Revenue Cycle - Baystate Health
Req#: R23911
Category(s): Finance, Revenue Cycle
Full Time / Part Time: Full-Time
Shift: First
Summary:
The incumbent is responsible for collaborating with BMP Leadership, revenue cycle staff, and IT support personnel to design and implement effective processes that maximize patient revenue and collections under current regulations and contractual guidelines. The incumbent works closely with partners to ensure the efficiency and accuracy of patient and billing data flow to integrated, external, and vendor subordinate systems. This position reports to the Director Revenue Cycle Systems and Performance Excellence and will collaborate closely with other leaders within the MPBS and outside the department.
The incumbent is expected to aid in the resolution of complex issues through analysis, research and by interfacing with internal and external subject matter experts. The incumbent will support the practices for issues related to the front-end revenue cycle tasks, including but not limited to; scheduling, insurance, eligibility, referral, authorization, estimation, registration, check-in, billing and point of service collections. The incumbent will work collaboratively with the Revenue Cycle leaders responsible for those workstreams to ensure the BMP practice process flows compliment the system workflows to gain the maximum efficiency.
The Manager serves as a key member of the MPBS leadership team and is responsible for the internal communication of system and process changes related to professional billing to both MPBS and Practice staff.
Other core responsibilities include supervising and mentoring the Client Services Consultant (2FTE's) and the Claims Support team (7 FTE's) staff, which involves daily contact, the prioritization of workflow, and staff development through training.
Job Responsibilities:
1) Effectively manages the day-to-day front-end systems support staff to realize system and practice efficiencies, maximize cash flow, and maintain the accounts receivable of BMP.
2) Oversees and manages claims support functions, including claim, scrubber edits and charge corrections.
3) Performs complex business and clinical systems analysis and develops recommendations for changes to existing processes consistent with third party payer and regulatory guidelines.
4) Identifies, recommends, and implements system solutions that improve workflow for end users and enhance system performance.
5) Monitors and ensures resolution of all front-end user questions and issues. Reports and logs system related issues. Performs follow up, tracks progress and effectively communicates outcomes, and manages internal expectations.
6) Acts as a liaison between Information Services, MPBS, the Contact Center and the BMP practices and collaborates with constituents to revise and maintain effective BMP revenue cycle policies and procedures.
7) Participates in projects, upgrades, and implementations, serving as the subject matter expert for the MPBS operation.
8) Monitors compliance with all policies, procedures, and controls to ensure that adherence to front-end standardization processes at BMP practices.
9) Maintains a current working knowledge of governmental and contractual payment methodologies and can partner with departmental staff to translate these into operational processes.
10) Incumbent is expected to adhere to System and department compliance policies and all applicable laws and regulations
11) Attends and participates in all BMP manager, Revenue Cycle and Practice administrative meetings as required
12) Other duties as assigned.
You Belong At Baystate
At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.
DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.
Education:
Bachelor of Science (Required)
Certifications:
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.