Summary:This Manager, RCM Operations is responsible for the day to day supervision of a Claims Resolution Service Team. This individual supervises the Reimbursement Specialists and oversees the quality and performance of a Claims Resolution team responsible for claims processing to final claims resolution. Identifies areas of improvement or trends by monitoring leading and lagging indicators in key performance areas in order to enhance the clients overall service experience. This individual will use conclusions from this monitoring to facilitate system or service improvements that improve the financial and business performance of their assigned client base. The Manager is ultimately responsible for client outcomes and providing meaningful client deliverables that provide clients feedback and metrics by which the client can measure AdvancedMD Medical Billing Service's business performance.
ESSENTIAL JOB FUNCTIONS:
Manage and motivate Claims Resolution Service Team to analyze and create solutions that enhance the client experience and outcomes.
Oversees the daily activities and workload for their Client Resolution Service Team.
Mentor Claims Resolution Service Team and create a vital team culture
Assist in the development of standards of assessment for claims resolution and predictive claims outcomes, working directly with peers in Utah, Georgia, and India.
Collaborate cross functionally within the organization to ensure consistent client service levels are met.
Assists in the development and documentation of processes and workflows as assigned
Develop and report on key metrics that monitor claims resolution and service levels are being met with attention to efficiency and improved business performance.
Provide consistent and reliable reporting on specified client service metrics as they relate to Client Experience initiatives and measurable goals
Provide deliverables relative to claims resolution, claims insight with possible workflow changes to strengthen the client partnership.
Continually look to decrease the time a claim will cycle to resolution through automation and all available technology.
Manage client escalations
Establish clearly defined department and individual goals and objectives and communicate these to associates through department meetings and performance planning. Provide periodic performance feedback versus objectives and conducts annual performance review on all associates. Responsible for hiring and terminations as required. Determines teams training requirements and ensures that timely and effective training is performed to enhance the skill base of the team.
Responsible for obtaining monthly performance metrics; adhere to all policies and procedures, within the most stringent attention to complying with all governmental and HIPAA mandated patient confidentiality regulations
Perform other duties as needed and directed by leadership
Bachelor or Associate Degree or equivalent in education and experience required.
- 10+ Years of medical billing experience
- 4-5 years of direct associate supervision experience required.
- 1-2 years of Client Facing experience.
- Experience in a large Revenue Cycle Management Company Preferred.
- Prior experience creating and maintaining department policies and procedures with a focus on continuing staff education.
- Strong working knowledge of Windows, MS Word, Internet Explorer, Excel, PowerPoint.
- Strong leadership skills with a proven track record of motivating, mentoring and supervising a team of billing and reimbursement specialists.
- Focus on quality of service as a driving principle.
- Understanding and commitment to process improvements that are driven by a deep commitment to a continuously improved client experience and business outcomes.
- Excellent written and oral communications skills
- Strong organizational skills with a customer service focus and attention to detail.
- Ability to prioritize effectively and handle shifting priorities professionally
- Strong analytic and problem solving capabilities
- Self-starter, with the ability to organize work for maximum efficiency and attention to quality
- Proven ability to meet deadlines in a fast-paced environment
- Some travel required
Global Payments Inc. is an equal opportunity employer.
Global Payments provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex (including pregnancy), national origin, ancestry, age, marital status, sexual orientation, gender identity or expression, disability, veteran status, genetic information or any other basis protected by law. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department.
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