Business Finance Revenue Cycle Utilization Manager

NeuroRestorative, a part of the Sevita family, provides rehabilitation services for people of all ages with brain, spinal cord and medically complex injuries, illnesses and other challenges. In a variety of locations and community-based settings, we offer a range of programs, including vocational and therapy programs, day treatments, and specialized services for infants, children, adolescents, Military Service Members and Veterans.

Monday-Friday (some flex start/stop times)

Salaried with full benefits

SUMMARY

The Manager of Revenue Cycle Utilization Review will report to the Chief Financial Officer and will be responsible for leading and managing successful Front End revenue cycle activities. He/she will lead the strategic planning, analysis, continuous quality and productivity improvements of the geographically dispersed/decentralized utilization review specialist, operations staff and other key members of front end field revenue cycle team. The ideal candidate will have experience in Front End revenue cycle management and patient service provision processes. The candidate must be an inspiring manager, able to attract motivate and retain an industry leading team. S/He must be comfortable working in a fast-moving and evolving environment. This is an amazing opportunity for the right candidate to lead a high impact, emerging function at a high growth division.

ESSENTIAL JOB FUNCTIONS

To perform this job successfully, an individual must be able to satisfactorily perform each essential function listed below.

• Build and manage a high performing team responsible for the front end cycle of revenue process, including but not limited to patient intake set up, recurring insurance eligibility/authorization, payor setups, insurance rate set ups, along with timely/accurate service provision capture 

• Responsible for daily coordination and tracking systems of incoming service delivery documentation and support to ensure accurate system submission and setup; SME around systems and their use for gaining most efficiency 

• Performs weekly, bi-weekly, and monthly reviews and verifies completeness of required information. Reports status of various service delivery targets and projects outcomes to supervisor (i.e. weekly non authorized service reporting, weekly trended service capture revenue reviews, weekly eligibility reporting)

• Help establish reporting communication to operations and field leaders regarding operations related front-end activities. He/she will be responsible for recommending ongoing improvements to further enhance revenue cycle performance in the department 

• Actively engage in on-going communication with shared service center team to facilitate timely resolution and remediate root cause process issues coming from front end revenue cycle denials

• Assists in communication to respective parties to address areas of identified errors, corrections, or needed services related to billing units and over/under utilization areas. 

• Maintains some functional knowledge base related to current and new funding Rules and Contracts, provides updates and information to supervisor and others specific to impact on service delivery, authorizations, utilization of services and billing team.

• Identify, develop and implement consistent front end revenue cycle policies and procedures across sites and regions

• Drive front end process changes that lead to more successful revenue cycle outcomes and an improved collection experience for the business

• Develop tools and dashboards that are regularly reviewed to ensure performance targets are met for core Front End KPI metrics

• Determine appropriate internal staffing levels; recruit, hire, and onboard new staff

• Monitor staff and supervisor productivity to ensure timely and accurate work completion

• Support staff and supervisor quality audits and approve employee performance evaluations

• Actively maintain up-to-date best practice healthcare and revenue cycle/billing knowledge

• Actively maintain up-to-date knowledge of EMR workflows and system configurations

• Performs other related duties and activities as required.

• Responsible for the maintenance of an effective control environment under SOX 404 for the accounting operations he or she oversees. This includes both key and non-key controls and extends to the timely updating and modification of control design where necessary and the oversight of control remediation activities should exceptions be encountered in testing

SUPERVISORY RESPONSIBILITIES

Makes decisions on employee hires, transfers, promotions, salary changes, discipline, terminations, and similar actions. Resolves employee problems within position responsibilities.

Minimum Knowledge and Skills required by the Job

The requirements listed below are representative of the knowledge, skill, and/or abilities required to perform the job.

Education and Experience:

• Bachelor’s Degree or 5+ years relevant experience 

• Previous management experience

• Experience with systems such as BrainTree, AVATAR, iserve, Salesforce is a plus

Certificates, Licenses, and Registrations:

• Certification in medical billing coding/requirements is a plus

Other Skills and Abilities:

•3-5 years managing, training and retaining hourly staff

• Proven people leader with a successful track record of collaborating across functions within all levels of an organization

• Excellent communication skills, with demonstrated history of effectively influencing leadership positions and driving desired outcomes.

• Demonstrated ability to work effectively at both detail and big-picture levels and to drive projects forward.

• Strategic and analytical thinker with demonstrated ability to perform root cause analysis, prepare and implement action plans, and lead improvement initiatives.

• Demonstrated expertise in all aspects of teammate management including recruitment, hiring, retention, and performance management.

• Strong written, verbal, and interpersonal communications skills including ability to listen effectively and to communicate information clearly.

Physical Requirements:

1) Normal Office Work, Data Entry:

Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

AMERICANS WITH DISABILITIES ACT STATEMENT

External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job functions either unaided or with assistance of a reasonable accommodation to be determined on a case by case basis via the interactive process.

Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face.

We’ve made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S.

 
As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.