Supervisor, Rev Cycle Systems (Resolute)

Position Overview

The Supervisor, Rev Cycle Systems (Resolute) manages the day-to-day operations of the Exact Sciences Laboratories Systems team. Their primary responsibilities include providing supervision, hiring, training, and coaching, managing workloads, and handling escalated concerns related to revenue cycle systems and analytics.

• Maintain accurate data reporting and be responsible for metrics and productivity measures, as well as any other key performance indicators.
• Facilitate contract implementation and revenue pull-through activities, both proactive and reactive, with internal and external parties as needed.
• Ensure billing and payment processes are efficient, timely, and in compliance with corporate goals, contracts, and/or regulations.

Essential Duties

• Coach, mentor, and engage team members to increase overall performance.
• Assist in identification and reporting of system errors and workflow solutions.
• Oversee the creation and maintenance of payor and client master files to ensure accurate and timely updates or changes.
• Investigate and resolve electronic remittance errors.
• Drive operational excellence of order entry and exception handling processes; including process flow, data integrity, information alignment, and continual process improvement.
• Support and Lead cross-functional initiatives across multiple departments.
• Act as a liaison between other functional areas within Exact Sciences Laboratories.
• Collaborate with team leadership and support the day-to-day team operations.
• Lead the development and maintenance of a contract database and contract management system, working with the credentialing and legal teams.
• Collaborate with finance and analytics to identify, analyze, and determine next steps to address negative revenue pull-through scenarios specific to payers and across payer segments, including Medicare Advantage, Blues, Medicaid, etc.
• Collaborate with RCT Managers to develop and leverage relationships with billing operations staff and payers when resolving claim adjudication issues, both contractual and non-contractual.
• Support execution of pull-through plans to meet quarterly revenue goals.
• Facilitate conversations with appropriate Exact personnel early in the contracting process to provide an overview of the account to avoid delay in implementation down the road.
• Report and suggest system changes to Revenue Cycle Leadership and Revenue Cycle staff as needed.
• Work closely with vendor and payor partners to identify and resolve systematic issues.
• Provide systematic support to ensure timely electronic submission of claims, including subscriber ID format, Z-code requirements, etc., based on payor and contractual requirements.
• Work directly with Client Support and Implementation Services (CSIS) teams to ensure accurate and timely client implementations as concerns the revenue cycle.
• Develop and oversee processes and procedures for the efficient and successful flow of interdependent information between the third-party billing vendor, the receivables department, and Exact Sciences’ contact center.
• Aid in the oversight of maintenance and updates regarding software vendor changes.
• Provide escalation support to staff.
• Takes part in the creation of training and Standard Operating Procedures (SOP) materials as appropriate; identifies additional training needs/resources as needed.
• Provide guidance on priorities for the department; ensures work is completed in a timely and accurate manner.
• Assist with recruiting, hiring, onboarding, coaching, and counseling of department staff.
• Supervise staff; including, but not limited to, organize and prioritize work, write/conduct performance reviews, train/develop, and manage work performance.
• Communicate goals clearly to employees to ensure understanding and success in achieving them.
• Ensure that appropriate training opportunities are identified and provided to employees to grow personal, career, and organizational development capabilities.
• Promote a team-oriented environment that fosters effective collaboration within and outside of the department.
• Provide on-going coaching to staff to ensure a consistent level of service is maintained.
• Provide input and guidance in the identification of updates needed to standard operating procedures (SOPs), communications of official guidance (COOGs), workflow, or documentation in collaboration with operational leaders and in accordance with all regulatory practices.
• Respond to technical questions consistent with level of training; seek guidance appropriately if answers are not known.
• Coordinate, develop, implement, and performs competency assessments or proficiency testing, as necessary.
• Monitor associates and overall department metrics to ensure revenue cycle systems functions are addressed according to company/department goals.
• Supervise staff through prioritization and organization of work, writing/conducting performance reviews, training/developing training expertise, and managing work performance.
• Apply excellent interpersonal skills and the ability to interact and build strong working relationships with internal clients and key stakeholders as well as peers at all levels of the organization.
• Ensure compliance with all Company procedures and guidelines; including, but not limited to, Code of Business Conduct and Ethics.
• Maintain confidentiality in compliance with HIPAA regulations and ensures that department remains compliant with all relevant regulations.
• Ability to successfully manage multiple priorities/projects at one time; ability to handle pressure of deadlines and complex issues in an effective way.
• Strong analytical, critical thinking, and forecasting skills.
• Excellent written and verbal English communication skills and the ability to professionally communicate with vendor partners.
• Ability to work independently.
• Uphold company mission and values through accountability, innovation, integrity, quality, and teamwork.