Healthcare Operations Manager

3 weeks ago

New Orleans, Louisiana, United States LCMC Health Corporate Full time
Job Summary

The Manager of CBO Collections and Follow-Up Rev Cyc is responsible for managing system-wide hospital insurance follow-up and/or denial management functions. This role collaborates with the revenue cycle team to set departmental goals, measure process effectiveness, and identify areas for policy and procedure updates.

Key Responsibilities
  • Manage and coordinate daily workflows associated with insurance follow-up and/or denial management.
  • Ensure staff compliance with departmental and organizational policies, procedures, and standards.
  • Track the status of unpaid accounts, denied accounts, and accounts held for additional information.
  • Utilize internal tracking tools to extract data for reports, training, and educating staff on follow-up and/or appeal strategies.
  • Provide direction and support to staff to ensure quality and productivity standards are met.
  • Gather and assemble documentation related to insurance follow-up/denials, information requests, trends, and root causes for committee meetings and regular check-ins with revenue cycle leadership.
  • Meet with revenue-generating departments to communicate root causes of payment delays and/or denials and provide direction to mitigate future payment delays.
  • Act as the primary liaison between insurance follow-up/denial management vendors and the organization.
  • Resolve problems and rectify inefficiencies related to payment delays or denials.
  • Assist in providing payment/denial information related to contract negotiations and renegotiations with payor organizations as needed.
Requirements
  • High School Diploma/GED or equivalent and 5 years of experience in healthcare billing, collections, payment processing, or denial management.
  • 3 years of management experience.
  • Ability to pass basic computer skills test and system level training.
  • Working knowledge of system reports and ability to analyze system information to determine the impact of possible changes.
  • Demonstrates knowledge of Hospital and professional billing processes and reimbursement strategies, third-party contracting, insurance protocols, delay tactics, and ERISA guidelines for denials and appeals.
  • Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change.
  • Possesses efficient time-management skills and proven ability to multitask under tight deadlines.
  • Demonstrates excellent leadership, conflict-resolution, and customer service skills.
  • Exceptional writing and communication skills.
  • Strong comfort level with computer systems.
LCMC Health Culture

LCMC Health is a community that values authenticity, originality, equity, inclusion, and a little 'come on in' attitude. We celebrate everyday extraordinary and strive to bring the best possible care to every person and parish in Louisiana and beyond.

We are an equal opportunity employer and welcome applicants from diverse backgrounds. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.

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