Revenue Cycle Account Representative I

Description

GENERAL SUMMARY

The Account Level Representative Level I provides leadership, direction, and support for delivering world class results while providing efficiency and effectiveness for the Revenue Cycle operations within the Revenue Cycle function of National Spine and Pain Centers. This includes all related activities specific to all Patient Access Services and cash flow with respect to billing and the accurate presentation and maximization of the Revenue Cycle results. These associates will work closely with all operational areas within the National Spine and Pain Centers and the NSPC revenue cycle function such as pre-service clearance, financial management reporting, patient satisfaction, coding and the payors to apply new and emerging approaches for the National Spine and Pain Centers clinical, administrative, financial and operational areas.

Further responsibilities include identifying, analyzing, and resolving all operational issues associated with the internal processing of approximately $150.0 million of accounts receivable while insuring annual cash flow of approximately $275.0 million. These responsibilities further include the management of approximately xxx revenue cycle associates with respect to $1.0 billion of gross revenue, $275.0 million in net revenue, in excess of 1.0 million encounters on an annual basis with an operating budget in excess of $xx.x million.

The Account Representative Level I, will actively look for opportunities to maximize revenue throughout the system to transform the patient experience with a focus on improving both the patient experience and satisfaction as well as providing accountability for strategic business units that impact the patient experience and service pillars of the organization.

The incumbent will focus on opportunities to maximizing the patient experience and patient revenue by strategically re-engineering the revenue processes to improve the patient experience, increase patient volumes and retain current patients by expanding the services in question.

The Account Representative Level I will exhibit behaviors consistent with the standards for organizational values of National Spine and Pain Centers. Demonstrates actions consistent with National Spine and Pain Centers “expectations” as duties are performed on a daily basis.

Span of control includes the following areas:

Patient Demographics and Patient Registration

Revenue Leakage – (Denials, Missing Charges and Payment Variances)

Out-of-Pocket Collections

Identification of Patient Insurance

Denial Resolution

Requirements

MINIMUM QUALIFICATIONS

A. Education, Experience and Training

Two (2) years or more of relevant experience is preferred and may be substituted in lieu of educational requirement. Bachelor’s degree in accounting, finance or management desirable and advanced degree preferred. Health Care Certification including, but not limited to CHAM, CHAA, FHFMA would be considered a plus.

Prefer but not required, that the candidate possess extensive knowledge of professional fee revenue cycle or health care finance/operations experience and regulatory requirements as they relate to the revenue cycle, health care operations and the clinical enterprise. Experience preferred within a similar setting of size, volume and organizational structure.

Prefer but not required that the individual have significant experience with payors, providers, hospitals and physicians and understand the commensurate requirements for facilitating hospital and professional revenue cycle operations, health care financial operations, revenue management operations, analysis and the corresponding operational activities, financial compliance auditing, accounts receivable resolution, cash flow, billing, revenue enhancement and patient service issues. Additional requirements for this position include the following:

Previous health care experience in revenue cycle operations and Patient Access preferred

Health care financial and operational experience preferred

Health care consulting background preferred

Experience with the mentoring / coaching of staff

Extensive knowledge in financial systems & healthcare applications preferred

B. Other Qualifications

Incumbent must possess strong presentation skills with the ability to effectively communicate with many different audience levels. Familiarity with computerized applications is essential. Also, experience within a centralized business office processing hospital and professional fee claims is preferred.