RCO Payer Perform Nat'l Direct

Responsibilities

• Understand and execute day-to-day processes of the payers as they relate to revenue cycle functions.
• Build and maintain relationships with operational leaders, support team members, and payer contacts at every level.
• Work strategically, proactively, and collaboratively to align revenue cycle, clinical operations, managed care, and credentialing to ensure transparency on the payer’s performance.
• Provide feedback on key AR performance indicators, an understanding of current AR, and where we are in identifying gaps in our efforts to maintain all established metrics.
• Speak to, address, and resolve revenue cycle performance deficiencies by payer.
• Provide analytical analysis and create written executive summary updates/briefs of all work and be expected to present these findings to Executive leadership.
• Responsible for the wind-down process when locations/practices close or transitioning to another TIN.
• Facilitate payer projects for AR that needs special attention.
• Ensure proper resources are delegated to specific accounts.
• Outline and maintain updates for leadership on expected date of completion so that bank accounts can be closed and outstanding patient AR can transition to collections.
• Maintain insurance billing tools within the RCO Repository remains current within the established time frame (seventy-two (72) hours of awareness).
• Compile and prepare various status reports for performance analysts to identify trends and make recommendations.
• Produce and analyze monthly reports that assist in the monthly forecast processes.
• Work with Practice Performance Team to ensure we understand outward-facing customer-centric opportunities to develop strategies and tactics that positions RadNet to maximize timely collections.
• Communicate and disseminate relevant information pertaining to the Payer to respective Teams Leaders {Ops, Credentialing, Contracting, IVT, Systems, etc.}
• Provide projections and reports as required for development and management of budget.
• Partner with SME in revenue cycle management including monthly reporting, identifying issues affecting performance and recommended actions to drive success.

Requirements

• Bachelor’s degree in healthcare administration, business management or closely related field is strongly preferred.
• At least five years of radiology industry experience.
• Three to five years’ experience in healthcare, preferably in Billing/Reimbursement Operations setting, or in a Managed Care Contract Administration/contract negotiations setting.
• Strong presentation skills and track records presenting to Boards, C-level executives.
• Strong analytical skills and adept in interpreting strategic vision into an operational model.
• Experience communicating at all levels in the organization, with strong oral, written skills.
• Ability to work independently.
• Demonstrated ability to multi-task, manage multiple projects and customers.
• Extensive knowledge with billing applications such as databases, off-the-shelf billing software, radiology information systems and general intermediate skills utilizing Access and/or Excel.
• Previous management/leadership experience required.

Qualifications

• Attends and organizes regular corporate and interdepartmental meetings as requested and/or required.
• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, co-workers, patients, visitors, and vendors.
• Demonstrates initiative, personal awareness, professionalism, and integrity, and exercise confidentiality in all areas of performance.
• Follows all local, state and federal laws concerning employment to include but not limited to: I-9, Harassment, EEOC, Civil rights and ADA.
• Follows OSHA regulations, RadNet and site protocols, policies and procedures.
• Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.