Job Description Summary:
This position provides operational management for all aspects of assigned area(s). Adheres to the philosophy, policies, procedures, goals, and budget of the assigned area(s) and Logan Health (LH). Ensures exceptional customer service and solid understanding of State and Federal regulations and requirements to assure compliance.
Qualifications:
- Minimum of one (1) of the following required:
- Bachelor’s degree in a related field.
- Minimum of five (5) years’ experience within Revenue Cycle.
- Minimum of five (5) years’ experience in healthcare operations.
- Minimum three (3) years’ leadership experience required.
- Certification(s) required by specific area:
- Professional Coding: CPC, CCS, CCS-P, RHIT, or RHIA
- Facility Coding: CPC, CCS, RHIT, or RHIA
- Comprehensive knowledge of regulations related to Medicare, Medicaid and other third-party payers, HIPAA, and Compliance programs required.
- Experience in process improvement projects and processes required.
- Excellent organizational skills, detail-oriented, a self-starter, possess critical thinking skills and be able to set priorities and function as part of a team as well as independently.
- Commitment to working in a team environment and maintaining confidentiality as needed.
- Excellent verbal and written communication skills including the ability to communicate effectively with various audiences.
- Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
- Possess and maintain computer skills to include working knowledge of Microsoft Office Suite and ability to learn other software as needed.
Management Job Duties:
- Strategic Execution: Drive organizational objectives by operationalizing changes and initiatives effectively and efficiently. Proactively anticipate both the needs of Logan Health and the impact operations has on the organization’s success. Collect and analyze data, prepare and present recommendations, and explain associated benefits and risks for improving operations.
- Business Acumen: Demonstrate and further develop competencies in the areas of leadership, financial management, employee engagement, human resources knowledge, organizational dynamics and governance, organizational communication, strategic planning, change management, risk management, compliance, patient safety and quality improvement. Demonstrate professional ownership, self-development and a desire for life-long learning.
- Emotional Intelligence: Serve as a role model for others by exhibiting the Logan Health core values: integrity, compassion, service, excellence and ownership. Lead and influence the team to provide outstanding customer service. Develop and foster relationships with other Logan Health leaders, departments and members of the team to support open communication, trust, transparency and collaboration.
- Leadership: Creates a supportive department culture by fostering individual motivation, coaching and training for optimum job performance. Collaborates with Human Resources to develop, implement and support programs and processes that add value to Logan Health, its leadership and employees. Leads to improve culture, employee and physician engagement, empowerment, growth and retention, while remaining committed to Logan Health’s management and prosperity for its customers, employees and community.
Job Specific Duties:
- Ensures standardized processes, procedures, and policies across Logan Health as applicable to assigned area(s).
- Develops and implements policies, procedures, and training to guide and support service, and ensures orientation and continuing education as applicable to assigned area(s).
- Ensures optimum customer service for assigned area(s). Institutes and monitors proper procedures to ensure effective communication between hospital, practices, and other system entities.
- Manages budget processes for assigned area(s). Prepares departmental financial, operating and performance variance reports. Compiles, interprets, analyzes and communicates reports and information.
- Works with appropriate stakeholders to ensure the highest standards of business performance. Provides timely information regarding status of business and recommends future plans of action to improve overall business practice.
- Consistently identifies ways to improve, enhance and streamline the processes and experience.
- Exhibits behavior that aligns with Logan Health’s mission, visions, values, policies and procedures.
Area Specific Job Duties:
Facility Registration and Ambulatory Registration:
- Oversees and coordinates assigned staff in Patient Access positions for LH hospitals or clinics.
- Engages in audits of registrars by ensuring compliance with federal regulations and LH policies and procedures.
- Serves as a subject matter expert in Patient Access areas including (but not limited to) patient insurance, point of service collections and federal and state requirements as it relates to patient registration.
Financial Clearance:
- Oversees and coordinates assigned staff within LH Pre-Registration and Authorization departments.
- Engages with operational stakeholders to ensure excellent communication between the financial clearance department, and appropriate stakeholders.
Revenue Cycle Compliance:
- Coordinates compliance related activities in partnership with the LH Compliance department. This includes, but may not be limited to; post-payment audits, prepayment audits, state specific audits, internal audits, monitoring and collaboration with Revenue Cycle departments to ensure compliance with state and federal regulations.
Patient Accounting:
- Oversees assigned team of Patient Accounting Specialists. The team will be responsible for all patient billing activity within the scope of assigned area.
- Scope of assigned area limited to one (1) of the following:
- Payer-alignment
- Cash posting
- Customer service
- Leads process improvement efforts to improve the accuracy and/or efficiency of work completed.
Denials:
- Oversees and coordinates assigned Denial Management staff with claim denials for patient related services.
- Identifies trends in denials and prevention strategies with appropriate stakeholders.
Facility Coding:
- Oversees and coordinates assigned LH Facility Coding staff.
- Leads internal and external audits of assigned staff.
- Leads process improvement efforts to improve the accuracy and/or efficiency of work completed.
Professional Coding:
- Oversees and coordinates assigned LH Professional Coding staff.
- Partners with LH operational leaders and provides feedback and education related to professional coding changes or opportunities.
- Leads internal and external audits of assigned staff.
Health Information Management (HIM):
- Oversees and coordinates assigned LH HIM staff to include; medical record specialists, release of information specialists and transcriptionists.
- Collaborates with LH Compliance department and ensures compliance with federal requirements pertaining to patient medical records, release of information and patient accounts.
Charge Master and Charge Capture:
- Responsible for integration and maintenance of LH charge masters.
- Ensures compliance with billing and coding regulations as it pertains to the charge master.
- Collaborates with operational leaders and oversees LH charge capture and assists in department specific charge capture initiatives and optimization.
The above essential functions are representative of major duties of positions in this job classification. Specific duties and responsibilities may vary based upon departmental needs. Other duties may be assigned similar to the above consistent with knowledge, skills and abilities required for the job. Not all of the duties may be assigned to a position.
Maintains regular and consistent attendance as scheduled by department leadership.
Shift: Day Shift - 8 Hours (United States of America)
Schedule Details:
Please know schedules and shifts are subject to change based on patient care and department/organizational needs.
Schedule:
Logan Health operates 24 hours per day, seven days per week. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.
Notice of Pre-Employment Screening Requirements:
If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes:
- Criminal background check
- Reference checks
- Drug Screening
- Health and Immunizations Screening
- Physical Demand Review/Screening
Equal Opportunity Employer:
Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources.
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