Mgr II, RCM Rev Optimize

OverviewMEDNAX has grown from a single medical practice to a trusted health solutions partner with more than 10,000 employees and a presence in 50 states. Through our family of companies, we provide:

• physician services spanning the continuum of patient care
• revenue cycle management solutions
• performance improvement consulting

We invite you to grow with us and help shape the future of health care. ResponsibilitiesResponsible to oversee the areas of Hospital Associates, acquisition training, and liaison for the office based practice managers within the assigned Region. Develop, recommend and administer Company policies and procedures related to the front end, review of weekly and monthly denial reports, review all front end related adjustments, work as a liaison with the office based practices and Collection Departments on office based training and policy initiatives. Serve as the point person for all software testing and upgrades. The Hospital Associate Regional Manager will assist the Regional Director with projects as assigned.

• Assists in the development of short and long term goals and objectives for the Patient Accounts Department.
• Prepares written goals and objectives for departmental activities and translates these into successful plans of action for self and subordinate staff.
• Participates in Corporate wide and departmental planning for improvements in acquisitions, start ups, front end enhancement and training initiatives.
• Assists in developing and overseeing policies and procedures designed to ensure the appropriate functioning of the departments.
• Develops and implements internal workflows for the Hospital Associate areas of responsibility in order to meet the financial goals and objectives of the company.
• Develops expertise in the policies and procedures that govern non-collection processes and ensures appropriate training and oversight of staff.
• Directs and develops subordinate staff.
• Interviews and selects subordinate management staff necessary to meet departmental goals and objectives.
• Oversees and approves the selection of non-management staff in assigned Patient Accounts departments.
• Educates, develops, and assists subordinate management and specialist personnel to ensure performance and productivity standards are met.
• Evaluates, recommends, and approves actions regarding employee relations’ matters in accordance with departmental and corporate policies and procedures, as necessary.
• Resolves staff grievances, counsels, and authoritatively disciplines department personnel, as necessary.
• Evaluates the performance of subordinate personnel in a timely and effective manner.
• Hold regular meetings with Regional and Practice Management to maintain open communication.
• Responsible for the implementation of “morale building” activities that will be proven by minimal staff turnover.
• Directly manages the region’s Hospital Associate Manager.
• Maintains open communication with Corporate and regional departments.
• Meets with practice management and D.O.’s when warranted by insurance verification, registration or operational issues.
• Meets with Corporate department heads for coordination on shared initiatives such as system upgrades and “best practices” committees.
• Coordinates with Information Management and Clinical Services Departments.
• Communicates with Integration and Managed Care Departments on new acquisitions.
• Responsible for providing feedback to other departments regarding opportunities for improving operating processes.
• Monitors the bulk holds in OBR and Next Gen, and coordinates all efforts for acquisitions and organic growth. Leads all acquisition meetings and calls for the Region.
• Reviews Revenue Variance Reports to identify and communicate Operations concerns.
• Assesses Contract Evaluation Report trends and works with Managed Care Management, Health Plans, and Information Management to resolve under and over-payment issues.
• Serves as a liaison with Compliance on issues such as adoptions, red flag.
• Oversees the timely and efficient enrollment of the region’s providers in all the necessary health plans in order to minimize write-offs.
• Identifies procedures that detract from timely provider enrollment and takes steps to correct and/or communicates problems to the Regional Director of Patient Accounts.
• Identifies problem areas, outside the direct control of Patient Accounting, that negatively impact provider enrollment efforts. Takes appropriate action to discuss and correct these impact areas with other departments and/or communicates such problems to the Regional Director of Patient Accounts.
• Responsible for ensuring efficient management and timely and accurate resolution of the A/R credit balance, negative remittance, miscellaneous/takeback, and refund request workflows.
• Ensures the necessary reporting tools are available to target specific segments of the workflows for efficient resolution.
• Responsible for overseeing timely and accurate resolution of postings to billing area 98 and 99 accounts and charges, including “can’t find/not ours”, takebacks, ONACCT, and missing/bulk EOBs.
• Assumes responsibility for ensuring continued professional growth and development.
• Remains current on business developments that affect non-collection activities, in order to keep abreast of changes which may have a financial impact upon the company.
• Participates in projects, programs, and functions directed toward professional and personal growth and development.
• Attends applicable conferences and seminars.
• Ensures that the customer service call center is appropriately managed for effective, sympathetic and professional call resolution.
• Develops and maintains appropriate communication and relationships with others regions’ managers in order to effectively address customer service inquiries and trends.
• Investigates, resolves and responds to escalated customer questions, concerns, and complaints in an efficient and effective manner.
• Ensures the necessary procedures and workflows are established to maintain required customer service levels, and that updated policies and training manuals are provided.
• Verifies customer service staffing, schedules, and hours of operation are appropriately managed for maximum effectiveness.
• Reviews and interprets information, reporting trends and fluctuations, and gives status to the Regional Director of Patient Accounts at least once per month.
• Assists with preparation of a comprehensive monthly operational report following the approved format.
• Interprets information appropriately and reports status, trends and fluctuations within the timeframes assigned.
• Responsible for coordinating quality audit processes for the Hospital Associate Department.
• Coordinates and develops action plans and corrective action responses to be submitted to the Corporate Audit and Provider Enrollment departments.
• Conducts internal auditing on a periodic basis.
• Responsible for overseeing and coordinating training function for all subordinate new hires, and ongoing training for existing subordinates.
• Performs other job-related duties within the job scope as requested by the Regional Director of Patient Accounts.
• Maintain strict confidentiality in accordance with HIPAA regulations and Company policy.
• Any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment.
• Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties.
• Embodies the principles of the corporate Mission Statement and Philosophy at all times.
• Represents the corporation in a positive fashion and makes all individuals feel as comfortable as possible.
• Conducts all business in a professional manner maintaining respect for individuals at all times.
• Complies with departmental and company-wide policies and procedures.
• Maintains constant awareness of potential safety hazards insuring necessary safety precautions.
• Reads and complies with established policies and procedures.

QualificationsLevel of educational degree and years of experience in hospital administration and/or multi-specialty physician practice, with full exposure to managing the accounts receivables, physician billing, and CPT-4/ICD-9 coding with medical terminology will identify the appropriate candidate. The following ratio of educational degree and years of experience will apply:
Degree Years of Experience
High School Diploma 10 + years
Associate’s Degree 7 + years
Bachelor’s Degree 5 + years
Master’s Degree 3 + years

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The above noted job description is not intended to describe, in detail, the multitude of tasks that may be assigned but rather to give the associate a general sense of the responsibilities and expectations of his/her position. As the nature of business demands change so, too, may the essential functions of this position.

MEDNAX IS AN Equal Opportunity EmployerAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status