Manager Audit Compliance

2 weeks ago

Greensboro, United States Cone Health Full time

Overview:

Manages compliance reviews for audit testing to ensure established laws, regulations and policies are met. Works with departments in the development of action plans or potential compliance issues that have been identified. Ensures that policies related to Revenue Cycle are updated and remain current.

Talent Pool: Corporate Services/Professional

Responsibilities:

Manages assigned staff. Selects and hires qualified employees. Conducts staff meetings (group and one-on-one) to ensure all employees are kept up to date regarding process improvements and key measures. Conducts consistent employee rounding sessions to discuss any current departmental opportunities or successes. Measures staff performance and recommends appropriate evaluation results. Motivates and strengthens staff performance through effective communications. Creates an environment conducive to strong employee engagement and positive employee retention; monitors results and creates action plans to address deficiencies when needed.
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Sets key productivity and quality objectives. Identifies process improvements; ensures department objectives are met. Conducts audits and monitors achievement of quality and productivity benchmarks. Monitors staff performance and provides coaching and training where appropriate. Performs continuous quality monitoring of compliance with all regulatory requirements which may include compliance reports, denial reports, underpayment reports, credit balances (ensuring all self-pay refunds are completed within acceptable timeframes), vendor reconciliations and data requests.
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Prepares and controls financial objectives. Plans, budgets and utilizes resources in the most efficient manner. Assists with operating and capital budget preparation; monitors expenditures and prepares variance reports as needed. Monitors payroll (Kronos) and labor productivity reports; makes adjustments in staffing levels as needed. Assures that staff understand and comply with constraints pertaining to spending and overtime.
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Directs, organizes and plans day-to-day operations of the department to ensure maximum reimbursement, productivity and efficiency. Supervises daily workflow to ensure accuracy of work. Reviews work queues to ensure appropriate and consistent follow up and resolution. Conducts audits to ensure that procedures and work flows are efficient. Sets an example of professionalism and courtesy in interactions with patients, families and team members.
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Communicate policies and procedures to all staff; provide timely updates when changes are made in policies and procedures. Conduct audits to ensure that policies and procedures are being followed. Ensure that difficult accounts and/or customer situations are resolved by analytically applying health system policies and procedures.
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Promotes staff knowledge of and compliance with regulations as they pertain to Revenue Cycle performance. Develop training sessions as needed on legal and regulatory guidelines. Inform staff of rules and regulation changes that will affect daily operations of Revenue Cycle. Schedule regular meetings with major payer groups to ensure we have appropriate communication to resolve backlogs of outstanding issues and account resolution.
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Maintains professional and technical knowledge. Remains informed of professional issues and developments. Establishes positive personal networks with healthcare affiliates both within and outside the health system. Attends continuing education workshops and seminars relevant to the healthcare industry or management. Takes responsibility for own actions, avoiding blame or excuses.
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Qualifications:

EDUCATION: Bachelors, Business Administration, Required
Bachelor Degree in Business Administration or Healthcare Management preferred or High School Graduate or GED with ten years of healthcare revenue cycle experience.
EXPERIENCE: 3-6, Required
Minimum of 3 years of supervisory experience and 6 years of healthcare revenue cycle experience required.
LICENSURE/CERTIFICATION/REGISTRY/LISTING: REQUIRED
N/A
PREFERRED
N/A

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