Job Description

Description:

Develops, implements, and oversees all operation of Revenue Services; ensures programs align with the facility's strategic initiatives with emphasis on customer service and revenue capture and oversees the delivery of services that facilitate seamless patient access to the system, avoidance of bad debt related to unauthorized procedures, un-sponsored care or incorrect patient payer or demographic data, and enhanced patient/family and physician/provider satisfaction with revenue services.

Responsibilities:

1. Creates and exceeds service standards utilizing knowledge of patient/customer expectations and best practices. 

2. Ensures facility compliance with Advanced Beneficiary Notification (ABN), Medicare as a Secondary Payer (MSP), Advanced Directives, Patient Bill of Rights, medical necessity, observation status, and other regulatory guidelines. 

3. Monitors performance of all employees ensuring adherence to the department goals, hospital standards; ensures collection of cash deposits, retrieval of accurate information, and appropriate customer service interaction. 

4. Maintains current knowledge on regulatory and third party changes with respect to authorization, verification, and billing requirements supporting appropriate reimbursement. 5. Preparation and submission of billing data and medical claims to insurance companies including correcting rejected insurance claims and coding errors. 

6. 

Adheres to Rincon's organizational and department-specific safety, confidentiality, values, policies and standards. 

7. Performs related duties as assigned. 

Customer Relations and Personal Behaviors:

1. Demonstrates effective communication and interpersonal skills which promote a positive environment, teamwork and loyalty to the organization. 

2. Acts as a liaison between insurers, medical offices, and patients. 

3. Demonstrates behaviors and actions which support the mission, goals and operations of the Surgery Center that also contribute to continuous service improvement. 

4. Maintains a positive attitude, even during periods of stress and challenge. 

5. Maintains positive attendance and communicates in advance any absences from work.

Qualifications: 

EDUCATION : Bachelor's degree in healthcare, business, or related field required. 

EXPERIENCE : Seven (7) years of progressive management-level experience including five (5) years experience within an ASC environment. (Additional experience may substitute for the education requirement on a year-for-year basis). 

LICENSURE OR CERTIFICATION : None required. CHAM (Certified Healthcare Access Manager) preferred. 

Knowledge, Skills a Abilities:

• Knowledge of building and supporting teams and collaborative workgroups. 
• Thorough knowledge of health care reimbursement methods. 
• Knowledge of billing software and electronic medical records.
• Skill in conflict management. 
• Skill in strong verbal and written communications. 
• Knowledge of Medicare and AHCCCS regulations relevant to access services. 
• Ability to listen actively and respond to employees, physicians, patients, and payer issues in a competent manner. 
• Ability to present positive internal and external communication and effectively represent Rincon ASC. 
• Ability to effectively lead and work within teams. 

PHYSICAL DEMANDS AND WORK ENVIRONMENT : 

The physical demands and work environment described here are representative of that which an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel and talk or hear. The employee frequently is required to reach with hands and arms. Specific vision abilities required by this job include close vision. The employee is frequently required to stand, walk, and sit. He/she must occasionally lift and/or move up to 25 pounds. 

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