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Healthcare Operations 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 that values authenticity, originality, equity, inclusion, and a little "come on in" attitude. We believe in delivering healthcare with heart, giving people a reason to smile, putting a little love in our work, being honest and real, but with compassion, bringing some lagniappe into everything we do, and forgetting one-size-fits-all, thinking one-of-a-kind care.
We are an equal opportunity employer and welcome applicants from diverse backgrounds. We are committed to providing a work environment that is free from discrimination and harassment.
