Posting Manager, Revenue Cycle Management

Description

What You’ll Do

• Maintains and evaluates staff according to company policy and procedures.
• Interviews and hires qualified employees.
• Maintains staffing levels proportionate to the volume of accounts to preserve optimum efficiency and superior collections.
• Discipline employees fairly and consistently, ensuring compliance with policy, procedures and productivity standards.
• Implement productivity standards and maintain reports identifying compliance.
• Schedules staff work hours to ensure full coverage during normal work hours and distributes workflow to maximize efficiency.
• Maintains logs on PTO requests, absences, tardiness, etc. along with approving hours worked.
• Operates the department within the budget.
• Approves overtime only when necessary and within the budget.
• Works to minimize staff turnaround through good management and teamwork.
• Manages the day-to-day operations within RCM.
• Delegate and prioritize accounts to be worked.
• Ensure all accounts are worked in a timely and efficient manner.
• Provide guidance and training as necessary.
• Communicate with various departments to address issues.
• Conduct regularly scheduled staff meetings.
• Streamline workflow.
• Review adjustment and refund request submitted by staff within a timely manner.
• Review all adjustments and refund for accuracy.
• Authorize all adjustments and refunds reviewed and approved within authorized threshold for processing.
• Forward all adjustments and refunds reviewed for Director approval in accordance with established thresholds
• Completes monthly/daily reports that communicate the performance and progress of the department.
• Evaluate staff on job performance.
• Monitor work to ensure productivity standards are met.
• Meet with staff on a weekly or biweekly basis to discuss quality of work, productivity standards, attendance, and carrier issues.
• Assist with yearly performance evaluation of employees.
• Establish/maintain policy and procedures for department.
• Develop new department policies and procedures.
• Maintain department policies and procedures.
• Educate staff of policies and procedures.
• Recommends changes to existing policies to maximize the operations.
• Ensures and analyzes the performance of the employees on working the following reports timely and accurately:
• Not Worked Report – Summarizes outstanding accounts not worked within the department’s guidelines.
• Denial Report – Identifies specific denials posted from EOBs received.
• Residual Report – Identifies balances remaining after payer has made a payment.
• Emdeon Report: Identifies specific denials for claims submitted electronically. 
• Reviews AR Reports weekly with Director and determines areas of concern to be distributed to RCM team to work
• Analyze other management reports received from Regional Director.
• Make the necessary telephone or written contact.
• Contact payers to discuss carrier issues and solutions.
• Contact parents to obtain accurate insurance information.
• Phone appeals on denied claims.
• Contact the Provider Representative to arrange for an in service. 
• Provide Call Center backup as needed.
• Send appropriate letters.
• Assist in coordination of collection audits on accounts when needed.
• Review accounts for accuracy (i.e.; payments have been posted correctly, appropriate adjustments have been made, etc.).
• Process refunds for overpayments made by payers and patients.
• Process adjustments as necessary (i.e.; contractual, good faith, settlement, etc.).
• Assist in appealing denied claims via mail or telephone.
•  Request Accounts Receivable Status Reports when a denial trend has been identified.
•  Review accounts receivable report detail for denial trends.
• Obtain Medical Records from Hospital Associates and send them to the payer.
• Review diagnosis and procedure codes with the Coding Department.
• Review problem packs or appeals to specific payers.
• Assist in updating accounts as necessary.
• Update accounts in billing system with information obtained through correspondence and telephone (ie; insurance, authorization, address, baby’s name, etc.).
• Corrects inaccurate information in accounts as needed, including but not limited to transfer of pre-pays and unapplied amounts posted to incorrect charge lines
• Identify carrier related denial trends.
• Review all available systems, reports, documents to identify denial trends
• Resolve and/or bring problems to RCM Director.
• Maintain carrier issue logs.
• Records identified problems, A/R out to carrier, action(s), solution(s) and status.
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