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Delegates projects, directs and monitors work efforts, identifies resource needs, performs quality review; and escalates functional, quality and timeline issues. (Does not include oversight of business office functions.)
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10 |
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Establishes processes, metrics and monitoring systems to maximize reimbursement and cash collections. Provides recommendations and corrective action as appropriate.
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10 |
Applies proven human resource management skills in staff selection, development, and evaluation. Fosters a strong culture of teamwork and quality customer service to all constituencies to ensure the quality of daily revenue cycle operations, effective interdepartmental collaborations, and the timely achievement of objectives.
- Determine staff needs; hire, assign duties, evaluate performance, approve time records and requests for time off, resolve complaints, and discipline as appropriate.
Develop and train staff; mentor, and provide career coaching; motivate staff, individually and as a group.
Remain current on university procedures related to recruitment, compensation, discipline, complaint resolution and equal opportunity guidelines.
Facilitates staff meetings.
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10 |
Collaborates with leadership from business units across the medical center (decision support, reimbursement, billing, medical records, clinical units, etc.), to propose new or revised standardization of criteria and measurements, improve workflows, coordinate activities, and resolve issues. Partners with information technology on enhancements and new systems for efficient billing, AR and patient accounting processes.
- In conjunction with clinical enterprise leadership, develops, and implements approved fee schedule. Make recommendation to leadership on approval for cash and injectable pricing
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10 |
Ensures implementation of all revenue cycle policies; establishes and revises procedures as needed. Researches best practices to maintain currency with industry trends.
- Perform high level financial analysis supporting the financial goals of the clinical enterprise. Independently research/recommend financial policies, implement innovative business procedures, and provide financial forecasting using market trend analysis.-Continuously identifies changes in reimbursement patterns that impact overall collection rate, working with revenue generating areas representatives.
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5 |
Ensures timely billing and follow-up on patient accounts, implementing sound processes, metrics and monitoring systems.
- Maintains appropriate programs and infrastructure to ensure a high level of customer satisfaction that includes patient friendly billing techniques, prompt service recovery and creation of an ideal patient experience. Investigates and promptly resolves patient problems or reported service dissatisfaction.Works with practices and staff to ensure compliance with all supporting documentation necessary for successful claims submission and reimbursement.
|
5 |
Meets the billing reporting needs for staff, physicians, executives and department management.
- Produces and communicates scorecards/dashboards on professional fee billing and collection activity with detailed reporting by physician/service line and/or department.-Ensures physicians are credentialed with facilities/payors so revenue can be billed in compliance with laws and regulations.
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5 |
Conducts assessments and coordinates the development of training program (job tools, aides and learning delivery methods). Ensures subordinate staff provides departments with ongoing education and training on revenue cycle management policies and procedures.
- Stay abreast of changing government billing regulations, new programs and revenue opportunities. Ensures managers, supervisors, staff and billing vendors are current with required codes, bill forms, electronic claims processing tools and documentation rules.
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5 |
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Serves as the liaison between the IT design/build/testing team, the deployment team, as well as revenue cycle and financial business owners.
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5 |
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Supervise/direct all activities related to the professional billing and collections of the billing vendor. Supervise/direct to ensure appropriate encounters, claims submission and appropriate payments are received. Interpret financial reports from the vendor and make recommendations for improvement. Provide high level financial review on key performance indicators from the vendor that include, but are not limited to, A/R management metrics for bad debt and A/R less than 120 days. Monitor and make recommendations if metrics are less than targets. Evaluate practices, physician finances and productivity, explore best practices and formulate recommendations and present options. Reads understands and advises on all aspects of the Health Sciences Comp Plan, including all policies and procedures associated with additional physician compensation.
Review, analyze and recommend negotiating contract rates and provide analysis on reimbursements levels.
Provide input and make a selection on service contracts that support billing and collections. Ensure contract performance metrics are defined and met, fees are competitive, and concerns are addressed/corrected.
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15 |
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Approves documented standards/practices to manage vendor's performance; ensure timely and accurate cash posting and application of accounts receivable adjustments, write-offs, account transfers, and appeals. Approves write-off, adjustments, refunds, and referral of accounts to collection agency.
Understands and applies third party payor contracting terms and educates billing vendor and revenue management staff on system edits and rules, monitors actual payments and denials against contractual terms and directs billing vendor to work with payors to reconcile under or over payments.
Oversees the operational management of the revenue management functions of UCR Health.
Manages and meets the operating budgets for assigned areas. Prepares departmental financial, operating and performance variance reports, and maintains internal policies and procedures.
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15 |
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Oversees the School of Medicine's Health Sciences Faculty Compensation Program.
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5 |
