Manager - Revenue Cycle (1.0 FTE, Days)
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1.0 FTE, 8 Hour Day Shifts
Lucile Packard Children's Hospital Stanford is the heart and soul of Stanford Children’s Health. Nationally ranked and internationally recognized, our 311-bed hospital is devoted entirely to pediatrics and obstetrics. Our six centers of excellence provide comprehensive services and deep expertise in key obstetric and pediatric areas: brain & behavior, cancer, heart, pregnancy & newborn, pulmonary and transplant. We also provide an additional, wide range of services for babies, kids and pregnant moms.
Under the direction and leadership of the Chief Revenue Officer, and in conjunction with the Director and Assistant Director of Revenue Cycle Operations, the Revenue Cycle Manager will assist in enhancing and improving revenue yield, year over year. RCM is responsible for promoting financial viability of LPCH by effectively managing all aspects of the organization’s revenue cycle operations. Provides overall direction to identify issues, monitor performance, and assists in problem resolution. Acts as a liaison between vendors and hospital departments to ensure accurate and timely charge capture up to and including missed charge review. Manages staff to meet department's overall achievement of cash target, account receivable goals, and quality and productivity measures. Consistently monitors appropriate patient admitting, registration, billing, and collections by payor requirements to ensure maximum reimbursement.
• Assists with the implementation of regulatory and quality standards as they relate to or impact the overall functioning of revenue cycle programs.
• Conducts regular staff meetings to disseminate and discuss information concerning unit workflow, processes, challenges, successes, goals and solutions.
• Determines resources required for effective administration and operation of admitting and registration; develops budgets and maintains expenses within target limits; monitors budgets and resolves variances.
• Determines the number and qualifications of staff needed for revenue cycle operations, and provides supervision and leadership to staff.
• Develops and implements policies and procedures related to all aspects of the revenue cycle process including: registration, authorization/insurance verification, charge capture, coding, reconciliation, payor contract performance, and training.
• Develops and implements systems and business controls to monitor staff compliance; ensures staff are operating under all applicable standards.
• Directs and supervises the daily activities and workflows of registration and financial counseling staff to ensure that work areas are staffed appropriately, breaks are taken and overtime is utilized appropriately.
• Ensures compliance with federal and state laws, specifically pertaining to revenue cycle by analyzing internal policies, and implementing appropriate charges.
• Ensures reimbursement processes and procedures are set up and in compliance with established LPCH policies and procedures and follow all state and federal guidelines for insurance payors; and works with ACT Department to resolve problems associated with authorization or billing functions.
• Ensures that all staff follow appropriate registration requirements and receives necessary compliance training.
• Ensures timely updates to the registration system (Cerner) for appropriate registration edits.
• Establishes and maintains administrative policies, procedures, processes, and standards for all registration, billing, and collections; ensures business policies and procedures are congruent with established Patient Accounting practices and standards. Communicates issues and risks to the Director.
• Establishes appropriate and industry standard financial benchmarks for staff, and develops utilization and productivity standards; develops systems to improve and provide in depth financial analysis of operations; and provides financial spreadsheets and reports determining the feasibility of a new initiatives.
• Manages the day-to-day business and administrative functions relating to the operation of registration, billing, and collections.
• Monitors the financial success of insurance and Self-Pay billings and collections by ensuring registration and admitting guidelines are appropriately documented and performed; and ensures that established policies and procedures are followed to ensure maximization of revenues for new programs and services.
• Participates in development, implementation and maintenance of policies, objectives, short-and long-range planning; develops and implements projects and programs to assist in accomplishment of established goals.
• Performs supervisors functions by interviewing, selecting and providing training for new staff; by approving or disapproving recommendations from subordinate staff on personnel actions; by evaluating subordinates' performance; by hearing and resolving employee grievances; and by determining the need for and initiating disciplinary action in order to ensure adequate and competent staffing for the department, division or institution.
• Provides overall direction and supervision to the registration, admitting, and correct billing of all payor accounts.
• Serves as a contact to other departments for information on admitting and registration guidelines; updates staff and outside departments on Medi-Cal/Medicare and commercial regulations.
• Teaches staff how their functions impact bad debt
expense-uncompensated care, cash flow, and accounts receivable as well as customer loyalty, market share and the overall financial health of Stanford Hospital and Clinics.
• Works with staff to ensure appropriate registration, admissions, information gathering, account activation, collection of co-pays and deductibles are performed in an efficient and courteous manner.
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education: Bachelor's degree in a work-related discipline/field from an accredited college or University.
Experience: Five (5) years of progressively responsible and directly related work experience.
Knowledge, Skills, and Abilities
• Ability to adjust communications to fit the needs and level of understanding of the receiver.
• Ability to develop long-range business plans and strategies.
• Ability to establish and maintain excellent client relationship, exhibit exemplary interpersonal skills and exercise sound judgment and professionalism in business and personnel matters.
• Ability to foster effective working relationships and build consensus.
• Ability to mediate and resolve complex problems and issues.
• Ability to provide leadership and influence others.
• Ability to recognize and analyze the impact of regulatory changes on the financial performance of commercial revenue.
• Ability to solve problems and identify solutions.
• Ability to speak, read, write, and understand English effectively at a level appropriate for the safe and effective performance of the job.
• Knowledge of accounts receivables and reimbursement management.
• Knowledge of CPT, ICD9 coding and medical terminology.
• Knowledge of government program regulations and requirements as they relate to billing and collections of accounts receivable.
• Knowledge of information system and software relating to accounts receivables management and billing.
• Knowledge of managed care environment and patient service delivery systems and knowledge of federal and state rules and regulations regarding billing processes.
• Knowledge of principles and practices of organization, administration, fiscal and personnel management.
• Knowledge of project management process and systems.
Equal Opportunity Employer
Lucile Packard Children’s Hospital Stanford strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, LPCH does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements, and where applicable, in compliance with the San Francisco Fair Chance Ordinance.