analytical guidance and expertise. Recommends through analysis solutions of revenue cycle problems
- Follow-up with Revenue Cycle teams to ensure adherence to policies and their affect on metrics
- Work closely with Penn Financial Analysts to develop and maintain meaningful report sets and collaborate together to strategize and implement best practices within the department
- Assist and troubleshoot issues identified when related to revenue cycle. Analyzes and reports variances for a variety of Revenue Cycle functions
- Must stay current with industry standards, rules and regulations affecting reimbursement and revenue cycle
- Monitor front end/back end performance against established industries standards, monitor benchmark compliance for all revenue cycle functions
- Query writing using SQL and Access. Expert knowledge of excel data functionality
- Report development in SQL Server, Business Objects, Clarity, Access
- Bachelor’s degree in Healthcare, Finance, Engineering, Computer Science or related field required
- 5years of relevant work experience required in reporting/database structure and revenue cycle
- Knowledge of electronic systems for front end and back end functions and the willingness to learn new systems, applications and programs
- Experience in data extractions (DBMS & Data Warehouse Tools) and analysis role
- Experience working on SQL Server/Oracle or other relational database platform required
- Expert knowledge of excel data functionality, with excellent analytical and problem solving skills
- Proficiency in health insurance billing, collections and eligibility as it pertains to commercial, managed care, government and self pay reimbursement concepts and overall operational impact
- Ability to work independently and follow through and handle multiple tasks/special projects simultaneously
- Ability to communicate effectively in both oral and written form. This position requires the ability to interact positively and constructively with employees and leadership at all levels
- Must be a motivated individual with a positive and exceptional work ethic
- Ability to educate and train at all levels of professional staff
167
Supervisor Revenue Cycle Management Resume Examples & Samples
- Acts as liaison with Patient Access Services, Medical Records, Care Coordination / Utilization Management, Patient Financial Services, Financial Counselors, Information Systems and Third Party Collection Agencies regarding issues affecting the proper and timely billing and payment of accounts
- Proactively reviews payer aging reports and establishes achievable goals for AR reduction and/or cash acceleration. Notifies Senior Leadership of potential systemic issues and high risk / high exposure situations. Recommends solutions for resolving aging receivables
- Recommends changes to departmental procedures, i.e., job aides, training resources, and work flow, to promote process improvement
- Strong customer service expertise
168
Revenue Cycle Representative Resume Examples & Samples
- Previous experience in customer service
- Experience and proficiency with computer software applications (i.e. Microsoft Office Suite – Word, Excel, Outlook, PowerPoint) or comparable programs
- Self-motivated with initiative to seek out additional responsibilities and tasks along with generating suggestions for improving workflow
- Effective verbal and written communication skills, active listening skills and the ability to maintain professionalism while handling difficult situations
- Demonstrate effective problem solving abilities and meets challenges with resourcefulness
- Experience working in a complex hospital system is desirable
- Experience working in a collaborative team environment is desirable
- Pharmacy experience is desirable
- Knowledge of healthcare billing, experience working with insurance and/or federal and state assistance programs is desirable
- Experience working with multiple technology platforms (i.e. Epic, GE) is desirable
- Knowledge and understanding of the Health Insurance Portability and Accountability Act (HIPAA) is desirable
169
Director, Middle Revenue Cycle Resume Examples & Samples
- Directs Health Information Management Operations, Hospital Billing Coding, Professional Billing Coding, Clinical Documentation Improvement Program, and Documentation Integrity
- Leads and is accountable for organization projects affecting areas of responsibility
- Provides direction for Release of Information, Transcription, and other external service agreements
- Provides direction for Revenue Integrity (charge master, fee schedules, charge reconciliation and training, pricing)
- Develops and implements, policies and procedures that guide or support service, assesses and improves department performance, and ensures orientation and continuing education of department staff
- Develops specific objectives, budgets, and performance standards for each area of responsibility
- Actively seeks ways to control costs without compromising patient safety, quality of care of services delivered
- Actively participate in advising HCMC leadership on methods to optimize HCMC’s use of Epic
- Responsible for compliance with all applicable regulations including Hospital Attorney General Agreement, State of Minnesota Department of Revenue-Revenue Recapture, and HCMC Admissions and Treatment Policy
- Improve Revenue Cycle performance, efficiencies, transparency, and employee engagement through Lean Management methods including Visual Management Systems and incorporate metrics driven outcomes through revenue cycle
- Work with Public Relations, Patient Experience, and other HCMC departments to maintain and enhance community and patient communication related to HCMC charity care, billing and collection procedures, and methods for patients to access revenue cycle resources
- Collaborate with the Assistant Medical Director of Documentation Quality and Associate Medical Director of Clinical Documentation Improvement to improve and optimize the organization’s documentation quality standards and practices
- Bachelor s degree in Health Information Administration/Medical Record Administration
- 7-10 years of progressive management experience in a healthcare operations environment
- 5-7 years experience managing Health Information Management and Coding
- Certification as a Registered Health Information Administrator (RHIA)
- Extensive and demonstrated expertise in CPT-4, HCPCS, and ICD-10-CM coding
- Thorough knowledge of medical terminology, anatomy and physiology and ability to interpret physician’s medical documentation
- Working knowledge of HIPAA regulations, Joint Commission standards, and clinical information systems
- In-depth understanding of third party reimbursement and coverage policies
- Proven, successful, progressively responsible leadership, management and execution experience
- Ability to develop and implement process improvements, preferably using Lean or Six Sigma methodologies
- Exceptional strategic planning, problem solving and critical thinking when addressing organizational issues
- Excellent interpersonal skills and the ability to communicate and negotiate with people at all levels
- Epic Revenue Cycle Management Systems experience
170
Business Applications Analyst, Revenue Cycle Resume Examples & Samples
- Design, build, validation, implementation, and maintenance of Revenue Cycle application software using Cerner build tools
- Provides ongoing analysis, training and functional support for Revenue Cycle applications
- Creates and maintains detailed test plans and scripts. Participates in testing efforts and ensure issues are identified, tracked, reported and resolved in a timely manner
- Understands report qualifications and provides guidance with report development
- Identifies and implements system solutions that support improved workflows, reduces manual intervention, eliminates rework and increases efficiencies related to Revenue Cycle
- Manages incidents and requests that have been assigned through the IT Service Management System which includes the change management process
- Develops and maintains clear, understandable documentation to describe design decisions, build requirements and troubleshooting steps
- Updates system and support documentation as necessary to reflect changes to application design and functionality
- Minimum 5 years healthcare experience as an Analyst, or in an equivalent role, required
- Experience in one or more of the following revenue cycle functions required: Patient Accounting, Patient Access, Charge Capture or Patient Financial Services
- Prior experience configuring revenue cycle vendor-supplied software required
- Experience with CDM structure for professional and technical charges and methodology that supports charge capture within Cerner applications required
- Experience with Cerner Millennium Fundamentals preferred
- Experience with Cerner Millennium: Building & Maintaining Patient Accounting preferred
- Experience with Cerner Millennium: Building & Maintaining Charge Services preferred
- Bachelor’s degree, or equivalent professional experience, required
- Knowledge of Patient Accounting integration with Lawson, 3M, MedeAnalytics and MedAssets
- Demonstrated knowledge of automated Revenue Cycle functions in a multi-facility healthcare delivery system that includes Hospitals and Ambulatory Surgery Centers
- Knowledge of Electronic Data Interchange (EDI) formats
- Proven abilities in workflow improvement, issue resolution and root cause analysis
- Effective communication skills when developing project specifications, identifying issues and communicating resolution
- Ability to translate technical requirements and procedures into well-implemented application solutions
- Hands on experience gathering and documenting user requirements, performing design/build, writing/executing test scripts and performing ongoing maintenance and support
- Proficient in the use of Microsoft Office Suite and Cerner application build tools
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Revenue Cycle Coordinator Resume Examples & Samples
- Analytical skills; Problem solving skills; Action oriented
- Experience with A/R process flow
- Knowledge of CPT4 and HCPCS coding
- Ability to research and collect data
- Knowledge of the Charge Master Process
- Knowledge of Government compliance regulations
172
Revenue Cycle Representative Resume Examples & Samples
- This job requires proficiency with the computer systems that are used in the practice including Practice Management System, Internet products that relate to office functions and Microsoft office systems available to the office
- Knowledge of the Medicare Program particularly as it relates to CPT and ICD9 coding CPT. Thorough knowledge of Medicare Fraud and Abuse regulations
- Ability to counsel patients financially regarding outstanding charges and effectively resolve problems via the highest customer service skills and etiquette
- Possess full knowledge of HIPAA regulations
173
Revenue Cycle Consultant, Project Manager Resume Examples & Samples
- Management, delivery, and completion of projects across various functional areas
- Provides subject matter expertise in areas including project scope definition, risk identification, project methodology, resource allocation, facilitation, budget management, and other areas of expertise based on established project management techniques
- Establishes timelines based on project scope of services
- Ensures projects are completed on time and in scope
- Monitors and tracks project status using established tools and techniques such as MS Project or other established tools
- Responsible for project financial performance including creating/establishes project budgets based on statement of work (SOW) requirements, updates project tasks to trigger billing and invoices, approves invoices generated from ERP, reconciles budgets to ensure on track based on SOW
- Maintains ongoing communication with client with routine status reports, team calls, etc
- Makes presentations to management on project updates, project cycle, and expected results
- Provides explanations and interpretations within area of expertise
- Provides consulting services to clients in areas of the healthcare revenue cycle, i.e., patient access, patient financial services, revenue integrity, decision support and analytics, health information management, clinical documentation improvement, managed care contracting, among others
- Development of recommendations and action plans for client improvement
- Learn and understand Optum technology and services and how they will improve client operations
- Accountable for all decisions, actions, and directives with respect to job responsibilities
- Escalates potential risks and issues identified as appropriate
- Other duties as assigned by leadership
- Proficient or above in Microsoft Excel, Word, PowerPoint, Visio, Project as well as SharePoint
- Experience managing at least 3-5 projects concurrently
- Strong analytical Skills
- Process Improvement focused
- Professional services/consulting or healthcare background
- Has revenue cycle experience in core area(s) including: Patient Access, Revenue Integrity, Patient Financial Services, Billing, Vendor Management, etc
- Has project management / coordination experience in a healthcare setting
174
Administrator, Revenue Cycle Resume Examples & Samples
- Collaborates with Physicians, various practice department management, and US Oncology management to identify areas of exposure and design processes to increase knowledge and improve outcomes in service, quality and accuracy including patient accounting, revenue compliance, health information, and centralized scheduling. Demonstrates ability to effectively facilitate parties toward a "win win" agreement; identifies key players; defines objectives, significant issues, and shared interests; determines motivational drivers and potential obstacles for all parties; communicates effectively; gains results without either party losing face
- Assess revenue cycle performance in accordance with set goals and objectives. Identifies gaps. Creates and implements action plans to close gaps and achieve business metrics. Provides focus and direction to process improvement in revenue cycle management. Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty
- Establishes standards and processes to ensure continuous improvement in the revenue cycle. Identifies revenue cycle external benchmarks and best practices
- Monitors effectiveness of software, vendors, payers. Provides feedback and recommendations to Managed Care Contracting
- Manages Practice-wide projects including any legal requests. Responsible for building affective working relationships with US Oncology counter parts to facilitate problem resolution
- Establishes vision and identities goals and priorities for management staff. Identifies and eliminates obstacles as well as identifies and obtains resources to accomplish business goals. Develops and implements high standards for long and short term goals that align with the company*s vision and business goals. Cascades goals down to staffs annual objectives
- Attracts high caliber people, accurately assesses strengths and development needs of employees; gives timely, specific feedback and helpful coaching; provides challenging assignments and opportunities for development. Responsible for interviewing, recommending hires, assessing performance, recommending salary changes, and progressive discipline. Enforces adherence to the Practice*s and US Oncology*s policies
175
Revenue Cycle Project Manager Resume Examples & Samples
- 3-5 years experience is preferred
- Comfort with reviewing financial information
- Excellent interpersonal/communications skills
- Exceptional organizational skills and the flexibility to handle multiple tasks and deadline pressures
- At least 3+ years of project management experience within revenue cycle
- Certification(s) in project management a plus
176
Financial Analyst Revenue Cycle Management Resume Examples & Samples
- Generate financial and statistical reporting by obtaining data from disparate sources ensuring the applicability and accuracy of the information
- Evaluate payer reimbursement trends and system modifications to drive increased cash collections and reduce denials and bad debt
- Develop analytical tools to evaluate revenue cycle performance and financial results
- Conducts reviews and variance analysis
- Assist management team in evaluating strategic plan metrics
- Assist management team by assembling and presenting any requested information necessary for the preparation of reporting packages and presentations
- Preparation of schedules and financial reports for internal and external audits
