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Clinical Business Office Manager
2 months ago
We are seeking a highly skilled and experienced Healthcare Operations Manager to join our team at LCMC Health Corporate. As a key member of our revenue cycle team, you will be responsible for managing system-wide hospital insurance follow-up and/or denial management functions.
Key Responsibilities- Assume responsibility for managing and coordinating various activities and daily workflows associated with insurance follow-up and/or denial management.
- Ensure staff compliance with application of departmental and organizational policies, procedures, and standards.
- Track the status of all unpaid accounts, all denied accounts, or accounts held for additional information from various departments.
- Utilize internal tracking tools to extract data for reports, training, and educating staff on follow-up and/or appeal strategies to promote reimbursement.
- Provide direction and support to staff by adhering to an established educational plan 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 various revenue-generating departments to communicate root causes of payment delays and/or denials and provide direction to mitigate any 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 various payor organizations as needed.
- Ensure that services are provided in accordance with state and federal regulations, organizational policy, and accreditation/compliance requirements.
- High School Diploma/GED or equivalent
- 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 the 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, including use of denials, systems, and workflows, ERISA guidelines for denials and appeals, regulations related to 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
We are a community-driven organization that values authenticity, originality, equity, inclusion, and a little 'come on in' attitude. Our culture is built on delivering healthcare with heart, giving people a reason to smile, putting love in our work, being honest and real with compassion, bringing lagniappe into everything we do, and providing one-of-a-kind care.
We are an equal opportunity employer and welcome applicants from diverse backgrounds. We are committed to creating an inclusive and supportive work environment that values and respects all individuals.
