Job Title: Revenue Cycle Management, Application Administration Manager
Summary
The Revenue Cycle Management, Application Administration Manager role is to provide strong leadership and direction to the RCM Applications Administration Support staff and is responsible for all aspects of providing technical support to the billing center(s) to ensure functional needs are achieved. Technical support to include but not limited to planning, coordinating and managing all activities relating to the design, development, implementation and ongoing support of the RCM application(s) and associated ancillary vendor products to insure stable operations.
This position is highly visible and requires a strong leader with the ability to plan, prioritize and manage a department with a focus on quality, efficiency and optimization. Adaptability and willingness to respond to changing priorities a must. Requires critical thinking and complex decision making.
Essential Duties and Responsibilities
- Accountable for all aspects of RCM applications to ensure stable operations; update and maintain core business system master files and tables; maintain integrity and ongoing quality control of RCM system configurations and reporting consistent with company policy/procedures.
- Manage all RCM vendor products to ensure stable operations; function as primary point of contact between billing and ancillary vendors coordinating communications and problem resolution.
- Assess, diagnose and resolve problems related to RCM application and vendor products in a timely manner; coach internal customers on proper problem-solving process as appropriate; provide technical assistance and support in adherence to established processes for incoming inquiries and issues. Include proper recording, documentation and closure of problem resolution and conversations to create detailed log of incidents through helpdesk software.
- Oversee RCM Systems Support staff’s workload; exceed and/or maintain standards as set forth by departmental service level agreements (SLAs), key performance indicators (KPIs) and company policies to achieve best practice workflow standards. Ensure work is performed accurately and efficiently.
- Establish departmental incident escalation criteria and develop associated processes; initiate escalation protocols when events occur. Monitor trends of events and root cause to ensure gaps are addressed with the aim of improving escalation procedures as well as reducing the number of escalations.
- Oversee departmental operations to ensure resources are being optimized and that requests and projects are prioritized appropriately and performed as expected to achieve customer needs and delivery dates.
- Oversee the deployment, monitoring, maintenance, development, and support of RCM systems and associated vendor hardware and software based on department and company needs
- Schedule and direct activities, in a timely and accurate fashion, impacting uptime/downtime of RCM systems and vendor products; includes installs, upgrades as well as resolutions to hardware and software failures
- Oversee all aspects of version testing for RCM systems and associated vendor software including stress testing, performance testing, functional testing and regression testing. Review version release documentation and prepare test case assignments. Review test procedures and assist with constructing test scripts as needed to ensure appropriate positive/negative test scenarios are completed. Track, record and review results and report any issues identified to leadership.
- Define measurable KPIs & SLAs for analysts (individually) as well as departmental (team). Establish reporting and cadence of each metric. Ensure performance meets and or exceeds expected thresholds consistent with company’s goals related to profitability, productivity, customer satisfaction and stakeholder impact.
- Define, plan and implement quality assurance levels; routinely perform random and focused audits on RCM System Support staff and RCM systems for compliance to policy and procedures. Include proper recording and documentation of results and corrective actions.
- Maintain a thorough understanding of business processes; accurately translate business requirements to detail-level system specifications and evaluate against current system capabilities.
- Personnel management; including recruitment, supervision, scheduling, mentoring and development, encouragement and motivation, team building, evaluation and disciplinary actions adhering to Company Human Resource policies and procedures.
- Perform basic project planning and management; define and communicate project milestones, service level agreements, and resource allocation to department leads, support staff, and end users to include all pertinent IT activities on a defined basis
- Provide representation and/or leadership related to internal billing/operational/IT initiatives; interact with customers (internal/external) in a professional manner; help foster teamwork to complete designated tasks
- Create and maintain accurate and up to date documentation of departmental SOPs in support of RCM configuration requirements and other departmental responsibilities. Implement policies and procedures to maintain best practice workflow standards.
- Perform strategic planning and priority setting in a dynamically changing environment
- Evaluate and identify opportunities for optimization, to include but not limited to software, processes, procedures; improve process efficiencies and maximize automation; examine and evaluate organizational processes identifying shortfalls and bottlenecks; solving these problems.
- Follow HIPAA, compliance, privacy, security, and confidentiality standards at all times
- Enact the ethics and values of the organization; aligned towards the company’s objectives
- Advise management of situations that could significantly impact the business (system outages, emergency activities, compliance risks, etc.)
- Perform other tasks and projects as assigned to meet the goals of the department and company
Education/Experience/Qualifications
- Minimum 3-5 years work experience in health care billing with focus on RCM System oversight or equivalent combination of education and experience
- Minimum 3 years management experience preferred
- Strong customer service orientation; excellent communication skills both written and verbal
- Proven experience in strategic planning and development, project management, process improvement and policy development; ability to manage multiple projects concurrently
- Ability to effectively prioritize and execute tasks in a high-pressure environment
- Exceptional analytical and complex problem-solving abilities with attention to detail
- Proficient in Microsoft Office suite of tools (i.e., Excel, Word, Visio, etc.
- Ability to present ideas in business-friendly and user-friendly language
- Highly self-motivated, self-directed
- Strong organizational skills with the ability to meet multiple deadlines
Physical Demands:
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.
While performing the duties of this job, the employee is frequently required to stand; to handle or feel; to talk and to hear. The employee is occasionally required to walk, sit, reach with hands and arms and stoop, kneel, crouch or crawl. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by this job include close vision, depth perception and ability to adjust focus.
Work Environment:
Standard office and work from home environments.