- Adherence to and compliance with information systems security is everyone’s responsibility. It is the responsibility of every computer user to know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems
- Healthcare revenue cycle (provider side) experience and knowledge preferred
- 2 – 4 years analytics experience in a multi-company, multi-location environment helpful
- Data manipulation, forecasting, financial reporting, account analysis and account reconciliation experience required
- Tableau or dashboarding experience is preferred
- Extensive knowledge of Excel
- Comfortability with SQL, MS Access or any type of data retrieval tools is preferred
- Must have effective oral, written and interpersonal communication skills. Must be a self-starter and have the ability to develop analysis of accounts and financial statements with limited supervision
- Demonstrated Experience in analytical problem solving (including statement of problem, identification and collection of pertinent data, analysis, recommendation, and re-evaluation) strongly preferred
- Must be available for limited travel as needed
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Meditech Revenue Cycle Lead Consultant Resume Examples & Samples
- MEDITECH Patient Accounting/Revenue Cycle 6.1 experience is required
- Must have MEDITECH 6.1 implementaiton experience
- Candidate must have strong knowledge of MEDITECH 6.1 Patient Accounting/Revenue Cycle, including build and implementation experience, experience working as a Lead is preferred
- Candidate must have prior 6.1 experience implementing in a hospital environment, a multi-facility environment is preferred
- Required to sit for long periods of time
178
Revenue Cycle Project Manager Resume Examples & Samples
- Candidate must have very strong Revenue Cycle Project Manager experience
- The client is implementing several modules of Relay Health to work in coordination with their Soarian Financials product. We are in need of a Project Manager who can oversee the IS technical team tasks for the build and integration with Soarian, the user build effort and work side-by-side with the Relay Health vendor Project Manager
- Candidate needs to be able to coordinate internal staff, resources and tasks
- General Project Management skills required
- Candidates may live anywhere in the contiguous US and travel 75-100%, as needed by project
- Maintains at least 85% billable utilization rate
179
Technology Sales, Revenue Cycle Resume Examples & Samples
- Prospect and build new business within an assigned territory; acquire new clients successfully and negotiate to expand memberships for existing clients
- Serve as a subject matter expert across the Revenue Cycle practice area, with deep expertise in multiple products including Payment Integrity Compass, Revenue Optimization Compass, Business Office Suite, and Price Transparency Compass
- Responsible for knowledge of the Revenue Cycle practice area (both technology and consulting)
- Collaborate with a Practice Partner who oversees the Revenue Cycle practice area and helps clear the path for you to drive Technology and packaged Consulting sales within your territory
- Build relationships by meeting with senior executives (CEO, CFO, CMO, etc.) to discuss their strategic and operational challenges, present best practice solutions and effectively sell the vision of their capabilities
- Actively contribute to and drive forward product offering roadmap, helping to perfect and refine current offerings and test new offerings in the market
- Conduct onsite presentations, including a technical demonstration, to educate prospective members on our services
- Meet quarterly and annual revenue goals through management of a sales pipeline with pursuits in various stages of the evaluation process
- Maintain up-to-date knowledge of competitors
- Provide insights from marketing visits to inform future research initiatives and new product development inquiries
- Manage team member to goals, provide formal feedback, and guidance on professional development
- Must possess a minimum of four years post-undergrad experience in at least two of the following
- Relevant healthcare industry experience
- Technology experience (SAAS)
- Must possess a minimum of three years of commercial experience – track record of successful sales/ownership over a personal revenue target
- Strong presentation and facilitation skills; the ability to manage executive meetings and member interactions to desired outcomes
- Proven negotiation and persuasion skills
- Desire to succeed in a sales environment and sell prospects on the current and future proposition of a product
- Experience selling SAAS products, preferably in the health care industry
- Resilience and comfort with ambiguity – ability to be flexible and adaptable in a changing environment
- Ability to manage a Sales Associate to goal, coach and provide constructive formal and informal feedback
- Receptive to feedback, coaching and constructive criticism; ability to learn from mistakes
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Senior Consultant, Revenue Cycle Solutions Resume Examples & Samples
- Monitor engagement progress; answer questions and devise solutions to client problems
- Participate in new product and service conceptualization and planning
- Identify cross sell opportunities and support sales process
- Bachelor’s Degree
- Experience working in the health care industry
- Electronic Medical Records experience (i.e. Athena, Epic, Cerner)
- Possess 4+ years of professional experience and at least two of the following
- Consulting experience
- Experience presenting to senior executive level audience or facilitating training sessions
- Experience working at The Advisory Board Company highly preferred
- Background in health care consulting with specific expertise in one or more of the following areas of hospital operations: revenue cycle management, supply chain, clinical utilization, throughput and efficiency, cost
- Knowledge and previous experience in health care revenue cycle
- Experience performing root cause analysis
- Team-oriented but also highly self -sufficient and self-motivated
181
Cerner Revenue Cycle Consultant With Expertise Resume Examples & Samples
- 3+ years, current, in Cerner Revenue Cycle
- The ideal professional is well versed in the detailed aspects of design and build of Cerner Patient Accounting
- Experienced in implemented and/or maintaining a Cerner Patient Accounting system
- Ideal professional will have an analytical background in Patient Accounting and not a Biller/Coder with Patient Accounting
- Must be experiences in the Revenue Cycle workflow to improve financials
- Ability to travel up to 100% as required by client engagement and the ability to work remotely when not onsite with client
- Must have strong written and verbal communication skills to a technical and non-technical audience
182
Revenue Cycle, Executive Consultant Resume Examples & Samples
- Executive Consultation and Leadershp: Acts as an advisor or thought partner by structuring undefined issues for resolution, researching issues, summarizing information and working with relevant stakeholders to provide the executive with the information needed to make sound decisions
- Provides leadership, consultation and analysis regarding state-wide, cross-entity or cross-functional performance and strategic opportunities
- Identifies and recommends approaches to issues and identifies the most effective means of solving the issues
- Facilitates committees and task forces of diverse membership
- Ensures the delivery of high quality results on time
- Acts as a communication liaison between the office and direct reports by providing advice and speaking for the executive
- Routinely represents the executive's point of view and proactively makes decisions on behalf (within established parameters)
- Assists and advises direct reports to ensure their recommendations and reports to senior executives are coordinated across the organization and thoroughly crafted
- Partners with a variety of individuals from other entities, other regions, national program, and labor on behalf of the executive on projects or on issues that require resolution
- Prepares formal presentations for the executive as well as papers and public statements
- Develops, leads and monitors the office budget
- Develops and leads forums for executive consultants to coordinate efforts and cross-entity or department silos to help this set of individuals to continuously improve and build their skills and effectiveness in support of their executives and the organization
- Functional Area Management
- Drives internal planning processes associated with the development of a functional area goals and priorities
- Directs the development and execution of the functional area's operating and capital budgeting process, as well as ensures the development of accurate monthly forecasts
- Supports the planning, management and execution of key business processes associated with management of the applicable functional area, including but not limited to performance management, strategic planning, communications, and tactical initiatives. Applies process improvement methods and tools to improve and/or redesign organizational business processes
- Leads and/or participates on high priority projects for the executive
- Minimum ten (10) years of experience in consulting, operations or project management
183
Revenue Cycle Collections Director Resume Examples & Samples
- Technical Expertise – Some understanding of healthcare including knowledge of healthcare terms and accounts receivable processes
- Tactical Execution - oversees the development, deployment and direction of complex programs and processes
- Financial Management - applies tools and processes to successfully manage to budget
- Project Management - assesses work activities and allocates resources appropriately
- Interpersonal Skills - able to work effectively with other employees, patients and external parties
- PC Skills - demonstrates proficiency in Microsoft Office applications and others as required
- Basic Skills – demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly. Spell correctly and transcribe accuratel
- Minimum 5 years healthcare management experience with three of these years in the related area for the position. Relevant education may substitute experience requirement with SSC Executive approval
184
Associate of Revenue Cycle Management Consulting Resume Examples & Samples
- Perform data collection and analysis, identify issues and utilize models and analyses to support project deliverable content
- Develop understanding of KPMG methodologies, tools and techniques and apply them on assigned projects
- Communicate problems, barriers and issues within the appropriate context and identifies and present solutions to client performance issues
- Conduct research for, and make presentations, to clients and KPMG project team
- Handle routine client and project team interactions
- Identify and present solutions to client performance issues
- Bachelor’s degree in Health Care Administration, Business, Management Information Systems, Economics, Industrial Engineering, or Accounting from an accredited college/university
- Strong computer skills (Excel, Word, Windows, PowerPoint, Microsoft Office) and analytical skills (problem solving, quantitative, work flow process, etc.)
- Ability to demonstrate proficiency and comprehension of KPMG tools
- Capable of working with project management teams, drafting status reports, tracing issues, monitoring resources, workflow analysis and design
- Proficiency with foundational skills such as analytical, written, and verbal communication, client presence along with facilitation and presentation skills
185
National Director of Finance for Revenue Cycle Management Resume Examples & Samples
- Develop and monitor reporting tools to track key performance indicators (KPIs), (e.g., A/R, DSO, Cash Collections)
- Provide regular analysis of cost and performance of outsourcing vendors (e.g., billing and collections agencies, off-site storage suppliers, real estate property and equipment leasing companies)
- Analyze current and past trends in Key Performance Indicators, including: billing, payment sources, cash collections, productivity, A/R and DSO. Suggest initiatives to improve key metrics
- Develop in-depth intimacy with RCM functions and operations, including the flow of cash (by day/week of month, typical problems and issues)
- Respond to queries from Envision Physician Services Operations and Finance/Accounting with appropriate analysis and executive-level communications, regarding specific performance indicators, payer mix, cash collections, and other issues
- Develop and continuously refine cost accounting methodology and system, identify and capture all related costs and apportion them appropriately. Make adjustments for changes in systems or work flow which impact productivity and costs
- Communicate overall cash goals and priorities for the management team. Monitor changes in priorities and the resulting maximization of revenue. Ensure appropriate follow-through
- Set goals jointly with subordinates; clearly communicate goals and objectives; monitor them regularly through counsel and documentation
- Monitor and manage labor costs, inventory levels and production planning for designated departments. Optimize productivity while avoiding unnecessary costs such as excess overtime
- Oversee preparation of necessary materials for various audits and work with outside auditors and regulatory representatives
- Assure compliance with all local taxing, licensing and regulatory authorities. Provide support on state and federal tax issues
- Forecast and anticipate other operating expense needs (e.g., travel, training, and consulting). Make recommendations to SVP regarding operating and capital budgets
- Lead initiatives to develop new approaches to streamline existing processes, reorganize work, implement new technologies, and improve resource utilization, with a focus on best cost methods
- Develop and sustain excellent working relationships with Envision Physician Services professionals (e.g., Operations, Business Development, IT and Finance), as well as with the Company’s clients, payors, consultants, banks and financial intermediaries and government agencies
- Present image to subordinates, superiors, and client-users as: knowledgeable, creative, energetic, and assertive
- Manage and inspire staff with an “inspirational”, positive leadership style. Promote the advancement of the best performers
- Promote by personal example, a positive “esprit de corps”. Proactively identify negative attitudes and behaviors and bring a professional attitude to extinguish any negative influences and foster a positive, productive environment
- Healthcare billing, collections and other support functions including: audit, patient complaint, grievance processing, bid preparation, regulatory compliance
- Hospital processes, including functions and processes of Emergency Rooms and Admissions offices
- HIPAA, Sarbanes-Oxley and other critical governmental regulations
- Regulatory compliance and auditing practices
- Management principles
- Envision Physician Services business models
- Develop and document policies/procedures, SOPs, and reports
186
Revenue Cycle Supervisor Resume Examples & Samples
- Responsible for primary oversight of billing and patient accounts functions such as processing, denials and follow up on accounts
- Oversees write-offs, work orders, insurance processing and verification, patient chart maintenance, accuracy of billing, payment processing
- Researches incomplete, incorrect, or outstanding claims and submits claims with knowledge of all insurance plans and contractual arrangements affecting payments
- Investigates and resolves claims submission problems with insurance payers and reviews new and existing insurance claims processing information
- Works to resolve billing/insurance issues and ensure compliance with departmental financial policies
- Provides information and facilitates communication with and between interdisciplinary healthcare providers, employer groups, and patients
- Develops and implements overall cost effective staffing plans, schedules staff and confirms time records
- Interviews, orients, trains, counsels, mentors, disciplines and evaluates staff
- Provides leadership and direction in resolving operational issues
- Monitors and evaluates key processes in order to identify opportunities for improvement
- Addresses customer complaints and ensures that follow-up action is taken and documented
- The information above is for summary purposes, and is not intended to be a comprehensive list of essential functions
- High School diploma or equivalent, required
- BS degree or High School Diploma or equivalent with minimum of 5 years of supervisory experience in a health services group or physician office, required
