Manager - Transplant Service Revenue Mgmt. (Detroit, MI)

About the role

This position is a full-time daily in-person work format at the main hospital campus in Detroit. As a member of the Transplant Institute and hospital revenue cycle team, the manager will be responsible for a wide variety of operational and personnel functions related to Insurance Verification, Medicaid Application Services, Registration Services, EC2000, and other related “front-end" and billing processes.

Responsibilities

• Manage day-to-day administrative & operational functions of the revenue cycle through the supervision of multidisciplinary staff.
• Coordinate with key revenue cycle departments to assure successful business processes fit and perform within required clinical needs resulting in appropriate reimbursement for the Hospital and System.
• Manage complex projects that include participating with multi-disciplinary process improvement teams from across the System.
• Manage receivables for inpatient Medicaid applications, insurance rejections, and pending accounts.
• Plan and direct daily operation of securing insurance authorizations, COB, Charity Care, and other related information for all urgent, scheduled, and ambulatory procedures.
• Assist department Vice President in developing and implementing the departmental budget.
• Track, trend, and monitor billing rejections to develop strategies required to manage EC2000 and ambulatory billings.
• Review patient accounts and authorize billing of late charges based on insurance reimbursement guidelines.
• Develop and implement cash collection policies for outpatient, inpatient, and ambulatory procedures.
• Interview, hire, schedule, assign work to, evaluate, discipline, and recommend discharge of departmental personnel.
• Assist the department leadership with overseeing all quality assessment and continuous improvement activities.
• Design, implement, and conduct educational programs for staff regarding changes and updates to third-party requirements impacting the revenue cycle and customer service initiatives.
• Conduct meetings with departmental personnel and other divisions within Hospital Revenue Cycle to communicate information and facilitate improvement opportunities.
• Analyze data to identify patterns and trends of performance and address process performance issues.
• Collaborate with the System's Contracting Department to review, discuss, and monitor managed care contracts and performance.
• Review and reconcile transplant surgical denials and appeals.

Qualifications

• Bachelor’s degree in a related field, or the equivalent combination of education and/or experience.
• Prior supervisory/management experience required.
• Five (5) years of revenue cycle experience including but not limited to billing, registration/insurance verification, point of service collection related experience is required.
• Comprehensive knowledge of a wide range of revenue cycle processes is preferred.
• Proficient knowledge of Word, Excel, Access Database, Windows, and the Internet.
• Ability to create, analyze, and interpret reports and spreadsheets.
• Must have the ability to independently organize and prioritize responsibilities; problem-solve and implement solution-based ideas.
• Ability to effectively work and adapt to a wide variety of different staffs, environments, and situations.
• Excellent customer service skills and ability to interact with nurses, physicians, patients, families, agencies, and the Department of Human Services.
• Comprehensive knowledge of state and government billing standards as it relates to insurances for but not limited to, Motor Vehicle accidents, Workers Compensation, Medicaid, Group Health Plans, BCBS, and Medicare.

Working Conditions

Work in an office environment with infrequent exposure/discomfort to dust, temperature. Possible visual and physical strain due to review of patient accounts, report preparation, and repetitive computer use. Communicate policies and financial responsibility with minimal exposure to communicable disease, irate patients.