Manager, Revenue Cycle Management-Government Billing

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

Responsible for overseeing the day to day operations of the Corporate Revenue Cycle Government Billing department. Manages and develops billing teams and coordinates activities of team members. Will be responsible in assuring that the team reaches or exceeds clean claim objectives and billing goals within compliance standards. Will work with a diverse group of stakeholders - technical and non- technical personnel, management and department heads.Job Description

Desired Skill Sets:

• Must have hospital billing experience to be considered
• Must have Medicare billing experience
• Must have an understanding and knowledge of CMS guidelines and rules
• Manager experience highly preferred
• Must be tech savvy
• Experience working with claim edits
• Billing experience with inpatient and outpatient claims

Minimum Qualifications:

Education: Bachelor's Degree preferred or 10 years of revenue cycle experience in a healthcare setting

Licenses/Certifications: Membership and/or participation with a Revenue Cycle Association (i.e., HFMA, AHIMA, NAHAM, etc.) preferred.

Experience / Knowledge / Skills:

• Bachelor's degree requires five (5) to seven (7) years of hospital/healthcare business office or financial management experience with a minimum of three (3) years of formal or informal leadership experience. No degree requires a minimum of ten (10) years of hospital/healthcare business office or financial management experience with a minimum of three (3) years of formal or informal leadership experience.
• Experience in one of the revenue cycle functions, including but not limited to: Patient Access Management, Denial Management, Insurance Collections, Patient Remittance Posting, Claim Submission, Contract Management, or Appeals.
• Experience and working knowledge of health system administrative and clinical applications.
• Experience leading teams and managing multiple entry-level and experienced employees.
• Knowledge of payer contract agreements, billing practices, rules, and regulations for Medicare, Medicaid, Veterans Administration, and other state funded plans such as HHSC, Crime Victims, DARS, etc.) and all relevant state and federal laws regarding medical billing, including HIPAA privacy and security regulations.
• Knowledge of Medicare DDE, CWF, and TMHP on line system functionality.
• Knowledge of National Correct Coding Initiatives (NCCI), Medically Unlikely Edits (MUE), Medicare Secondary Payer (MSP), National Clinical Trial/Research, and other government applied claim edits and billing practice rules.
• Understanding of process management, system implementations and system maintenance.
• Strong interpersonal, customer-oriented skills. Must have proven organizational skills with an ability to effectively prioritize present information publicly, and communicate in writing clearly, concisely, thoroughly, and accurately.
• Must have experience in working with computer software, and be able to demonstrate strong analytical and problem solving skills, decision making skills, stress management skills and time management skills.

Principle Accountabilities:

• Responsible for oversight and management of government payer billing for multiple acute, post-acute, and outpatient locations including 17 acute care facilities and 163 ambulatory locations.
• Service lines include, inpatient and outpatient, emergency services, life flight, trauma, transplant, outpatient imaging, laboratory, inpatient/outpatient rehab, skilled nursing, and chemical dependency.
• Management of approximately two billion claims per year.
• Direct supervision of a team of 15-20 staff members, including all human resource related activities such as hiring and performance management. Ability to create performance measures, goals, and produce sustainable outcomes.
• Evaluates the performance level of the unit and individuals. Defines performance expectations, measurement tools and policy and processes. Assist in the developme