- Minimum of three years’ experience with billing, insurance claims processing, and ICD-9 coding, required
- Ability to communicate effectively and diplomatically within a multi-functional team, required
- Strong organizational skills and attention to detail, required
- Ability to successfully function in a fast paced, service oriented environment, requireed
- Experience in understanding and usage of computers, including the Microsoft Office Suite and preferably knowledge of billing/collections software, as well as the ability to learn applications relevant to the position, required
187
VP Revenue Cycle / Integrity Management Resume Examples & Samples
- Provides leadership in development, implementation, and oversight of system-wide/regional standards, programs, and/or systems in order to achieve desired and integrated strategic business initiatives, objectives, and outcomes including, but not limited to, growth, accountability and patient care
- Directs, supervises, and evaluates the work of staff. Holds management staff accountable for achieving plans and performance targets. Works with them to identify and resolve the most complex issues and problems impacting initiatives and operations. Develops staff to ensure continued professional growth and to provide the competencies the company needs to support its growth and long-term success. Articulates and demonstrates an expectation for continuous quality improvement utilizing processes that include consideration of all stakeholders. Fosters an environment that focuses on processes and outcomes
- Builds and supports effective collegial relationships with applicable internal and external stakeholders and organizations, ensuring and fostering a high level of collaboration in order to develop partnerships, coordinate activities, review work, exchange information, and/or resolve problems. Promotes and models positive relationships among various entities
- Oversees the development, implementation, and consistent application of effective organizational policies and practices. Participates in maintaining an effective internal control environment to ensure that assets are safeguarded, policies and operating procedures are followed, necessary controls are effective and efficient, proper compliance with existing laws and regulations achieved, and operations comply with the legal and regulatory parameters in which it operates
- Develops, reviews, and monitors financial and performance outcomes to assure attainment of organizational objectives established by corporate leadership and the Board of Directors. Maintains an effective budgeting and capital planning discipline in conjunction with operational management to ensure planned revenues, expenses, and/or profit goals are met
- Directs the development and integration of new and innovative operations and/or services by providing leadership that maximizes management staffs contributions and assures timely decision-making reflective of the mission, vision, and values of the system
- Reviews, prepares, analyzes, and presents reports and recommendations to senior management regarding operations and/or other applicable areas of interest in order to provide concise and accurate information that aids in decision-making
- May serve as a staff resource to the organizations Governing Board and/or applicable committees. Develops, implements, and reports to the Board on strategic initiatives, outcomes, and measurements
188
Supervisor, Revenue Cycle Management Resume Examples & Samples
- 4+ years experience in related field
- Administers and executes policies and procedures
- Ensures employees operate within guidelines
- Interactions normally involve information exchange and basic problem resolution
- Role will be focused on supporting government payors and ensuring compliance with CMS guidelines
- Role will also be responsible for the returns and refunds team
189
Revenue Cycle Representative Resume Examples & Samples
- Act as a liaison between UI Health Care and assigned payors via telephone/websites in regard to insurance claims follow-up and revenue collection from an escalated perspective
- Perform extensive research on reimbursement methodologies, maintain industry knowledge related to changes regarding reimbursement, and apply knowledge to claims processing
- Have a direct impact on cash collections due to continuous reimbursement analysis and findings of over- and underpayments, based upon our contracted commercial and governmental payors. Work closely with the Revenue Integrity Coordinator to identify payment trends; escalate and address claims processing errors at the payor level
- Participate in the training of new Revenue Integrity staff, create training/reference materials specific to payors, and test changes in GE, Epic, and other systems
- Attend appropriate conferences and training sessions provided by various payors, vendors, and fiscal intermediaries as it relates to reimbursement
- Strong attention to detail with a proven ability to gather and analyze data, identify trends through data analysis and keep accurate records
- Self-motivated with initiative to seek out additional responsibilities, tasks and projects and demonstrated ability to maintain or improve established productivity and quality requirements
- Revenue Cycle experience (typically 6 months or more) in a healthcare environment
- Working knowledge of Health Insurance Portability and Accountability Act (HIPAA) laws
- Advanced knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs
- Experience with Experian Contract Management software
190
Epic Revenue Cycle Director Resume Examples & Samples
- Guides the project team through the design, build and implementation phases of the Revenue project
- Serves as the central point of communication for the Revenue Program to ensure a common vision, plan and goal are maintained across all areas of the project. Communicate regularly with Revenue business leaders
- Provides regular status reporting and issues escalation/resolution to the Access and Revenue Application Director and Program Director
- Promotes the new systems and represent it positively to the user community
- Builds the Revenue team. Directs, guides and mentors the Revenue Team and Leads
- Manages assigned staff. Hires, terminates, assesses performance, recommends salaries and rates, recommends assignments, promotions, and demotions, provide counsel and feedback. Develops staff. Schedules and assigns work
- Conducts regular status meetings with the Revenue team, and represent the Revenue team through participation in regular status meetings with the Program Leadership Team
- Champions Lahey Health project management guidelines and policies
- Maintains strict adherence to the Lahey Clinic Confidentiality policy
- Champions LH project management guidelines and policies
- Maintains courteous and effective interactions with colleagues and patients
- Demonstrates an understanding of job description, performance expectations, and competency assessment
- Demonstrates a commitment toward meeting and exceeding the needs of our donors, prospective donors, patients and other stakeholders and consistently adheres to our Office of Philanthropy and system-wide service protocols and standards
- Participates in departmental and/or interdepartmental quality improvement activities
- Participates in and successfully completes Mandatory Education
- Performs other duties in support of the organization as required or directed
- 1)Must have leadership experience with at least one full life cycle implementation with demonstrated past-success
- 2)Experience with at least two of the revenue program areas which includes; HIM, Hospital Billing/Claims, Professional Billing/Claims, Home Health Billing/Claims
- 3)Experience in building the application from the ground up (application is currently not live and no build has occurred)
- 4)Should have experience leading large teams of individuals and the ability to manage staff effectively
191
Revenue Cycle Supervisor Resume Examples & Samples
- Supervises the daily business functions of the patient visit from point of entry to accurate adjudication of the patients* accounts. Scope of responsibilities includes appointment scheduling, insurance eligibility processes; charge processing; claim submission and processing; payment processing; collections and accounts receivable management; denial management; reporting of results and analysis; concurrent and retrospective auditing; proper coding; credentialing; customer services relative to revenue cycle; training and development relative to revenue cycle; analytics, and all other revenue cycle management activities. Resolves escalated and unique revenue cycle issues
- Responsible for quality work, meeting deadlines, and adherence to the Practices Standard Operating Procedures (SOPs); regularly audits staffs work to ensure compliance
- Monthly, prepares revenue cycle financial analysis, including aged accounts. Monitors and assesses business metrics in order to refine processes and improve efficiencies. Guides individuals and teams toward priorities; clarifies roles and responsibilities of others; coordinates resources to meet objectives. Cascades goals down to staffs annual objectives
- Champions new initiatives; acts as a catalyst of change and stimulates others to change; paves the way for needed changes; manages implementation effectively. Steps forward to address difficult issues; puts self on the line to deal with important problems; takes ownership and accountability
- Responsible for the overall coordination of front office duties to include scheduling, check-in, and co-pay/co-insurance collection
192
Revenue Cycle Application Architect Resume Examples & Samples
- Ensure the design of their domain of application(s) and the associated processes are completed successfully, leveraging best practices
- Contribute to team performance by providing key stakeholders with direction and critical domain knowledge to help drive best outcome for overall IT strategy
- Effectively communicate to clients about current and future domain functionality
- Leverage domain expertise to contribute to optimal application performance and utilization
- Responsible for contributing to the development and mentoring of Application Consultants
- Complete change tasks and update them with relevant information and status changes
- Perform other responsibilities as needed
- Bachelor’s degree in healthcare, information technology, business or related field strongly preferred
- 3 years experience with Patient Access solutions such as Scheduling, Registration
- Experience with physician facing and/or scheduling, registration solutions
- Must live in or be willing to relocate to Silver Springs, MD area
- Strong troubleshooting skills, specifically in performance and stability troubleshooting
- Strong client facing presentation and facilitation skills
- Experience working with clients recommending changes in software development, business processes, maintenance, and/or system standards
193
Director Physician Revenue Cycle Resume Examples & Samples
- In collaboration with Executive Director Revenue and Reimbursement, and VP of Revenue Cycle, establishes processes for an effective revenue cycle, ensures excellent customer service is given to patients, staff, and other users who interact with the department
- Plan, coordinate and implement new centralized physician revenue cycle
- Plan, lead and coordinate new billing system implementation to ECW
- Organizes the billing and collection activities of revenue cycle
- Create metrics and reporting tools to monitor and enhance Revenue Cycle performance
- Administers corporate and departmental policies and procedures to ensure ethical and sound business practices and procedures are followed
- Evaluates, monitors, and communicates identification of the organization's registration, charge entry, and coding problems impeding the revenue cycle process, in relation to billing and AR resolution
- Responsible for managing and supervising Revenue Cycle Staff including
- Assist, mentors, and promotes the growth of the department's staff in achieving objectives and duties
- Measures and reviews staff performance and quality, recommending and assigning training
- Responsible for the professional conduct of staff and maintaining a professional work code and environment
- Assist with new hire on-boarding (interviewing, training, assessing)
- Work collaboratively with other members of management to find solutions, create policy and monitor for successful resolution
- Evaluates and monitors daily process controls to meet departmental effectiveness and efficiency standards
- Responsible for implementing changes needed to comply with third party/governmental rules and requirements, coordinating the training of staff on these changes
- Ensures department areas timely and accurate response to patient and internal inquiries
- Independently initiate and manage projects designed to improve team efficiency, productivity, and quality
- Perform other work related duties as assigned or requested
- Bachelor's degree or equivalent industry experience of 3-5 years
- Required 3-5 years experience of physician receivables, third party billing and payment requirements, medical terminology, and ICD9 and CPT4 coding
- Ability to evaluate personal performance against established goals
- Athena experience required
- Demonstrates goal-oriented thinking, leadership ability, and strong interpersonal, operational and organizational skills
- Prior experience enforcing, maintaining, and updating department policies and procedures
- Excellent communication skills, including listening, writing, and relationship development
- Prior experience supervising a group of individuals from both a development and personal issues standpoint
194
Revenue Cycle Director Resume Examples & Samples
- Plans and directs registration, patient insurance, billing and collections and data processing to ensure accurate patient billing and efficient account collection
- Manages the Business Office within the established budget including annual planning. Develops monthly status reports
- Develops, implements and administers annual capital budget; initiates corrective action to significant variances
- Plans and prepares monthly revenue reports for review and use by Administrator, senior leadership and faculty
- Provides ad-hoc reports on associated revenue metrics (i.e. RVU, Payor Mix, CPT volume, etc) as requested by Chairman, Division Chiefs, Faculty and Administrator
- Establishes and maintains a working relationship with all third party vendors assigned to the billing office. Oversees all collection efforts, account management and related patient to vendor relationships
- Manages Physician credentialing process with managed care and government payors. Interfaces with the IPA, Medical Staffing and faculty to ensure credentialing is completed in a timely manner
- Develops, supervises and maintains daily cash processing workflows and associate reconciliations. Ensure all monies received to general ledgers match the posted receipts in IDX
- Reviews current status of patient accounts to identify and resolves billing and processing problems in a timely manner
- Directly supervises accounts receivable collection team. Monitors progress of team on a daily basis and re-directs follow up efforts as appropriate
- Establishes and implements methodologies for the collection of delinquent accounts ensuring third-party payors are contacted
- Establishes and recommends credit and collection policies, and makes recommendations for improvement
- Solves difficult payment and associated business office problems. Audits problem accounts
- Maintains contacts with medical records and other departments to obtain and analyze additional patient information to document and process billings
- Develops and oversees business systems and works with information technology to ensure timely and accurate implementation
- Supervises, trains, orients and evaluates performance of assigned personnel. Recommends merit increases, promotions, disciplinary actions
- Monitors daily operating activity of department and makes necessary adjustments in work assignments
- Initiates and answers pertinent correspondence. Maintains required records and files
- Attends administrative meetings and participates in committees as requested. Conducts special projects and studies as directed
- Participates in professional development activities and maintains professional affiliations
- 10 years directly related and progressive health care revenue cycle experience will be considered in lieu of a degree. With degree, minimum 5 years medical business office experience, with 2 years as a department manager in billing, accounting or information systems
