Business Finance Revenue Cycle Utilization Manager

NeuroRestorative, a part of the Sevita family, provides rehabilitation services for people of all ages with brain, spinal cord and medically complex injuries, illnesses and other challenges. In a variety of locations and community-based settings, we offer a range of programs, including vocational and therapy programs, day treatments, and specialized services for infants, children, adolescents, Military Service Members and Veterans.


Monday-Friday (some flex start/stop times)

Salaried with full benefits


SUMMARY

The Manager of Revenue Cycle Utilization Review will report to the Chief Financial Officer and will be responsible for leading and managing successful Front End revenue cycle activities. He/she will lead the strategic planning, analysis, continuous quality and productivity improvements of the geographically dispersed/decentralized utilization review specialist, operations staff and other key members of front end field revenue cycle team. The ideal candidate will have experience in Front End revenue cycle management and patient service provision processes. The candidate must be an inspiring manager, able to attract motivate and retain an industry leading team. S/He must be comfortable working in a fast-moving and evolving environment. This is an amazing opportunity for the right candidate to lead a high impact, emerging function at a high growth division.


ESSENTIAL JOB FUNCTIONS

To perform this job successfully, an individual must be able to satisfactorily perform each essential function listed below.

• Build and manage a high performing team responsible for the front end cycle of revenue process, including but not limited to patient intake set up, recurring insurance eligibility/authorization, payor setups, insurance rate set ups, along with timely/accurate service provision capture

• Responsible for daily coordination and tracking systems of incoming service delivery documentation and support to ensure accurate system submission and setup; SME around systems and their use for gaining most efficiency

• Performs weekly, bi-weekly, and monthly reviews and verifies completeness of required information. Reports status of various service delivery targets and projects outcomes to supervisor (i.e. weekly non authorized service reporting, weekly trended service capture revenue reviews, weekly eligibility reporting)

• Help establish reporting communication to operations and field leaders regarding operations related front-end activities. He/she will be responsible for recommending ongoing improvements to further enhance revenue cycle performance in the department

• Actively engage in on-going communication with shared service center team to facilitate timely resolution and remediate root cause process issues coming from front end revenue cycle denials

• Assists in communication to respective parties to address areas of identified errors, corrections, or needed services related to billing units and over/under utilization areas.

• Maintains some functional knowledge base related to current and new funding Rules and Contracts, provides updates and information to supervisor and others specific to impact on service delivery, authorizations, utilization of services and billing team.

• Identify, develop and implement consistent front end revenue cycle policies and procedures across sites and regions

• Drive front end process changes that lead to more successful revenue cycle outcomes and an improved collection experience for the business

• Develop tools and dashboards that are regularly reviewed to ensure performance targets are met for core Front End KPI metrics

• Determine appropriate internal staffing levels; recruit, hire, and onboard new staff

• Monitor staff and supervisor productivity to ensure timely and accurate work completion

• Support staff and supervisor quality audits and approve employee performance evaluations

• Actively maintain up-to-date best practice healthcare and revenue cycle/billing knowledge

• Actively maintain up-to-date knowledge of EMR workflows and system configurations

• Performs other related duties and activities as required.

• Responsible for the maintenance of an effective control environment under SOX 404 for the accounting operations he or she oversees. This includes both key and non-key controls and extends to the timely updating and modification of control design where necessary and the oversight of control remediation activities should exceptions be encountered in testing


SUPERVISORY RESPONSIBILITIES

Makes decisions on employee hires, transfers, promotions, salary changes, discipline, terminations, and similar actions. Resolves employee problems within position responsibilities.


Minimum Knowledge and Skills required by t