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Trinity Health Contingent Senior Revenue Cycle Operrations Consultant in Farmington Hills, Michigan

POSITION PURPOSE

Serves as ""second in command"" to a Vice President of a Patient Business Service (PBS) by providing financial management, leadership and expertise in overseeing all details of assigned PBS operations and works in conjunction with other departments including, but not limited to, patient access, managed care contracts, revenue management support, centralized payment recovery, information systems (TIS), general accounting, clinical services and other service areas to ensure that the financial and customer service goals are optimally accomplished. Responsible for implementing systematic approaches that contribute to the capture, management and collection of patient service revenue, as well as maximizing the organization’s net patient revenues, while maintaining strong regulatory and legal compliance, and high levels of customer and patient service.

Promotes financial and operational viability of Trinity Health by effectively managing all aspects of assigned Patient Business Services (PBS) operations. Responsibility includes day-to-day management, development, growth opportunities of assigned Patient Business Service center, modifying and maintaining policies; continually seeking mechanisms to streamline and automate processes; enhancement of net cash collections, reduction of costs, and building and maintaining external and internal customer and patient relationships.

Supports, develops, and enhances the revenue cycle vision and strategy for the assigned Patient Business Services center within Trinity Health as it pertains to operational and financial performance; collaborates with other Patient Business Service (PBS) locations, System Office, and Regional Health Ministry (RHM) leaders to identify opportunities for workflow improvements, set department goals, measure process effectiveness and productivity, and identify any need for policy and procedure updates; analyzes financial and customer service benefits regarding buying and outsourcing versus in-house provisioning of revenue cycle services and skills; and leverages vendor relationships to provide products and services that increase value. This position reports to the Vice President of PBS (one of three regions).

ESSENTIAL FUNCTIONS

Knows, understands, incorporates, and demonstrates the mission, vision, and values of Trinity Health in leadership behaviors, practices, and decisions.

Identifies, facilitates and builds system and process standardization, centers of excellence, utilization of best practices, work integration, change management, issue resolution, metric development and measurement, and communication related to assigned revenue cycle initiatives:

  • Identifies opportunities to leverage systems, processes, standardization, or other vehicles to lower cost while maintaining or improving customer service. Facilitates planning across Trinity Health, in coordination with the Patient Business Services functional Directors, for process improvements, including prioritization and implementation in collaboration with key stakeholders
  • Develops and recommends to financial leadership appropriate processes, policies and structures to govern the organization’s revenue cycle operations and ensure data security and integrity in compliance with federal, state and local regulations, including HIPAA;
  • Analyzes all current revenue cycle policies and procedures to ensure standardization and compliance;
  • Provides input and direction into strategic plans, goals, objectives, and budgets as impacted by revenue cycle activities;
  • Develops and monitors performance scorecard to measure process outcomes, and to ensure continual process improvements, as required.

Provides leadership for departmental services through collaboration with customers, colleagues, physicians, clinics, other internal departments and services, and vendors. Scope of job duties, include and are not limited to:

  • Directly responsible for managing the Patient Business Services structure and functions assigned including: Billing/Follow-Up, Denial and Payment Variance management, Customer Service, Payment Operations such as Posting and Refunds, Eligibility Assistance and Financial Support programs;
  • Communicates regularly and works with physicians, physician office personnel, colleagues, service line leadership, and others in order to expedite the charge capture and billing/follow-up processes to avoid negative financial impact on the PBS and RHMs respectively
  • Maintains appropriate internal control over accounts receivable records and cash collections.
  • Monitors and coordinates responses to the latest regulatory billing/payment requirements of the federal, state and 3rd party payers to ensure the PBS and Trinity Health RHMs are in compliance and that electronic data processing (EDP) systems and coding structures are maintained to minimize manual processing and maximize claims acceptance and reimbursement. Translates regulatory requirements into daily operational procedures. Assists Revenue Excellence Leadership in expediting payment processing and resolving problems with major 3rd party payers;
  • Performs analysis of accounts receivable, billing, cash collections, and other key areas that directly impact the financial operation of the organization as it relates to collection of patient revenues. Completes and presents various financial forecasts, month-end financial reporting, receivable performance, short-term and long-term revenue cycle strategic planning for the PBS and respective RHM’s;
  • Maintains liaison with major 3rd party payers in order to maintain compliance and resolve problems;
  • Ensures prompt and appropriate handling of patient inquiries and complaints in a manner that is professional, understanding, patient and respectful; and
  • Serves as primary liaison regarding Patient Accounting functions and database issues; 3rd party reimbursement issues, charge capture, billing/follow-up, complex claims, denials management, operational write off management and other related Patient Accounts AR Management responsibilities.