195
Revenue Cycle Director Resume Examples & Samples
- 10 years directly related and progressive health care revenue cycle experience will be considered in lieu of a degree
- With degree, minimum 5 years medical business office experience, with 2 years as a department manager in billing, accounting or information systems
- Patient billing management software
- Knowledge of ICD and CPT guidelines
- Ability to shift priorities; superior problem-solving capabilities
- Persuasive, encouraging, and able to motivate others
- Ability to effectively prioritize and execute tasks in a high-pressure environment
196
Manager, Physician Revenue Cycle Resume Examples & Samples
- Responsibility for Revenue Cycle Management for physician revenue cycle service offerings
- Management of strategic and critical business initiatives related to revenue cycle management for professional services
- Maintain and a command of nephrology and physician practice revenue cycle trends, business performance management, and key performance indicators
- Responsible for management and oversight of Physician Revenue Cycle performance to included but not limited to scheduling, insurance verification, billing, denials management and avoidance, collections, cash posting
- Lead operational efforts through subordinates to complete the administration of business processes and services to ensure the operations effective achievement of goals within the assigned business unit(s)
- Direct and control the broad activities of the business unit(s) through the interpretation, application and implementation of Company-wide policies and processes appropriate to the functional area(s)
- Facilitate communication and coordination with cross-divisional teams, customers, vendors and/or third parties to ensure the effective exchange of necessary information
- Provide leadership, guidance and coaching for all direct reports to maintain an engaged and productive workforce; partnering with Human Resources on employee matters
- Collaborate with employees in the establishment of clear and concise development plans to ensure succession planning and the advancement of future leaders within the organization
- Provide technical guidance
- #L1-AF2
- 6 – 8 years’ related experience
- 5-7 years in Physician Revenue Cycle, preferably with direct Nephrology experience
197
Heathcare Revenue Cycle Resume Examples & Samples
- You will be the “face of IT support” to our Service Operations team
- Uphold enterprise policy and guidelines and recommend new/improved guidelines
- Facilitate daily standup and weekly incident review meetings with service operations
- Understand the solutions being used by operations and their upstream/downstream impact
- Provide support to service operations on development of application test approaches/plans
- Translate operation needs into system/technical requirements
- War Room/Situation Management participation when system down event is occurring
- Partner with functional teams and interact with service operation teams as well as vendors to find solutions for application issues and problems
- Responsible for various configuration documents and tools that are used to manage the solutions
- Bachelor's degree in related field or Equivalent Experience
- 3+ years healthcare revenue cycle billing experience
- 3+ years troubleshooting or client IT support experience
- MS Office (Including Word, Excel – to include pivot tables, VLookups, Formulas etc., PowerPoint)
- The willingness and ability to work in other offices in the Phoenix, AZ area on an infrequent basis
- Previous experience in a healthcare environment
- 837 and 835 formats
- Network Topologies
- Desktop utilities
198
Revenue Cycle Representative Resume Examples & Samples
- Bachelor’s degree, or equivalent combination of education and experience
- Experience (typically 1 to 3 years) in medical billing and claims processing; demonstrated at a working level proficiency
- Experience (typically 1 to 3 years) working with Electronic Medical Records (EPIC), demonstrated at a working level proficiency
- Knowledge of insurance authorizations and eligibility processes; demonstrated at a working level proficiency
- Working level proficiency with written and verbal communication skills including individuals with communication disorders
- Working level proficiency working within a medical clinic setting including handling confidential records and knowledge of HIPAA compliance
- Medical Billing certification
- Ability to run reports in EPIC
- Knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs; demonstrated at a working level proficiency
199
Revenue Cycle Senior Consultant Resume Examples & Samples
- 6+ years of healthcare consulting / management experience or leadership experience in provider organization
- Project management experience and technical expertise working with EPIC, Cerner, Allscripts and other systems
- Proven ability to probe, analyze, synthesize and articulate complex subject matter so it can be easily understood
- Ability to travel 70-80%
- Bachelor's Degree or Master's Degree in Business Administration or related field
200
Revenue Cycle Director Resume Examples & Samples
- Managing a large team of medical billers and medical coders
- Ensure HIPPA privacy regulations and keep up to date with CPT and ICD-10 coding protocols and procedures
- Analyze reimbursements, bad debt and AR aging along with forecasting of AR sub ledger functions to management
- Lead continuous improvement of department and minimize employee turnover
201
Revenue Cycle Auditor Resume Examples & Samples
- Internal controls
- SOX 404
- Sarbanes Oxley
- Public accounting
202
Revenue Cycle Improvement Senior Consultant Resume Examples & Samples
- Leads revenue cycle departments in the analytical components of workflow redesign. Identifies, creates and implements improvement solutions for BSWH revenue cycle related departments
- Monitors the performance of revenue cycle activities utilizing current monitoring tool sets and performance metrics. Creates and implements new performance metrics to address and manage new performance issues
- Leads revenue cycle department activities including, but not limited to technology planning, staffing assessments, operational improvement strategies, and workflow optimization
- Leads revenue cycle improvement activities between BSWH Corporate departments and BSWH facilities
- Leads revenue cycle improvement communications across the revenue cycle
- Analyzes and identifies trends in revenue cycle operations. Uses this data to develop conclusions, recommendations, and implement process redesign solutions
- Assesses the current capabilities of IT revenue cycle systems and creates and leads implementation of innovative revenue cycle IT solutions
- Develops revenue cycle training tools and leads revenue management educational activities for BSWH revenue cycle departments
- Builds and manages successful relationships with multiple levels of stakeholders inside and outside of Revenue Cycle
- Plans, organizes, and prioritizes Revenue Cycle project activities using work plans and other project management tools
- Manages multiple projects and other activities at a time
- Assesses current and potential vendors and works to negotiate contracts or amend existing contracts
- Location/Facility – Bryan Tower/Dallas
203
Revenue Cycle Performance Analyst Resume Examples & Samples
- Compiles, analyzes, interprets and presents data necessary to assess goals
- Generates weekly and monthly accuracy reports and distributes to appropriate managers for performance review
- Reviews documentation quality as it relates to the revenue cycle and helps develop best practices that are monitored for accountability
- Timely resolution of Service Now tickets and WQs owned by Revenue Cycle team
- Works in conjunction with Revenue Cycle Managers and Directors to identify process opportunities to improve accuracy and workflows through random audits of patient accounts and site observations
- Serves as a subject matter expert and is able to answer questions and provide guidance
- Routinely monitors front-line WQs and reports to ensure targets are being met and trends are being identified. This may occasionally require assisting with error resolution
- Delivers instruction to individuals and groups in a variety of formats with an emphasis on revenue cycle operations
- Assists in developing annual competencies and records results
- Monitors and responds to Revenue Cycle communications as needed
204
Regional Director of Revenue Cycle Resume Examples & Samples
- Maintain knowledge and skill required to assure accurate and timely reimbursement of Accounts Receivable. Manage staff, projects, and systems that impact the success of achieving successful fiscal integrity related to Accounts Receivable
- Develops and implements department budget that demonstrate efficiency and prudent utilization of resources to manage Revenue Cycle teams
- Establish strategic goals for each Revenue Cycle Department that align to the Organizational Goals. Collaborate with the Management team to implement and monitor success
- Assures all Patients are registered accurately and timely demonstrating respect to meet the needs of all patients. Collaborates with the Management Team to optimize pre-registration, insurance verification, and financial counseling at scheduling, registration, and at discharge
- Creates and implements efficient work flow in Coding and Transcription to bill timely and accurately, provide data to departments relying on the accurate assignment of charges, diagnosis, and procedures for revenue and abstraction of data
- Assures that Medical Records are maintained accurately, utilizing electronic and paper formats. Assures critical data elements are analyzed to identify and correct deficiencies. Assures compliant release of patient’s records following prescribed policies and procedures to protect the privacy of the patient, and meet Federal and State regulation
- Oversee Billing, Follow-up, and Collections performed by the Patient Accounts department and Customer Service relating to Billing inquiries. Assures all assigned staff are trained and meet established performance standards. Oversees the Charge Description Master file and assures that charges reflect the documented services provided to patients in their Medical Record
- Monitors cash flow applied to AR to analyze deficiencies and create and apply corrective action to assure accurate and timely receipt of payment from Patients, Government Agencies, and Commercial insurers
- Establishes policies and procedures to assist Patients in meeting their financial Responsibility for payment of services received at the Hospital. Strategize with Management and staff to maximize the benefits to all patients in need of assistance
- Create an environment that empowers staff to continuously develop performance improvement processes. Solicits input in daily operations and projects to improve all Revenue Cycle functions. Assists staff in developing new skills and applying them to the work place
- Assures all staff are treated fairly and consistently in accordance with the organization’s Human Resources policies and procedures
- Achieve annual and periodic goals for significant statistical indicators or revenue cycle performance and for the organization’s overall financial performance
- Works with utilization management staff in all patient care sites in order to ensure timely and accurate care authorization, response to, and resolution of care denials
- Three (3) years’ experience of Healthcare Management in a Financial or Revenue Cycle related role
- Two (2) years’ experience of providing leadership
- Two (2) years’ experience of medical office experience
- Five (5) to Seven (7) years’ experience in a HealthCare Management Role preferred
- Ability to read and understand oral and written instructions, and effectively communicate information. Basic computer skills (including opening/reading email, basic internet use). Expert at managing Revenue Cycle workflow to assure optimum results. Ability to manage large and diverse work groups to assure cohesive interactions to maximize achievement at meeting department and Organizational Goals
205
Dir Revenue Cycle Resume Examples & Samples
- Create and communicate revenue cycle policies and procedures for scheduling, registration, insurance verification, transcription, coding, medical records, billing and collections
- Determine best practices and educate business office staff
- Collaborate with executive ASC entity leadership and others to establish new programs and processes to improve revenue cycle performance across ASCs
- Prepare and present reports and data regarding revenue cycle performance including, for example, accounts receivable, cash collections and process improvement initiatives
- Set key operating metrics and monitor performance against benchmarks
- Audit ASCs revenue cycle performance on regular basis, document and report results and improvement plans and monitor progress
- Coordinate with ASCs entity accounting to ensure appropriate month-end patient financial system accounts receivable closing and balancing processes to lead to reliable accounts receivable reports
- Lead ASCs in annual Charge Master reviews and adjustments
- Lead ASCs in understanding their payor contracts, including maintenance of payor tables and loading of payor contracts into patient financial systems
- Lead process improvement innovation including evaluating new vendors and/or technology
- Lead on-boarding and education of new ASCs and business office staff for implementing revenue cycle processes and technology
- Lead relationships with third-party billing and collection firms, where applicable
- Lead relationships with patient financial system vendors
- Lead standardization of patient financial system tables and reporting
- Manage change management process for enterprise-wide patient financial system tables
- Manage timely completion of payor applications
- Manage timely filing of state data submissions
- Support the evaluation of new ASC business office managers or comparable position candidates
- Position requires up to 50% travel to ASCs
- Bachelor’s degree in accounting, finance or related field required and Master’s degree in in health care management, finance, business administration or related field a plus
- Five years minimum multi-site managerial experience as a Director, Assistant Director or Manager in ASC revenue cycle required
206
Revenue Cycle Associate Resume Examples & Samples
- Provides reception for Revenue Cycle Administration office, greeting and directing visitors. Assists and responds in a timely manner to internal and external customers, providing direction, support and information to ensure high quality customer service. Assesses all customer needs and independently addresses concerns within the scope of the position
- Receives, distributes, and processes US Postal and interoffice mail within the department
- Processes and posts credit card payments received for patient accounts. Prints and mails receipts to patients
- Performs a variety of administrative tasks including, but not limited to, printing and mailing patient letters, producing documentation for patient refunds, developing check requests, preparing invoices for medical record requests, posting of patient account information to the practice management system and placing and answering telephone calls
- Monitors and maintains inventory of office and kitchen supplies, places orders as needed. Receives and puts away orders ensuring accuracy of packing slip/invoices. Coordinates the maintenance and repair of office equipment
- Validates accuracy of invoices related to the operation of the Revenue Cycle Department. Enters and processes invoices for payment in the accounting system (Meditech). Maintains appropriate back up and files
- Tracks and reports financial and banking information for SHMG practice locations. Compiles a variety of reports for end of month processing. Interacts with bank courier. Orders banking supplies for all SHMG locations
- Serves as a liaison, as needed, to building supervisor and building management as it involves maintenance and other issues on a daily basis
- Maintains appropriate documents, reports and files in order to comply with all applicable laws and policies
- Performs other related duties as assigned or requested in order to maintain a high level of service. Completes required continuous training and education, including department specific requirements. Complies with departmental organizational policies and procedures and adheres to external agency requirements
- High school diploma or equivalent with 1-3 years relevant healthcare experience in front office or billing office
