- Professional
- Office in Silver Spring
Minimum Education
Associate's Degree (Required)
Bachelor's Degree (Preferred)
Minimum Work Experience
5 years progressively responsible experience in healthcare revenue cycle operations for a large, complex health care environment, including experience in an academic medical center. (Required)
2 years direct supervisory experience. (Required)
Required Skills/Knowledge
Superior customer service skills and professional etiquette.
Expert knowledge of Medicare and third-party payer reimbursement preferred.
Intensive knowledge in managed care requirements as they relate to hospital reimbursement
Strong written and oral communication skills
Attention to detail and ability to multi-task in complex situations
Demonstrated leadership, financial, and management skills
Demonstrated ability to solve problems independently or as part of a team
Knowledge of and compliance with confidentiality guidelines and CNMC policies and procedures
Knowledge of insurance requirements and guidelines for Governmental and non-Governmental carriers
Knowledge of and compliance with regulatory guidelines, such as JCAHO guidelines, HIPAA, EMTALA
Experience with IT systems related to patient access, patient accounting
Experience in department budget and interpersonal communication preferred.
Bilingual a plus
Functional Accountabilities
Operational Duties
Program and Service Administration and Implementation
Organizational Accountabilities
Organizational Accountabilities (Staff)
Organizational Commitment/Identification
Teamwork/Communication
Performance Improvement/Problem-solving
Cost Management/Financial Responsibility
Safety
Associate's Degree (Required)
Bachelor's Degree (Preferred)
Minimum Work Experience
5 years progressively responsible experience in healthcare revenue cycle operations for a large, complex health care environment, including experience in an academic medical center. (Required)
2 years direct supervisory experience. (Required)
Required Skills/Knowledge
Superior customer service skills and professional etiquette.
Expert knowledge of Medicare and third-party payer reimbursement preferred.
Intensive knowledge in managed care requirements as they relate to hospital reimbursement
Strong written and oral communication skills
Attention to detail and ability to multi-task in complex situations
Demonstrated leadership, financial, and management skills
Demonstrated ability to solve problems independently or as part of a team
Knowledge of and compliance with confidentiality guidelines and CNMC policies and procedures
Knowledge of insurance requirements and guidelines for Governmental and non-Governmental carriers
Knowledge of and compliance with regulatory guidelines, such as JCAHO guidelines, HIPAA, EMTALA
Experience with IT systems related to patient access, patient accounting
Experience in department budget and interpersonal communication preferred.
Bilingual a plus
Functional Accountabilities
Operational Duties
- Ensures that patient experience and service standards are met. Works with manager to gather and monitor departmental and program specific productivity and quality of service statistics.
- Monitors the accuracy of demographic and insurance information obtained by staff for patient registrations and authorizations and communicate any concerns to manager.
- Works with team to ensure accurate and timely claims submission.
- Investigates errors, suggests changes and/or implements solutions to encountered problems. Escalates issues to manager when appropriate.
- Keeps abreast of insurance, referral, and billing requirements. Requests system enhancements as needed to facilitate accurate registration and prior authorization and to support financially clearing a patient for services.
- Supports process improvement projects across the department.
- Supervise daily functions and activities of the Financial Clearance Unit
- Work with manager on staffing plans that effectively manage patient/account workload while adhering to departmental budgetary guidelines
- Monitors and drives productivity to optimize staff utilization and efficiency
- Utilizes strong problem-solving skills to provide resolution to departmental challenges, i.e. staff performance, morale, customer complaints, backlogs in work, training deficiencies, etc.
- Effectively communicates expectations of staff roles and responsibilities, performance targets, and progress towards goals
- Promotes staff satisfaction through understanding, clarifying mutual expectations, coaching, development, and regular communication and feedback
- Coordinates and facilitates the development and delivery of training to staff. Implements and manages cross training to ensure adequate daily staffing coverage.
- Encourages staff to effectively prioritize, manage time, make good decisions, conduct proactive follow-up and document clearly
- Assists staff with prioritization and time management when appropriate
- Completes performance appraisals in compliance with organizational protocols and expectations
- Contributes to the strategic plan for department services, including short-term and long-term objectives
- Collects and analyzes customer feedback and evaluates service/department effectiveness
Program and Service Administration and Implementation
- Works with manager on strategic plan through management of day-to-day operations of department, division or service area
- Collaborates with manager to evaluate current as well as new program initiatives for effectiveness, feasibility and cost
- Ensures compliance with organizational and departmental policies and procedures, and regulatory standards
- Support manager with compiling and analyzing data for decision-making
Organizational Accountabilities
Organizational Accountabilities (Staff)
Organizational Commitment/Identification
Teamwork/Communication
Performance Improvement/Problem-solving
Cost Management/Financial Responsibility
Safety