Promotes a service-oriented culture within the organization and assures satisfaction with the quality and amount of support provided for departmental functions, initiatives and projects:

  • Maintains effective levels of communication between key business and clinical stakeholders for all aspects of services being provided by the PBS;
  • Maintains professional attitude and ability to relate well with executive management, physicians, other care providers, patients, and others in the hospital community;
  • Proactively identifies revenue cycle process improvements required to improve service and implements solutions;
  • Assesses and responds to current and future internal and external healthcare trends in order to establish and ensure the necessary direction for revenue cycle activities;
  • Continually seeks ways and means for improving the delivery and support of revenue cycle activities and programs;
  • Ensures all departmental systems incorporate the principles of total and continuous quality improvement while exceeding the expectations of the customers;
  • Ensures satisfaction among customer groups with the quality and amount of support provided by monitoring and responding appropriately to outcomes and feedback; and
  • Understands the job functions of all revenue cycle staff; is aware of process flow across other departments, and involves them, as appropriate, when recommended actions may impact their work functions.

Assists in the development and maintenance of the PBS operating and capital budgets in coordination with RHMs as applicable for relevant PBS based support functions being performed:

  • Monitors and analyzes ongoing departmental performance (quality and productivity) and implements necessary corrective actions; and
  • Maintains positive vendor / outsourced partners’ relationships in coordination with the vendor management team regarding pricing and performance concerns.

Maintains professional development and growth through journals, professional affiliations, seminars, and workshops to keep abreast of trends in revenue cycle operations and healthcare in general:

  • Participates as appropriate in continuing educational programs and activities that pertain to healthcare and revenue cycle management, as well as specific functional areas;
  • Develops and implements an annual plan of personal and professional development; and
  • Participates in local, regional and national health care revenue activities and professionally represents Trinity Health at these functions.

All other duties as needed and assigned by the Vice President of PBS, or other Revenue Excellence Leadership, including but not limited to leading and conducting special projects. Develops project work plans, facilitates resource allocation, executes project tasks and obtains assistance from other intra and inter-Regional resources, as required.

Maintains a working knowledge of applicable Federal, State and local laws/regulations; the Trinity Health Integrity and Compliance Program and Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

MINIMUM QUALIFICATIONS

Must possess a comprehensive knowledge of revenue cycle functions and systems, as normally obtained through a Bachelor’s degree in Business or Healthcare Administration or a related field, and minimum seven (7) years of experience within the area of revenue management and operations, specifically experience managing functional areas of Billing/Follow-up, Customer Service, Payment Posting, Payment Variance, or other management functions related to revenue cycle activities or an equivalent combination of education and experience. Experience in a complex multi-entity healthcare organization or large complex revenue cycle services.

Demonstrated knowledge of process improvement techniques are essential to success, as is the ability to be a self-starter and work independently to move projects successfully forward.

Must possess strong analytical skills in order to understand financial systems and patient accounts and to detect and resolve problems related to accounts receivable and system implementations. Ability to address complex problems with multi-level impacts and with solutions not readily apparent and uses sound judgment, in depth analysis and expertise to resolve issues.

Ability to prioritize and deliver on key initiatives; demonstrated success in achievement of key performance metrics targets within time and budget constraints.

Must possess strong written and verbal communication skills to effectively manage department and communicate with a wide-ranging audience.

Displays a demonstrated understanding of project management, revenue cycle technology infrastructure and related issues.

Must be comfortable operating in a collaborative, shared leadership environment.

Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

Demonstrated ability to interpret 3rd party payer contract requirements and recommend, design and implement procedures for compliance with regulations and standards.

Ability to deliver consistent services utilizing subject matter knowledge and expertise to address culture, people, process, structure and technology related issues.

Ability to be the front-line change leadership agent to enable and deliver long-lasting and sustainable organizational changes while minimizing disruption to the patients, colleagues, and business. Seeks innovative ways to deliver higher value programs and services more efficiently and effectively.

Strong leadership, integration, and execution skills. Considerable experience in planning, formulating, and executing strategies. Ability to define programs, processes or business objectives and scope. Demonstrated proficiency and expertise to identify, evaluate and articulate operational opportunities, and risks, business needs/gaps, and understand customer/stakeholder interests.

Excellent written and verbal communication skills to effectively identify, assess and facilitate improvements and resolution and to present advisory, persuasive and authoritative recommendation to all levels

Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel.

Must be comfortable operating in a collaborative, shared leadership environment.

Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

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PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS

This position operates in a typical office environment. The area is well lit, temperature controlled and free from hazards.

Incumbent communicates frequently, in person and over the phone, with people in all locations on product support issues.

Manual dexterity is needed to operate a keyboard. Hearing is needed for extensive telephone and in person communication.

The environment in which the incumbent will work requires the ability to concentrate, meet deadlines, work on several projects at the same time and adapt to interruptions.

Must be able to set and organize own work priorities and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles.

Must possess the ability to comply with Trinity Health policies and procedures.

The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

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Job Number: 00155779

Location: Farmington Hills, MI

Organization Name: Trinity Health

Facility: SO - SE MI PFS Shared Service Ctr

Employment Type: Full time

Hours: 40

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