- High level of competency with computers, the Internet, and computer software such as MS Office or equivalent is required. Experience with Practice Management systems preferred
- Ability to organize and prioritize workload to manage multiple tasks and meet deadlines with minimal supervision
- Excellent verbal, written, organizational, and interpersonal skills are required. Effectively communicates with internal and external customers positively, confidentially and professionally
- Ability to work with individuals at all organizational levels, particularly peers, team members, other departments, patients, and the community is required
- Strong problem-solving skills and ability to make timely decisions in a fast-paced environment
- Demonstrated ability to work in a continuously changing environment and willingness to assist with a variety of tasks as needed
- Willingness to learn and share knowledge with others
207
Operations Analyst, Revenue Cycle Resume Examples & Samples
- · Works with management on all Access/Revenue Cycle initiatives such as meaningful use of the EHR, telemedicine projects etc
- Manages Project Request for System Enhancements and Changes by working closely with the IT team
- Protects the integrity and confidentiality of all data and information through physical and electronic measures
- Provide service according to the expectations of policies/procedures and standards developed around the Access/Revenue Cycle for client departments
- Evaluates and documents client needs and all aspects of business processes both operational and financial, including current process analysis; and proposed revisions to optimize business processes
- Assists with the design and documentation of business/system functional requirements in formats to facilitate the development of deliverables such as Request for Proposals and/or Information, custom development efforts, project based planning documents such as scope documents and client services communication
- Works with ISD staff, clients and/or vendors to evaluate technology solutions including both packaged system solutions and custom development application and component development options
- Assures quality of information technology solutions through business case and application level testing; validates test results to initial business needs
- Provide ongoing troubleshooting, support and maintenance of eRecord production applications
- Work with Information Services staff and the integration team to design, test and deploy appropriate hardware solutions, connectivity requirements and interface solutions, as appropriate
- Bachelor degree in Information Systems/Computer Science, Nursing, Health Information Management, Business, clinical or financial studies or related field required OR an equivalent combination of education and experience would be considered
- A Masters degree in a related field preferred
- Four years experience in financial and/or medical analysis or successful completion of the FMR Program with a minimum of three years of health care, business or IT experience required
- Good oral and written communication skills are required
- Extensive related experience will be considered
- Superior computer skills with expert knowledge in Word, Excel and EpicCare/eRecord preferred
- Demonstrate a high degree of professionalism, enthusiasm and initiative on a daily basis
- Ability to work in a fast-paced environment a must
- Ability to manage multiple tasks and projects, and forge strong interpersonal relationships within the department, with other departments, and with external audiences
- Attention to detail is critical to the success of this position, with demonstrated competency in customer orientation and the ability to deal with ambiguity
- Excellent planning, communication, documentation, organizational, analytical, and problem solving abilities
- Ability to interpret and summarize results of various analyses in a timely and meaningful way
- Ability to effectively approach problem solving
- Ability to re-engineer processes to positively impact productivity in terms of timeliness and accuracy
- Possess technical knowledge and expertise in understanding patient access, physician template utilization and must possess an understanding of the complex information system solutions and the implementation/support of those solutions in the client community
- Ability to analyze financial & clinical results and to comprehend forecasting models
- Well-informed and conversant with general business, economic, and clinical matters
- Effective analytical skills are required
- Must be able to work within an aggressive deliverables based and/or service quality based environment
- The ability to continuously interact effectively with all levels of clients is critical
- Available to work overtime if required
208
Consulting Analyst, Revenue Cycle Consulting Resume Examples & Samples
- Serve a key role in coordinating logistics of complex engagements
- Review and support development of presentation and report deliverables, and present recommendations
- Support client calls and in person meetings at the client site
- Set and execute against project milestones
- Assist in providing on-site and off-site assessments and consulting services for large clients
- 1+ Year of Professional Work Experience
- Willingness to travel 50% domestically and valid Driver’s License
- Previous experience working at The Advisory Board Company
- Strong track record of attention to detail and service orientation
- Ability to manage multiple projects simultaneously and communicate project timelines effectively
- Understanding of Advisory Board Company Revenue Cycle Consulting and Management team
- Demonstrated analytical reasoning and solution-focus problem solving skills
- Demonstrated project management and organizational expertise
- Ability to drill down to the root cause of issues and be creative in problem solving
209
VP-revenue Cycle Management Resume Examples & Samples
- Plans, directs and supervises revenue cycle systems and operations
- Actively works with the Acute Division Hospitals' Leadership Teams and corporate leaders to review revenue cycle performance and pursue ways to improve cash flow
- Addresses regulatory reimbursement and managed care issues related to revenue cycle management
- Develops and implements policies and procedures to ensure that the clinical revenue cycle is effective and properly utilized
- Directs technology related activities to achieve desired goals and maintain compliance with federal, state and local regulations
- Develops budgetary goals and initiates corrective action to address variances
- Interacts with vendors and various departments that impact the revenue cycle management results, including: Patient Access, Patient Accounting, HIM Case Management, I/S, Finance and hospital patient care areas
- Performs other duties as assigned/required
210
VP of Revenue Cycle Resume Examples & Samples
- Perform complex data analysis and make independent decisions
- Interacts with executives, other directors, and all members of the Revenue Cycle team
- Knowledge of state and federal regulations as they pertain to billing processes and procedures
- Insurance claim processing and third party reimbursement
- Detailed understanding of all negotiated agreements
- External contacts may consist of patients and their families, insurance companies, state and federal agencies, auditors, and vendors
- Technical or professional accounting
- Skill in time management and project management
- Advanced proficiency in Microsoft Excel
- Apply appropriate supervisory, management and leadership techniques in an operational setting
- Deal effectively with constant changes and be a change agent
- Ability to set priorities and use good judgment for self and staff
- Seven (7) to ten (10) years hospital accounts receivables experience is required
- Three (3) years of progressive leadership experience (at a supervisor level and above) in a complex healthcare organization is required
211
Revenue Cycle Supervisor Resume Examples & Samples
- Serve as floating supervisor Front End / Patient Access staff of up to 80 team members (25 on the weekends)
- Acts as liaison with Patient Accounts, Care Coordination/Utilization Management, Patient Financial Services, Financial Counselors, and Information Systems regarding various issues that arise in the Consolidated Business Office
- Proactively reviews work lists, staff activity, productivity and time and attendance. Notifies Senior Leadership of potential systemic issues and high risk/high exposure situations. Recommends solutions for resolving issues
- 2+ years of experience to ensure familiarity with patient accounting, patient registration, insurance verification and/or patient access
- 5+ years of experience in a healthcare setting
- Must be able to work in variance schedule (requires weekends and holidays)
- Knowledge of basic accounting principles, business administration, and computer systems as normally acquired through completion of 2+ years of college, business or technical school
212
Revenue Cycle Supervisor RAD ONC Resume Examples & Samples
- Supervises the daily business functions of the patient visit from point of entry to accurate adjudication of the patients* accounts. Scope of responsibilities includes appointment scheduling, insurance eligibility processes; charge processing; claim submission and processing; payment processing; collections and accounts receivable management; denial management; reporting of results and analysis; concurrent and retrospective auditing; proper coding; credentialing; customer services relative to revenue cycle; training and development relative to revenue cycle; analytics, and all other revenue cycle management activities. Resolves escalated and unique revenue cycle issues for RAD ONC
- Develops, implements, and maintains the Practices revenue cycle training materials. Conducts training of SOPs, systems, metrics, government regulations, and etc
- Excel experience with pivot tables and V look up strongly preferred
- Attracts high caliber people, accurately assesses strengths and development needs of employees; provides timely, specific feedback and helpful coaching; provides challenging assignments and opportunities for development. Responsible for interviewing, recommending hires, assessing performance, recommending salary changes, and progressive discipline. Enforces adherence to the Practice*s and US Oncology policies
213
Epic Certified Revenue Cycle Business Analyst Resume Examples & Samples
- Analyze and document client's business requirements and processes; communicate requirements to technical personnel by constructing basic conceptual data and process models, including process flowcharts and technical specifications
- Presenting concepts in a concise and focused manner, including narrative, process diagrams, role and accountability diagrams and business-focused story boards
- Coordinate user groups and project teams, convening conference calls and meetings and maintaining minutes and follow-up logs
- Work collaboratively with Systems Analyst to develop designs, mockups and prototypes
- Experience with an Epic implementation at a multi-hospital system, and/or a major academic medical center
- A Baccalaureate Degree from an accredited college or university in computer science, Information systems, business administration or equivalent experience or education is required
- At least 3 years of revenue cycle healthcare systems experience
- At least 3 years of experience on commercial core revenue cycle applications
- Strong understanding of the core functions and processes of the billing office
- Experience documenting system architecture design and revenue cycle system workflow
- Excellent verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts
- Must be well organized, detail oriented, highly analytical, possess strong problem solving skills and must have a desire to be accountable for project success
- Detailed knowledge of general phases of SDLC, project management methods
- EPIC - Resolute Hospital Billing Administration, Claims Administration certification required
- EPIC – Charge Router, Resolute Hospital Billing Electronic Remittance, Resolute Hospital Billing
- Expected Reimbursement Contracts Certification preferred
- Experience with Epic integration
- Strong technical background, including an understanding of ANSI 837 and 835 formats and the ability to create and customize logical rules to prevent incorrect claims from being submitted
- Have a full understanding of the PPS and non-PPS Hospital Billing revenue cycle and the revenue cycle as it pertains to Epic
- Hospital Billing experience
- Must have General Ledger experience
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Epic Revenue Cycle Business Analyst Resume Examples & Samples
- Decompose information gathered into details including sources of data, data types, users, user types, interface components, interface navigation needs, reporting needs, and administrative system needs
- Communicate technical design issues to non-technical people
- Ability to work independently and as part of a fast moving team
- Experience with HL7 communications is a plus
- Experienced working in a Project Management Office (PMO) with cross-functional teams is a plus
- Completed multiple go-lives, and at least one from (near) inception to completion
- At least 3 years of clinical healthcare systems experience
- At least 3 years of experience on commercial core clinical applications
- Experience documenting system architecture design and clinical system workflow
- EPIC - HIM Coding and Abstracting required
- EPIC – Identity
- EPIC build and integration experience
- Strong technical background,
- Have a full understanding of HIM processes and procedures, coding, Medical terminology, Hospital Medical Record coding experience
215
Revenue Cycle Management Manager Resume Examples & Samples
- Overall responsibility for accounts receivable-related metrics and goals, developed in conjunction with Revenue Cycle Management Director and Home Care leadership
- Utilize reporting and metrics to identify strategies, tactics, and to manage the team collectively and as individuals
- Engage in audit activity, as needed
- Timely and accurate billing; manage unbillable and timely filing risks and denials
- Accurate revenue recognition; includes accruals, reserves and bad debts
- DSO management/cash collections; maintain and oversee collection process, handle escalations, process refunds, manage relationships with outside collection agencies, review patient financial waivers
- Monitor cash application processes and ensure accuracy relevant to appropriate fee schedule application and over or underpayments
- Credits and adjustments; assess appropriateness, review and approve credits and adjustments per policy guidelines; recommend exceptions to Revenue Cycle Management Director
- Identify needs and coordinate initiatives related to development of payer policy strategy necessary to support timely resolution of accounts receivable
- Recommend and monitor Billing and A/R policies and procedures for third party Respiratory Care business
- Act as a liaison with sales team regarding open A/R balances and actions taken regarding credits and adjustments
- Develop escalation path with Payer Database, Managed Care, and other partner teams to identify and establish process for payer or claims issues
- Identify and implement technology, structure, and process enhancements to improve department efficiencies
- Special projects include challenging assignments in payer analysis, third party billing process improvement and business project support
- Lead development and execution of Revenue Cycle Management initiatives
- Apply broad knowledge to solve others’ challenges and lead the solutions to problems
- Effectively manage team, including performance, personnel issues, and conflict resolution
- Recognize and reward success of team and individuals
- Manage execution of initiatives and activities to drive for results
- Network and participate in industry or trade organizations, as appropriate
- Other duties and projects as needed or assigned
- Recruit, train and provide for career development of staff
- Monitor and evaluate team effectiveness and individual productivity measured against established performance standards. Apply corrective measures as appropriate to ensure standards are maintained and goals are achieved
- BS/BA degree or equivalent experience
- 8+ years experience in Revenue Cycle Management, preferably with a DME supplier
- 3+ years leadership/management experience
- Strong management skills and proven ability to effectively manage through change
- Knowledge of federal, state, and local regulations, guidelines, and standards, including a working knowledge of Compliance and HIPAA rules and regulations
