Manager, RCM Contract/ Data (Remote) Job at Help At Home
Help at Home is the nation's leading provider of high quality care and support solutions. Our goal is to enable the highest level of personal independence and meaningful lives for our clients. Help at Home is committed to delivering a gold standard in care through our attentive and well-trained staff who support our clients comfortably and safely within their homes and communities.
Job Summary:
Overall responsibility for Revenue Cycle contract set-up and data management within various payer portals and agency management systems encompassing all markets in the Help at Home portfolio. Partners with cross-departmental teams to ensure validity and accuracy of critical data related to the Revenue Cycle process. Primary responsibilities include direct oversight of change management related to agency management system backend tables and payer portal data fields.
Responsibilities:
Duties/ Responsibilities:
Responsibilities include, but are not limited to:
Required Skills/ Abilities:
Education and Experience:
Physical Requirements:
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions upon request.
Help At Home is an Equal Employment Opportunity (EEO) employer and welcomes all qualified applicants. Applicants will receive fair and impartial consideration without regard to race, sex, color, religion, national origin, age, disability, veteran status, genetic data, or religion or other legally protected status.
Job Summary:
Overall responsibility for Revenue Cycle contract set-up and data management within various payer portals and agency management systems encompassing all markets in the Help at Home portfolio. Partners with cross-departmental teams to ensure validity and accuracy of critical data related to the Revenue Cycle process. Primary responsibilities include direct oversight of change management related to agency management system backend tables and payer portal data fields.
Responsibilities:
- Serve as Agency Management System Administrator throughout the enterprise. Must be able to:
- Complete payer set-up
- Update master reference tables, including services, bill codes, adjustment reasons & any other RCM-specific data element
- Validate, input and update rates as needed
- Grant access and security permissions to operations level users
- Serve as Payer Portal System Administrator throughout the enterprise. Must be able to:
- Complete registration of NPI/Tax-ID for all entities
- Ensure validity of provider demographics, work with Payers to update if outdated
- Confirm all impacted team members have been registered and assigned to appropriate entities with correct security settings
- Alert team members impacted and leadership in regard to registration delays or issues
- Works with Director, AR Processing & Managers, RCM to ensure understanding of payer set-up, application of contract terms and ensure alignment of processes
- Monitors state and payer portals for notifications of changes impacting revenue cycle operations.
- Manage controls around updates to AMS systems related to rate increases, payor (funder) adds and implementation of bug fixes and enhancements. Including communication and training assistance to RCM team.
- L ead communication with the Business Development team upon rate update completion and validation of contracts
- Documentation of QA review with outcomes and feedback provided monthly to RCM leadership team.
- Manage day to day issues and problems, escalating in a timely manner as necessary
- Create and manage portal and AMS access for new hires or terminated employees
Duties/ Responsibilities:
Responsibilities include, but are not limited to:
- Demonstrate ability to work effectively at both granular and big-picture levels
- Think analytically with the ability to perform root cause analysis, prepare and implement action plans, and lead improvement initiatives
- Create communication plans to provide updates to leadership team on a weekly, monthly, quarterly or yearly basis.
- Create SOP documentation and process maps, updating with any process changes
- Help drive RCM projects to create efficiencies and streamline processes.
- Actively contribute to and/or lead company-wide Revenue Cycle Management related activates and visioning
- Performs other related duties as assigned.
Required Skills/ Abilities:
- Analytic and persistent; able to get to the root of problems. Self-motivated; reliable; strong attention to details; maintains confidentiality; complies with all policies and procedures.
- Demonstrates maturity and the ability to function as a team member; good communication skills.
- Able to supervise staff and coach them to improve functioning and overall agency services. Organized, assertive, mature, approachable and open-minded. Willing to take initiative. Identifies and progresses toward meeting personal and professional goals.
- Able to deal with stress and conflict appropriately.
Education and Experience:
- Bachelor's degree and/or 5+ years of revenue cycle experience
- Prior healthcare revenue cycle management/billing experience and knowledge of Home Care service technology, Long Term Care Insurance, Medicaid and Medicare is preferred. Advanced computer skills, including the use of Microsoft Office applications (e.g. Word, Excel). Ability to generate and utilize Microsoft Excel advanced formulas, pivot tables, power queries and advanced charting required.
Physical Requirements:
- Typical office setting, indoor and extensive use of computer
- Minimal lifting, bending but role typically requires long period of sitting
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions upon request.
Help At Home is an Equal Employment Opportunity (EEO) employer and welcomes all qualified applicants. Applicants will receive fair and impartial consideration without regard to race, sex, color, religion, national origin, age, disability, veteran status, genetic data, or religion or other legally protected status.
Manager/Supervisor
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