NI-Manager, Revenue Cycle

J  o  b    D  e  s  c  r  i  p  t  i  o  n

JOB INFORMATION

Effective Date:

1/2/2012

Entity:

Illinois

Job Code:

NI-1652AC

Job Title:

NI-Manager, Revenue Cycle

Exemption Status:

Exempt

JOB SUMMARY

Under the direction of the Director of Revenue Cycle, the Manager is responsible for daily activities of planning, directing, coordinating and controlling the operation and activities of preauthorization, referral, registration, provider enrollment, charge capture, claims, follow up, insurance reimbursement, patient collections and patient payments, professional coding, nurse auditor, IS of the Revenue Cycle and training, revenue integrity for  related entities' hospital and professional services

This position is responsible for the financial control, supervision and support of the billing and collection for hospital and professional services.  The manager ensures timely and accurate payment and designs edits to ensure proper billing.  This position is responsible for the conduct, operations, and results of the supervisory staff to ensure that operations maximize reimbursement and are in compliance with state and federal regulations.  This individual also designs and implements procedures and systems to optimize efficiency and minimize the need for manual processing of accounts.

The Manager of Revenue Cycle manages projects for Revenue Cycle and supports enterprise-wide projects and initiatives that relate to SwedishAmerican Health System priorities, health care legislation and compliance, and systems redesign that support new initiatives, improved revenue, and/or reduced cost.

Working with Compliance, the Manager is responsible for investigating and self-reporting issues, developing and implementing solutions to address existing issues and implemented process to mitigate compliance risk.

The Manager of Revenue Cycle prepares and presents various statistical reports and budget justification requests; assists the Director in establishing departmental policies, programs, and procedures; and evaluates, initiates, and implements various departmental systems and procedures and revises these as necessary to maximize efficiency. This position also assesses personnel and fiscal implications of organizational changes of these programs; assists staff in implementation of changes; monitors and analyzes the impact of change.

MAJOR RESPONSIBILITIES

•

Manages operations for Hospital and Professional billing in the Single Business Office. Formulates department goals, objectives and strategic plans that integrate the organization’s values, service excellence philosophy and assure overall compliance with regulatory, safety, security, accrediting body and hospital standards.

•

Encourage, coach and support Supervisors and staff to inspire professional, compassionate performance to create memorable customer experiences.

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Integrates and recommends changes as necessary which improve customer service, profitability and efficiency. Working closely with supervisors to insure a smooth implementing.

•

In conjunction with director and supervisors prepares and monitors department operating and capital budgets and analyzes monthly variances.

•

Oversees Supervisor and staff education and performance evaluation process ensuring competence and compliance with department and hospital rules and regulations and human resource policies. Maintains an environment that promotes positive change strategies and individual growth.

•

Monitors and evaluates Accounts Receivable, operational, financial outcomes and compliance standards making appropriate structural changes and communicating issues which need to be addressed to management, staff and other lines of business and meet with the Operation Managers, supervisor and providers at their site.

•

Work on projects that involve multiple resources in the assigned deadlines.

ALL DUTIES AND REQUIREMENTS MUST BE PERFORMED CONSISTENT WITH THE UW HEALTH PERFORMANCE STANDARDS.

X

Non-Clinical

JOB REQUIREMENTS

Bachelor's Degree

in business administration or an Associate degree in related field (equivalent experience may be substituted for educational requirements).

Required

Five years of experience in health care business setting and at least three years in related leadership role.

Required

Eight years of experience in a medical group practice or hospital business office for a complex health care environment.

Preferred

•

Ability to make good judgments in demanding situations.

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Ability to react to frequent changes in duties and volume of work.

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Effective communication skills.

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Ability to listen empathetically.

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Ability to logically organize details.

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Responsible for medium to large scale projects involving multiple resources and spanning many months from start to finish.

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Ability to manage multiple concurrent activities.

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Effective organizational, planning, scheduling and project management abilities.

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Effective leadership skills. Knowledge of supervisory skills and responsibilities.

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Ability to implement change in a positive, sensitive and forward-thinking manner.

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Planning and problem solving.

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Developing goals and objectives, and establishing priorities.

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Inspires confidence, Good judgment and ability to act decisively at the right time.

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Self-starter with a willingness to try new ideas.

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Positive, can-do attitude coupled with a sense of urgency.

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Ability to persuade others and develop consensus.

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Effective communication skills both in written and verbal presentation with a communication style that is open and fosters trust, credibility and understanding.

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Ability to analyze data and workflows in order to develop and analyze options, recommend solutions, and solve complex problems and issues.

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Strong customer service and human relations abilities.

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Ability to effect collaborative alliances and promote teamwork.

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Ability to insure a high level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders.

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Ability to use various computer applications is preferred including EPIC.

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Excellent PC operating skills (keyboard, mouse) and use of MS Office.

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Broad knowledge of health care and/or hospital business office practices and principles.

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Knowledge of general accounting principles.

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Knowledge of medical terminology.

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Knowledge and understanding of state and federal rules and regulations including laws regarding confidentiality, compliance, release of information, probate and lien legislation, Fair Debt Collection practices, and insurance regulations.

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Knowledge of third party payer practices including but not limited to precertification, filing deadline, claims processing, coverage issues, referral requirements.

PHYSICAL REQUIREMENTS/WORKING CONDITIONS

Standing

X

Walking

X

Climbing

X

Bending

X

Crouching

X

Pushing / Pulling

X

Carry

X

Fine Hand / Eye Coordination

X

Color Discrimination

X

Hearing Ability

X

Lifting / Lowering 1 -15 lbs.

X

15 - 30 lbs.

X

30 - 50 lbs.

X

Over 50 lbs.

UW Health does not require, nor does it expect that its employees lift more than 50 lbs unassisted. Objects in excess of 50 lbs should be lifted or moved with mechanical means or through a team lift. Employees in patient care areas are expected to utilize mechanical lifts and adhere to the "Use of Mechanical Lifts (Liko)" policy in the Patient Services Policy and Procedure Manual.

Concentration on Detail

X

Attention Span of 1 + Hours on a Task

X

Ability to Remember Multiple Tasks

X

Oral Communication

X

Written Communication

X

Exposure to Blood and Body Fluids

X

Exposure to Toxins, Cytotoxins, Poisons

X

Exposure to Extreme Heat, Cold, Temp Fluctuations

X

Exposure to Hazardous Chemicals

X

Exposure to Radiation

X

Note: The purpose of this document is to describe the general nature and level of work performed by personnel so classified; it is not intended to serve as an inclusive list of all responsibilities associated with this position.