- Knowledge of accounts receivable principles, procedures, standards and documentation within a medical billing environment
- Strong financial, analytical, and strategic skills
- Proficient in Microsoft Office Software
- Exceptional written, verbal and interpersonal communication and presentation skills
- Detail oriented, organized, and good discretionary judgment
- Strong negotiating skills
216
Revenue Cycle Consultant Resume Examples & Samples
- Revenue cycle turn around / redesign
- Provide consulting services to clients in all areas of the healthcare revenue cycle which includes
- 3+ years of experience in the Healthcare revenue cycle
- Expert in MS Word, Excel and Visio
217
Revenue Cycle Pre-service Coord Resume Examples & Samples
- Obtain and revise patient demographic, insurance, and account information as needed to ensure payment
- Assures all PCP, Specialty, and Out of Network Referrals are obtained effectively and efficiently
- Produce an Estimate of the Patient’s out of pocket liability for both the facility and professional services
- Cash Collections/Financial Assessment
- Performs other area support activities
- Knowledge of medical and insurance terminology, provider billing, access operations, medical insurance plans, or managed care plans
218
Supv-revenue Cycle Resume Examples & Samples
- Determines, coordinates and supervises daily staffing assignments and staffing levels
- Trains, coaches, and evaluates assigned staff on performance expectations. Applies progressive discipline when appropriate. Participates in hiring and termination procedures
- Ensures accurate identification of managed care plans, network eligibility, and/or compliance with contractual and regulatory requirements. May alert provider and/or patient as necessary
- Determines the patient financial responsibility and performs revenue collection. May perform daily balancing, coding and charge entry procedures. Refers any patient deemed necessary to the financial counselor. May qualify patients for financial assistance
- Minimum three (3) years of experience directly applicable to the primary work required
219
Supv Revenue Cycle Resume Examples & Samples
- Three years experience in a hospital setting or related field
- A collaborative team player with a high degree of comfort interacting with patients and hospital leadership
- Able to effectively communicate in English, both verbally and in writing
- Experience as a Lead or Coordinator preferred
- One year experience in a Revenue Cycle role preferred
- Strong analytical skills and proficiency with Microsoft products to analyze and trend data preferred
220
PNO Supervisor, Professional Revenue Cycle Resume Examples & Samples
- Strong leadership competencies in team development, coaching, mentoring and situational skill assessment with proven track record of building, motivating, and developing high performing teams
- Five years of increasingly responsible related healthcare management experience required, such as clinical or administrative practice operations, physician or hospital billing revenue cycle, finance, patient access, informatics, information systems, process improvement, consulting, or business intelligence
- Two years of experience using healthcare information systems required, i.e. practice management, electronic health record, and/or billing
- One year of supervisory experience required
- Experience with system implementations, HL-7 interfaces, and/or EDI transactions highly desirable
- Provide oversight, strategic direction, and guidance for the Physician Network CBO by defining objectives, goals, tracking progress, and measuring success. Partner with PNO leadership to assume responsibility throughout the physician billing revenue cycle, from front-end processes to account resolution. Responsible for the overall direction, coordination, planning, and assignment of work. Establish deadlines and productivity standards to efficiently minimize accounts receivable and enhance professional fee collections, while maintaining standards through ongoing quality assurance measures
- Ensure compliance with and assist in the development, planning, communication, and implementation of department policies and procedures. Provide oversight and guidance for the implementation of new initiatives and processes. Modify and/or create procedures aimed at reducing backlogs, improving financial performance, or cash collections. Serve as a liaison with third parties to ensure billing processes are compliant and within current standards
- Develop systems and controls to ensure successful claims processing and payment through pre and post claim editing systems, continuously striving to increase the percentage of electronic transactions. Develop effective internal dunning processes and collection techniques, along with an effective outsourcing strategy to achieve the highest possible self-pay collection results. Develop and maintain a patient friendly bill statement
- Monitor, report, and manage discrepancies and/or deficiencies, analyze for trending and root cause, and develop action plans. Monitor key indicators through accounts receivable aging summaries, workfiles, and other ad-hoc reports to recommend improvements. Work with other departments to adjust operations accordingly to meet unit objectives
- Participate in continuous quality improvement efforts by proactively identifying improvement opportunities, comparing performance to industry best practices, encouraging hands-on problem solving, and implementing appropriate solutions. Develop systems and controls to ensure that accounts receivable issues are identified, and resolved in a timely, cost effective manner. Generate and implement new ideas for reducing costs while maintaining similar or better service levels
- Assist in the development of annual department budget to ensure appropriate allocation of resources to support operations and meet departmental goals, managing costs within budgetary constraints
- Maintain high standard of professional conduct, demonstrating a positive, open-minded, can-do attitude, representing the PNO and CBO with a team perspective, willingness, and enthusiasm to collaborate with others. Work closely with Trinity Health, other Regional Health Ministries, and key stakeholders to expedite the resolution of issues, understand, and address key business needs aligned with organizational goals
- Serve as technical project manager, billing system subject matter expert, and system training specialist. Assist with technical set up, maintenance, and on-going support of system. Implement new and optimize existing technology to ensure revenue enhancement and efficient operations. Investigate, analyze and diagnose operational, technical and communication issues. Translate billing requirements into solutions that improve processes, increase automation, and decrease expenses. Maintain ongoing priority/issues log for the department
- Provide leadership, coaching, supervision, and reporting structure to support superior performance and well-being of colleagues. Provide clear channels of communication, delegation and accountability. Hire and retain qualified staff by providing opportunities of continuing education, professional development, skill training and upward mobility. Conduct regular department meetings for purposes of education, goal monitoring, and feedback
- Partner with Human Resources to address employee issues, develop performance improvement plans, discipline and rewards, address complaints, and resolve problems within the department. Conduct regular and timely performance evaluations. Foster positive team environment that encourages productivity, loyalty, job satisfaction and positive reinforcement to achieve patient satisfaction and employee engagement goals
- Demonstrates and actively promotes an understanding and commitment to the mission of St. Joseph Mercy Oakland through performing behaviors consistent with the Trinity Health Values
- Maintains a working knowledge of applicable Federal, State, and Local laws and regulations, the Trinity Health Organizational Integrity Program, including the Standards of Conduct, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behaviors and maintains confidentiality. Actively engage in professional development to maintain current skills and knowledge of industry trends, best practices and business opportunities
221
IT Revenue Cycle Business Analyst Resume Examples & Samples
- Master’s degree in Business Administration, Computer Science or other health care related field is highly desired
- Physician Billing experience preferred
- Cerner Millennium experience preferred
- Cerner CCL experience preferred
- Working knowledge of database structures, query tools, and reporting system
- Ability to work effectively on team project
- Strong analytical, interpersonal, customer service, and problem solving skills
- Possess meticulous eye for detail and accuracy
- Advanced proficiency with multiple software applications including Microsoft Word, Excel, Access and Visio
- Practical experience with project delivery and systems development life cycles
222
Centralized Scheduler Infusion Center Revenue Cycle Kissimmee Resume Examples & Samples
- Accuracy and data entry within established time constraints
- Knowledge of medical terminology (Preferred)
- Knowledge of insurance health plans (Preferred)
- College education or coursework in business or healthcare, or related field (Preferred)
- Customer service experience (Preferred)
- Call center experience (Preferred)
- N/A
223
Revenue Cycle Strategist Resume Examples & Samples
- Acts as the subject matter expert for the specific market segments. Expertise in one or more is preferred, with the role expanding to encompass all sub-acute venues of care
- Communicates existing and emerging solution functionality to our Clients
- Defines/ develops or supports solution vision through client interaction, market research, interpretation of regulatory and accrediting agency guidelines
- Prioritizes and reviews content development to support area of responsibility
- Ensures alignment of client goals and strategies with current solution capabilities and roadmaps
- Manages backlog of needed solution capabilities, collaborating in prioritization and definition of the functionality
- Support Cerner Sales and Marketing processes
- Identify, research and lead selection of possible partner solutions
- Bachelor's Degree with emphasis in related field or equivalent experience
- 3 - 5 years’ experience in managing Revenue Cycle
- Experience in behavioral Health, Home Health, Rehab, Skilled Nursing or other sub-acute venues of care
- Ability to travel 30% to 50%
- Must live in or relocate to the Kansas City metro area
- Master’s degree or advanced certificate in business, healthcare, or information technology
- Related industry certifications through HFMA, AHAM, MGMA, ACHE or other professional organization (CHFP, CRCR, etc.)
- Progressive leadership responsibilities with 5-7 years of experience managing a healthcare revenue cycle, or through consulting or an IT solution provider
- Proven and polished communication skills. The Strategist must be able to discuss detailed processes with end users as well as lead presentations and discussions with health system executives
- Demonstrated writing ability which must be clear, concise, and professional
- Demonstrated subject matter expertise by speaking at conferences and publishing articles
224
Registration Representative Infusion Center Revenue Cycle Altamonte Resume Examples & Samples
- Ability to use discretion when discussing employee/patient related issues that are confidential in nature
- Ability to respond to ever-changing matrix of hospital needs and act accordingly
- Self-motivator, quick thinker
- Ability to communicate professionally and effectively in English, both verbally and in writing
- High school diploma or GED (Preferred)
225
Analyst, Revenue Cycle Resume Examples & Samples
- Participate with management in strategizing for Process Improvement initiatives
- Attend and participate in management meetings
- Work with management on special organizational projects for CCHC
- Assist the supervisor in the performance of the daily operations of the physician revenue cycle department
- Reviews, monitors, resolve, and escalate matters related to delays and failure of accurate and time submission of electronic claims/billing statements
- Assists in the development and implementation in efficient and effective operational policies, processes and best practices within functions of the revenue cycle which includes claims processing and patient billing management
- Aids in the development and implementation of appropriate billing policies and procedures
- Identifies, tracks, and reports issues related to unbilled receivables, internal denials, claim edits, special adjustments, and/or write-offs as required and facilitates to staff for resolution
- Assists in preparation, and/or maintain requested reports on billing activities
- Investigates and delegates matters for resolution of billing complaints and issues
- Maintains up-to-date expertise and knowledge of healthcare billing laws, rules, regulations, and developments necessary for the organization to make informed business decisions
- Develops and delivers organized, concise yet thorough communications to management, Sr. Leadership, and other departments regarding proposed changes, deficiencies, developments, and opportunities affecting the organization and Physician Revenue Cycle department
- Make sound and evaluative judgments; strong organizational, problem solving and analytical skills
- Bachelors Degree in business, health care administration or related field preferred
- Extensive knowledge with billing concepts, practices, and procedures
- Two years work experience in a hospital/physician environment dealing with Revenue Cycle billing operations or software billing organization; experience with government regulatory payers preferred
- Excellent interpersonal, problem solving and critical thinking skills are required
226
Front End Revenue Cycle Management Associate Director Resume Examples & Samples
- Provide revenue cycle management services to client/partners in all areas of the healthcare revenue cycle which includes
- Proficient personal computer skills, including Microsoft Office
- Master's Degree in Business Administration or related field
- Prior Revenue Cycle hospital based provider consulting or revenue cycle management experience
227
Revenue Cycle Consultant Resume Examples & Samples
- A minimum of 5 years of experience in billing and coding for physician offices and/or healthcare facilities
- Must possess presentation skills
- Proficiency in Microsoft products required
- Oral communication skills needed to develop rapport with physicians, office managers, staff and internal & external customers
- Written communication skills necessary for written reports, physician communication, and both internal and external customer communications
- Presentation skills for classroom settings as well as one-on-one presentations
- Demonstrated customer service skills including; conflict resolution, employee relations, and maintaining client satisfaction
- Excellent organizational skills and the ability to manage multiple tasks/projects simultaneously
- A positive, results oriented approach to problem solving is needed
- Ability to travel by automobile or plane as needed
228
Director of Financial Ops / Revenue Cycle Resume Examples & Samples
- Developing department capital and operative budget with assistance of the CBO Director of Operations, CFO and staff
- Maintains department operations within budgetary guidelines
- Monitors employee productivity on an ongoing basis
- Accepts supervisory responsibilities inherent in position
- Demonstrates ability to initiate planned change in department, due to change in workload, schedule changes, or emergency situations and reallocates staff appropriately
- Extends special attention and sensitivity to all patients, visitors, physicians and fellow employees
- Assists in maintaining an atmosphere of cooperation with other departments and allied professionals
- Actively participates in an encourages actions that promote good public relations with patients, families, visitors and the community
- Accepts changes as an opportunity for growth, learning and development; adapts to changing procedures and goals in a cooperative and positive manner
- Responsible for daily operations of the Patient Accounting areas and functions. Accepts supervisory responsibilities inherent in position
- Demonstrates responsibility in Professional Growth and Development
- Supports the attainment of facility goals and the CBO
- Assists the CBO Director of Operations in preparing the operating and capital budget utilizing cost effective strategies
