Manager Front End Revenue Cycle Compliance position is responsible for complete oversight of the revenue cycle process and its staff, and will work collaboratively with the PO CBO, Finance Manager and Administrator. The position is responsible for monitoring, tracking all billing charges to be sure they are captured in an appropriate manner and identifying, analyzing, and reconciling billing errors or omissions. The position monitors and assesses current procedures with the goals of improving quality of services provided by the department and maximizing revenue. The position will be departmental/front end subject matter expert on all billing, revenue cycle, insurance authorization questions, EPIC work queues, EPIC cube report building, etc.
The manager position responsibilities include managing the daily work activities of the work unit/department staff, ensuring quality, productivity, functional excellence and efficiency while assisting management in accomplishing strategic and operational objectives. In addition, this position provides guidance to staff and is responsible for staffing, budget compliance, contributing to staffing decisions such as hiring and terminating employment, coaching and counseling employees on work related performance, and assisting in the development and implementation of policies and procedures to ensure a safe and effective work environment. This position also implements training, monitoring and operations initiatives that assure compliance with ethical and legal business practices and accreditation/regulatory/government regulations.
PRIMARY JOB RESPONSIBILITIES
Job responsibilities labeled EF capture those duties that are essential functions of the job.
PEOPLE - 30%
- Performs management responsibilities of selection, scheduling, supervision, retention, and evaluation of employees in Front End Revenue Cycle Compliance department. Provides development and mentoring of staff. Meets or exceeds threshold goal for department turnover. Develops direct reports to perform these same functions. (EF)
- Provides leadership and communication to maintain a competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees, completing performance appraisals, conducting new hire feedback sessions, coaching/corrective counseling, and providing recognition/commendations to achieve desired outcomes. Provides timely guidance and feedback to help others strengthen specific knowledge/skill areas needed to accomplish a task or solve a problem. (EF)
- Facilitates the promotion of teamwork within and between departments; participates and/or leads and facilitates department process improvements as needed. (EF)
- Meets or exceeds threshold goal for department and/or system metrics on employee engagement indicators: action readiness score, tier level. (EF)
- Serve as the liaison and advocate between department and DBO to monitor revenue team responses to practice issues/concerns and ensure appropriate follow-through. Act as escalation resource when needed.
SERVICE - 30%
- Plans and organizes day-to-day Front End Revenue Cycle Compliance department operations, schedule and activities. Sets priorities and functional standards, giving direction to staff as necessary to ensure the best possible delivery of service and high customer/patient satisfaction. (EF)
- Drives department service standards and activities to impact department and/or system score for patient/customer-based satisfaction, through role modeling and fostering accountability. Serves and actively participates on various entity committees as a voice for the Front End Revenue Cycle Compliance department. (EF)
- Responsible for front-end denial monitoring/trending and education, collaborating with divisional managers and staff to reduce and prevent front-end denials to allow for timely payment.
QUALITY/SAFETY - 10%
- Ensures a safe and effective working environment; monitors and/or revises the Front End Revenue Cycle Compliance department safety plan and/or any specific accreditation/regulatory required safety guidelines. (EF)
- Uses and optimizes information systems to enhance operations; supports entity-specific performance improvement and data management/analysis functions. (EF)
- Employs a proactive approach in the optimization of safe outcomes by monitoring and improving the department workflow, using peer-to-peer accountability, and identifying solutions via collaboration. Adopts lean principles in driving process improvements. Role models situational awareness, using teachable moments to improve safety. (EF)
- Monitors self and employee compliance with policies, procedures, and System HR Standards of Practice and performs associated actions upon non-compliance (i.e., focal point review requirements, disaster plan, inservices, influenza immunization, wage and hour, standard hours, timely termination submission, timely timecard approval, etc.). (EF)
- Analyze front-end related trends, proposing recommendations to decrease ongoing deficiencies.Subsequently, work collaboratively with front-end stakeholders to reduce actions that impact insurance, registration, billing, claims, reimbursement and collections performance.
- Responsible for driving process improvement initiatives related to front end revenue cycle functions, in collaboration with the operations leadership and satellite managers.
FINANCE - 20%
- Assists in the development of department budget and ensures that the department operates in a cost effective manner. Manages/audits department expenses within approved budget parameters, ensuring that the Front End Revenue Cycle Compliance department meets the budgeted/flex revenue and/or expense targets on a monthly and annual basis. Develops staffing plans and schedules to meet department needs that reflect understanding of the importance of cost-effectiveness. (EF)
- Implements department strategies to achieve financial target and staffing needs, developing others to do the same, through optimizing productivity, supply/resource efficiency, minimizing incidental overtime and overtime percentage, and other areas according to department specifications. (EF)
- Manage the day to day billing operations within the departments with special emphasis on the front-end systems to assure that all information provided to CBO is accurate and timely across all divisions and locations. This includes registration, scheduling, referral management, front end charge review work queue, co-pay collection, self-pay collection, etc.
GROWTH/INNOVATION - 10%
- Identifies and implements innovative solutions for practice or workflow changes to improve department operations or other department-specific measures by leading unit projects and/or other department/system directed activities. Supports change initiatives, maintaining effectiveness when experiencing major changes in work responsibilities or environment; adjusts effectively to work within new work structures, processes, requirements or cultures. (EF)
- Proactively evaluates processes; recommends and implements action plan(s) for change. Participates in the development and implementation of new procedures and the review and revision of existing procedures. (EF)
- Identifies opportunities and takes action to build strategic relationships between one's area and other areas, teams, departments, and units to achieve business goals. (EF)
- Seeks opportunities to identify developmental needs of self and staff and takes appropriate action. Ensures own career discussions occur with appropriate management. Completes and updates the individual development plan (IDP) on an on-going basis. Conducts conversations with staff on their development and IDP. (EF)
- Ongoing responsibility to identify opportunities to help address preventable loss of revenue.
This job description is not intended to be all inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.
Bachelor's degree required
- Minimum 5 years of experience to include revenue cycle process oversight to include, but not limited to, report generation, authorization, analytical review, financial analysis of revenue cycle, resolution of denials, charge capture, work queue review, and insurance authorization
- Minimum of 2 years of Supervisor experience
- Excellent communication and analytical skills, including financial reporting
CERTIFICATIONS, LICENSES AND REGISTRATIONS REQUIRED