- Company 401K
- Medical, dental, vision insurance
- Paid time-off
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Associate VP of Revenue Cycle Operations Resume Examples & Samples
- Responsible for achievement of client service level agreement targets including Cash, A/R, Denial, and Bad Debt targets
- Work closely with the VP of Service Center Operations to communicate and report results
- Oversees and monitors progress against specific business goals and cost containment efforts
- Leads team in day to day operations of specific functional responsibilities
- Performs duties and job responsibilities in a manner that supports the mission, vision and values of Optum360
- Oversees the monthly results and planning
- Ensures that financial analyses, financial forecasts and routine reports are completed accurately and within established schedules for operational areas
- Identifies and provides implementation recommendations and administration concerning means for reducing costs and/or increasing revenue based on market trends and industry operating procedures
- Participates in the development of short and long term objectives that will assure the continued growth of Optum360 and the provision of healthcare services required by the community
- Monitors performance and communicates with Information Technology management to ensure optimal use of installed technology, planned system conversions and identify future needs
- Practices and adheres to the Mission and Values of Optum360
- May require travel between the various locations, occasional travel out of the area and travel to outside offices
- College degree or equivalent experience managing large scale healthcare operation
- Experience managing $1B + in billed AR
- 10 or more years of revenue cycle management experience with five or more years of leadership
- Broad experience with RCM operations, people leadership, and transition / change management
- Industry knowledge
- Proficient in packaging PowerPoint presentations summarizing outcomes
- PC skills in Microsoft Office applications and others as required
- Project management experience - administering tools and processes to identify and communicate project goals, schedules, responsibilities, progress and performance
- Managed Care financial and operational experience
- Consulting experience in areas of business transformation, finance re-engineering, shared services, change management and project management
- Health Plan Operations
- Healthcare provider service background
- Ability to execute large scale transition while monitoring ongoing changes for performance impact
- Ability to earn respect and trust of facility CFOs and other external customers
230
Intern Revenue Cycle Operations Resume Examples & Samples
- Currently has a bachelor degree or in a bachelor degree program
- Previous internship or work experience preferred
- Passion for solving complex challenges facing the US healthcare industry
- Superior oral and written communication skills
- Working knowledge of Microsoft Word, Excel, and PowerPoint
- Knowledge of Business analytics, SQL or CCL a plus
- Ability to travel within Southeastern Wisconsin
- Strong Conceptual, qualitative and quantitative skills
- Work as a member of a team as well as a self-motivated independent
- Regularly uses close visual acuity and operates computer equipment to analyze and transmit data
- Generally work in an office environment
231
Revenue Cycle Overpayment Resolution Manager Resume Examples & Samples
- Minimum 3 years management experience preferably in a multi-site/multi-state environment
- Preferred experience in a healthcare setting
- Strong call center operational knowledge
- Ability to work simultaneously with multiple systems
- Strong team-building skills
- Excellent written skills
- Excellent verbal skills
- Ability to Identify Trends
- Ability to build and maintain internal and external relationships
- Proven track record of inventory management and account resolution
- Proven track record managing staff productivity and quality
- Proven track record of successful process improvement in account resolution
- * ONLY CANDIDATES WITH SALARY REQUIREMENTS LISTED WILL BE CONSIDERED***
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Revenue Cycle Billingmanager Resume Examples & Samples
- Identify, research, and resolve outstanding billings and collections issues as necessary
- Contribute to the development and implementation of policies and procedures within the assigned function(s): ensuring compliance with company policies and procedures, Sarbanes-Oxley Act (SOX), and other regulatory requirements
- May support process reviews, business process analyses and internal control monitoring to ensure compliance with the specifications of SOX within assigned function(s)
- May support internal and external audits as necessary
- Act as an SME by providing support, guidance and expertise on diverse issues within assigned function(s)
- Serve as a liaison to cross-divisional teams and management as necessary; managing cross-divisional team communication and ensuring effective dissemination of information
- Strong working knowledge Generally Accepted Accounting Principles (GAAP) and SOX
233
Spvr Revenue Cycle IV / FC Resume Examples & Samples
- Supervises day-to-day operations as they relate to hospital billing, registration, admitting, and office management, as applicable
- Analyzes, recommends, implements and monitors approved work-flow changes
- Ensures comprehensive authorizations are obtained for services provided. Collaborates with clinical personnel in obtaining authorizations and contacts insurance companies, as needed
- Ensures compliance with Department of Health regulations as they pertain to completion and filing of death certificates and termination certificates
- Maintains daily workflow in order to expedite processing while ensuring quality, accuracy and customer service
- Monitors the inpatient and outpatient registrations for Quality Assurance
- Supervises, hires, trains, disciplines and evaluates staff
- High School Diploma or equivalent, required. Knowledge of management, computer systems, and third party reimbursement as normally acquired through completion of a Bachelor’s Degree in Health Care, Business or Public Administration
- Proficiency in Excel and Microsoft applications, required
- Outstanding written and verbal communication skills. Ability to articulate departmental policies and procedures clearly too all levels of staff
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Administrator, Revenue Cycle Operations Resume Examples & Samples
- 636 licensed inpatient beds
- Emergency medicine
- Surgical services
- Ambulatory surgery services
- Skilled nursing units
- Cardiology services including emergency and elective angioplasty
- Oncology services from diagnosis to treatment
- Orthopedic services including joint replacements
- Bariatric Surgery Center of Excellence
- Birthing centers
- Outpatient diagnostic imaging
- Geriatric assessment
- Primary and family care practices
- Adult day care
- Mental health and chemical dependency programs
- Diabetes program
- Wound care
- Outpatient infusion services
- Physical, occupational and speech therapy
- Hospitalist services
- Rape intervention and support services
- Community screenings and support groups
- BS/BA in Business Administration, Accounting, Finance or a related field,; MBA preferred
- Minimum 7 - 10 years of progressive responsibility in a related healthcare field (hospital and/or provider based)
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Manager Hospital Revenue Cycle Resume Examples & Samples
- Manages, coordinates or participates in a wide variety of operational and personnel functions related to Insurance Verification, Medicaid Application Services, Registration Services, Cash Operations, EC2000 and other related front-end and billing processes
- Includes scheduled as well as emergent services for inpatient, outpatient and ambulatory surgical encounters
- Plans & directs day-to-day operations
- Key player in the development and implementation of revenue cycle improvement processes as well as metrics to measure performance. Participates in quality assessment & continuous quality improvement activities
- Performs other responsibilities to ensure an efficient and customer-focused operation
- Prior supervisory/management experience is required. A minimum of five (5) years of revenue cycle experience including but not limited to billing, registration/ insurance verification, point of service collection related experience is required
- Comprehensive knowledge of a wide range of revenue cycle processes is preferred
- Proficient knowledge of Word, Excel, Access Database, Windows, and the Internet. Ability to create, analyze and interpret reports and spread sheets. Must have the ability to independently organize and prioritize responsibilities; problem solve and implement solution based ideas
- Ability to effectively work and adapt to a wide variety of different staffs, environments and situations. Ability to interact with leadership, staff, patients and visitors of various social-economic backgrounds
- Coach and mentor staff in a positive manner. Must have excellent customer service skills and ability to interact with nurses, physicians, patients, families, agencies, and the Department of Human Services. Comprehensive knowledge of state and government billing standards as it relates to insurances for but not limited to, Motor Vehicle accidents, Workmen Compensation, Medicaid, Group Health Plans, BCBS and Medicare
- Must have excellent written & verbal communication skills & strong facilitative interpersonal skills
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One Revenue Cycle Business Analyst Resume Examples & Samples
- Bachelor’s degree -or- equivalent combination of education and experience
- 2 years of Application Support or Business Analysis experience, with demonstrated problem solving skills
- 5 years Industry Related Experience with 3 years being in Healthcare Revenue Cycle or other applicable Business experience
- Prior Epic experience (certification a plus)
237
Revenue Cycle Rep-business Office CBO Resume Examples & Samples
- Advanced knowledge of third-party insurance in regards to plan types: HMO, PPO, POS, and Indemnity
- Excellent knowledge of the Medicare Program particularly as it relates to CPT and ICD9 coding CPT. Thorough knowledge of Medicare Fraud and Abuse regulations
- Possesses advanced knowledge of the Practice Management System. Possesses the ability to run standard reports in order to answer questions from practice manager and physicians
- Possess thorough knowledge of HIPAA regulations
238
Revenue Cycle Supervisor Resume Examples & Samples
- Consolidates/communicates problems within the Accounts Receivable (AR) and EDI Teams to the Revenue Cycle Managers and works with the Revenue Cycle Managers to resolve such problems
- Assists with changes and/or improvements to AR and EDI internal processes, policies and procedures
- Performs AR and EDI Team daily tasks
- Reviews AR reports and EDI rejections and develops plan of action and changes in work flow to improve revenue cycle and reduce timeline for claim payment
- Sets up patient appointments with Patient Services Department when needed
- Works directly with other West Clinic Departments to improve the revenue cycle
- Works with payers, EMR company and clearing house to improve revenue cycle
- Reviews EOBone for unpaid or incorrectly paid claims
- Develops procedures and policies AR and EDI
- Works in conjunction with MLH to create charity write-offs for mutual patients
- Assists with training/education processes, particularly AR and EDI personnel as needed
239
Revenue Cycle Director Resume Examples & Samples
- Bachelor's Degree in healthcare, finance, or related field required
- Understanding of CPT, HCPCS, APC, DRGs, and OPPS/IPPS required
- Highly motivated team player who demonstrates competency in working in teams and ability to effectively communicate with all levels as well as the ability to prioritize and work multiple projects simultaneously
- Demonstrated leadership in creating and implementing new processes
- Must possess a high level of interpersonal skills and strong analytical and financial abilities
- A minimum of 7 years' of progressive experience in health care management such as but not limited to clinic management, patient management, accounts receivables and payables
- A minimum of 2-5 years of experience serving the role of revenue cycle director directly reporting to a system CFO of finance team
- Willingness to work flexible hours
240
Healthcare Revenue Cycle Supervisor Resume Examples & Samples
- Produce monthly statistical reports for management on billing-related tasks; maintain statistics for quarterly and annual reporting
- Knowledge and ability to lead teams in process redesign/change management
- Conduct bill revenue and cash analysis to identify areas of opportunity for revenue enhancement
- Implement, monitor, and revise annual goals, objectives, and performance standards including team metrics
- Monitor, track, and evaluate staff productivity and performance and provide summary report to management
- Overseeing department training and individual development
- Collaborate with IT to development system enhancements and automation opportunities
- Strong organizational skills with the ability to work on multiple, complex projects with high quality results
241
PFS Revenue Cycle Representative Resume Examples & Samples
- Review and correct all billable claims in billing software in accordance with payor specific guidelines and billing requirements within one working day
- Work with HIM and applicable departments to resolve questions related to modifiers, orphan CPT/HCPCS codes, charge entry errors, ICD-9 and CPT/HCPCS coding errors, and other questionable claim form elements such as discharge disposition
- Perform timely and appropriate follow-up to resolve unbillable claims. Using Interpoint, document in account notes all reasons for billing delays and actions taken. Apply the appropriate hold reason code in billing software
- Process secondary billing in accordance with department procedures
- Every time an account is accessed, review and correct all account discrepancies, update demographics and other field values such as mnemonic, insurance and billing information, etc., to ensure data integrity in Cerner/Meditech as well as in the billing software
- Review all high dollar claims for potential stop-loss criteria and direct stop-loss claims to correct payor processing unit
- Prepare and submit appropriate billing attachments as required by specific payors
- Mail paper claims to appropriate payors
- Review daily claim rejection reports, resolve rejection issues, and resubmit corrected claims to ACS within 24 hours of rejection
- Collaborate with manager to resolve claim submission delays exceeding five working days
- Inform manager of recurring claim errors in order to facilitate system improvements
- Review and resolve non-covered charges according to facility procedures
- Review late charge report. Submit late charge or adjustment claims, or write off late charges as appropriate per facility procedures
- Review assigned Interpoint worklists to ensure appropriate and timely actions are completed
- Review and respond to mail, correspondence and reports on a daily basis
- Validate that all charges and/or accounts have been combined in accordance with regulations prior to claim submission
- Request and submit interim claims on long-term care inpatients every 30 days
- Perform timely and appropriate follow-up on unpaid, underpaid, suspended, and denied accounts
- Review credit balance accounts and take appropriate action to resolve the credit balance
- Review remittance advices to ensure payments are correct for services rendered and resolve payment discrepancies
- Submit adjustment request to reduce account balance for “not medically necessary” (failed) services where an ABN was not obtained
- Document payment details in patient account notes according to EOB documentation standards
- Evaluate EOBs and remittance advices by comparing amount paid against the expected reimbursement amount
- Evaluate denials to determine if appeals are warranted
- Submit adjustment requests as necessary to ensure that contractual discount amounts are correct according to contract terms
- Close carrier on correctly paid accounts when patient owes a share of cost (SOC), update financial class to next carrier and validate that account balance matches total patient responsibility amount as determined by Medi-Cal
- Escalate unresolved or unreasonably delayed appeals to Manager for special handling and/or assessment
- Utilize all available tools and resources to perform follow-up in the most efficient manner electronic transactions, Internet, phone calls, etc
- Submit denial adjustments on denied amounts not likely to be paid on appeal, if not billable to a subsequent payor
- Understand and comply with all current Medi-Cal regulations
- Work with departmental staff, hospital departments, physicians, physician’s office staff, government agency and insurance company representatives, patients, consultants and co-workers
- Maintain confidentiality of all patient information
- Ensure all billing documentation required by payers, including but not limited to CPT-4, HCPCS and ICD-9 coding, prior authorization, provider identifications, primary and secondary insurance, patient demographics, insured identification, charges and dates of service are complete and correct
- Complete claims submission on a daily basis
- Follow-up on 50 accounts per day. Follow-up is defined as activity performed that creates account resolution
- Percentage of accounts receivable > 60 days must remain below 36.0% of the total outstanding Medi-Cal balance on a monthly basis
- Percentage of accounts receivable > 90 days must remain below 15.0% of the total outstanding Medi-Cal balance on a monthly basis
- Percentage of accounts receivable > 120 days must remain below 10.0% of the total outstanding Medi-Cal balance on a monthly basis
- Percentage of accounts receivable > 180 days must remain below 6.0% of the total outstanding Medi-Cal balance on a monthly basis
- Ability to follow oral and written instructions and interpret institutional and other policies accurately
- Knowledge and appropriate use of electronic claims billing system
- Ability to work effectively with individuals at all levels of the organization
- Knowledge insurance and medical terminology
- Knowledge of accounts receivable system like SMS, IDX, or Meditech
- Knowledge of computer systems and software used in functional area
- Knowledge of one or more of the following: Medicare, Medi-Cal, Worker's Comp or Managed Care (HMO,PPO,POS, etc)
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VP, Revenue Cycle Resume Examples & Samples
- Responsible for all aspects associated with planning and delivering of the highest quality customer focused Revenue Cycle (over $1b net patient revenue) through a combination of direct and indirect oversight of the various revenue cycle departments
- Directly supervises day-to-day activities of the City of Hope National Medical Center revenue cycle staff and 3rd Party revenue cycle service providers, as well as provide oversight of the revenue cycle across the wider network to ensure that processes are coordinated and end-to-end performance is optimized
- Functions as a change agent; leads the enterprise-wide development and implementation of revenue cycle strategies that are optimal and consistent with best practice processes
- Provides support and information to the medical staff with regards to health information with the goals of optimizing revenue and promoting billing compliance
- Assesses and responds to current and future internal and external healthcare trends in order to establish and ensure the necessary direction for the revenue cycle activities
- Ensures Revenue cycle goals including Medical Center A/R days, cash and bad debt are delivered
- Responsible for coordinating and enhancing the development of data collection, analysis and reporting processes for senior management of the revenue cycle, including information integrity validation and interpretation
- Oversee the financial interface between and performance analysis of the patient financial services functions and other fiscal services functions
- Maintain a collaborative supporting relationship with other management staff across the network and encourage direct reports to do likewise to ensure integration of patient processes that will achieve optimal patient and financial outcomes
- Directly participate in completion of various financial forecasts, including cost center salary and direct expenses, month-end financial reporting, receivables, cost center productivity, and strategic plans for the department
- Lead Monthly Revenue Cycle Steering Committee Meetings, Participate in revenue cycle, denial management, charge master, and access management meetings
- Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers
- Bachelor’s Degree in Finance, Accounting, Economics or related field required
- Must have a minimum of ten (10) years of experience in a financial leadership role and demonstrated experience in a leadership role in hospital revenue cycle management
- Must be proficient in MS Office Suite, PeopleSoft and EPIC
- Thinks strategically; develops and operationalizes plans in accordance with the organization’s mission
- Demonstrated understanding of healthcare financing, strategy, community benefit, and charity care
- Exhibits strong executive presence, outstanding written and verbal communications skills, and public speaking skills
- Displays a passion for healthcare and for making a difference. Expresses commitment to City of Hope’s mission, personally identifies with its vision
- High ethics and strong set of values. Unwavering integrity. Demonstrated courage
- Exhibits flexibility while influencing others and is open-minded on alternative means of getting needed business results; excellent negotiation capabilities
- Anticipates needs, responds quickly, provides guidance and support, monitors and follows up as required
- Approaches change by accomplishing milestones and works with and through others to drive change
- Able to handle stressful situations yet remain calm in crisis
- Master’s Degree in Business, Finance, Accounting, Economics or related field
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Senior Revenue Cycle System Analyst Resume Examples & Samples
- Acts a liaison among stakeholders to identify opportunities and support efforts to develop and maintain all assigned applications to better meet the needs of the end user
- Maintains a working knowledge of all assigned application structures, and operating practices. Understands each application’s purpose and how it supports the end user’s needs
- Performs the daily maintenance operations necessary for the effective and efficient use of the application
- Initiates all additions and modifications to the application’s table structure after completion of appropriate testing and receipt of necessary approval
- Investigates business system issues, identifies opportunities for improvement and in conjunction with Information Systems develops and implements a plan to resolve or address
- Performs integration and acceptance testing, supports the development of training and implementation materials and accepts and addresses customer feedback about the provided service utilizing quality measures
- Performs data analysis and reporting by extracting data, preparing reports, graphics and analysis as needed to ensure operating processes are conducted and completed in an accurate and efficient manner. Works with management on process improvement efforts which are based on data results that are impacting financial outcomes, including the need for staff retraining and/or process flow modifications
- Identifies, troubleshoots and oversees the resolution of application functionality issues
- Responsible for leading projects related to the management and coordination of complete and accurate system data collection, claims analysis, and issue resolution
- Identifies opportunities for process improvement changes and makes recommendations to Director Revenue Cycle
- 2+ years of experience in writing business and / or system requirements and business / finance analysis
- 2+ years of experience with documenting processes and practices in an revenue cycle operational setting
- 2+ years of MS4 Experience or similar programs such as Meditech or Epic or others
- 2+ years of Revenue cycle experience from an Acute Care Setting
- Bachelor's degree in Business, Finance, Health Administration or related field or equivalent work experience
- 2+ years of Cerner Experience
- Previous experience with SQL
- Previous Healthcare Industry experience
- Previous Team Lead or Project Lead experience
244
Supervisor, Revenue Cycle Resume Examples & Samples
- Full time Supervisor for weekend and holiday staff of 27 - 30
- Serve as floating supervisor during the week for a staff of up to 92 team members
- Supervise and manage the Registration and Insurance Verifications as well as Patient Accounting
- 2 or more years of experience in patient accounting, patient registration, insurance verification and/or patient access
- 5 or more years of experience in a healthcare setting
- Proficiency in Excel, Word , PowerPoint and Outlook
- Must be able to work weekends and holidays
- BA Degree
- Union Experience
- Hospital experience
245
G-revenue Cycle Management Associate Resume Examples & Samples
- Open, deliver, route, scan, log and process incoming correspondence (faxes, mail, emails, return mail/email)
- Investigate and process billing, service order, collections, payment and audit/control related systems exceptions for timely and accurate revenue recognition
- Excellent communication skills with external customers, vendors and other employees
- Solid math skills
- Ability to investigate, review and reconcile financial transactions
- High School Diploma (Associate’s Degree preferred)
- 1-3 years of Customer Service or Financial Business Experience in an office setting
- Demonstrated experience of common business applications such as Microsoft Office (MS Word, MS Excel, MS Outlook)
- Must possess excellent interpersonal verbal and written communication skills
- Satisfactory completion of validated skills testing, as determined by the Company
246
VP, Revenue Cycle Resume Examples & Samples
- Builds a world-class outsourcing office through strategic hires, mentorship, and establishing a culture of accountability
- Promotes a service-oriented culture within the Winston-Salem office and assures client satisfaction with the quality of the AR services performed and feedback provided
- Meets regularly with all clients to review project results, identify improvement opportunities and communicate financial impact
- Assures satisfaction among customer groups with the quality and amount of support provided by monitoring and responding appropriately to outcomes and feedback
- Responsible for reporting any detected trends in payments or denials, as well as procedural problems, to the client
- Makes recommendations regarding the correction of these trends and/or problems
- Manages and balances future business opportunities with required resources to maintain excellent service delivery
- Continually seeks ways and means for improving the delivery and support of AR services performed in Winston-Salem
- Establishes and tracks key metrics for project success such as: imports, bills, touches, untouched accounts, productivity, quality, collections, etc
- Establish productivity monitoring for billing and collection follow-up staff to maximize resources and results
- Set processes and tools in place to consistently achieve monthly cash and margin goals
- Maintain a current working knowledge of all patient financial and healthcare related issues and regulations
- BA/BS in business or related concentration
- 7 years’ experience in the healthcare industry including 4 years’ experience leading a large Accounts Receivable team
- Hands-on experience and oversight for the billing, follow-up, cash application, and customer service areas, including the ability to represent the revenue cycle at all levels of the organization
- Experience in client facing at C Suite level
- Solid understanding of the revenue cycle industry
- Thorough knowledge of AR services drivers in a healthcare system / IDN setting
- Execution-oriented and able to thrive within a fast paced environment
- Strong financial acumen; ability to develop budgets, forecast revenue, develop early warning signs and adapt the organization to achieve financial targets
- Superior analytic and problem solving skills
- Solid knowledge of all MS Office Products
- Demonstrated leadership and organizational skills with the ability to facilitate and influence decisions by motivating others to achieve excellence in both the quality of work and their approach to team work
- Graduate degree, preferred
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Cerner Revenue Cycle Resume Examples & Samples
- Has 3 years minimum experience in managing Cerner Millennium Charge Services as it relates to Clinical Charge Capture
- Expert Knowledge in Cerner Millennium Alpha Billing within PowerChart
- Functional Knowledge of the cspricingtool and cstiermaint
- Functional Knowledge of how to monitor and resolve Suspended Charges in Cerner Millennium
- Functional Knowledge of how charges get dropped or created in Cerner Millennium and then interfaced into a foreign system
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Revenue Cycle Denial Analyst Resume Examples & Samples
- Responsible for prioritizing and managing to resolution denied claims with third party payers. Research, develop and maintain a solid understanding of payer requirements, including filing limit, claim processing logic, coordination of benefits requirements, patient responsibility and authorization requirements
- Ability to triage denied claims to identify those that should be appealed. Responsible for writing timely, comprehensive and compelling appeals to third party payers in order to get denial overturned. Responsible for timely follow up on filed appeals via telephone, writing, or the payer website
- Organizes, maintains and updates the access payer database to house the issues that need to be addressed with third party insurers, as well as maintaining an expert knowledge of the history of prior disputes and problems to prevent them from recurrence. Applies findings to internal systems and workflows such as pre-billing edits and system automation
- Performs ongoing analysis to determine the root cause of denials and makes well thought out recommendations for workflow, operations or systemic changes. Maintains action plans for improvements
- Compiles, maintains and distributes reports to management on success of appeals and root cause analysis. Serves as department resource related to denials and payer requirements
- High School diploma or GED required. Bachelor's degree preferred
- 1-3 years related work experience required
- Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases
- 3 -5 years Healthcare related experience
- Problem Solving:Ability to address problems that are highly varied, complex and often non-recurring, requiring staff input, innovative, creative, and Lean diagnostic techniques to resolve issues
- Independence of Action:Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager
- Written Communications:Ability to communicate clearly and effectively in written English with internal and external customers
- Oral Communications:Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers
- Team Work:Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments
- Customer Service:Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations
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Revenue Cycle Epic Applications Manager Resume Examples & Samples
- Partners with subject matter experts and other Electronic Health Record (EHR) AMs to ensure build consistency and successful end to end patient centric workflow
- Identifies and plans appropriate training for team members and leads the team in attaining a high level of application knowledge
- Responsible for implementing, administering, and supporting assigned systems under the minimal guidance of senior members of the team
- Minimum of 3 years of management/supervisory experience with demonstrated experience in information system development and advanced management practices
- Experience with implementing and supporting a major system in a clinical or system analyst capacity
- Epic implementation experience
- Understanding of Epic modules, ancillary systems, and health system operations
250
Revenue Cycle Financial Analyst Resume Examples & Samples
- Produce, publish and distribute scheduled and ad-hoc client and operational reports relating to the development and performance of products, processes and technologies
- Bachelors degree in Business, Finance, Health Administration, related field or equivalent work experience
- 2+ years of healthcare experience
- 1 +year of experience in business / finance including analysis experience with a solid understanding of data storage structures
- 1+ year of experience with project methodology (requirements, design, development, test and implementation)
- 2+ years of revenue cycle experience
