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Healthcare Operations Lead

2 weeks ago

Gisborne, Gisborne, New Zealand Tbwa ChiatDay Inc Full time

We're seeking a seasoned Healthcare Operations Lead to oversee the day-to-day activities associated with patient eligibility, charge entry, accounts receivable management, and patient invoice management. The ideal candidate will possess a deep understanding of revenue cycle management principles and best practices.

In this role, you'll be responsible for driving achievement of effective billing performance through management of workload inventories, quality of billing submissions to insurance companies/patients, and active management of payments that may be delayed due to denial of charges at the insurance company or other related impacts to accurate revenue collection. You'll work collaboratively with internal partners to ensure timely and accurate billing and resolve outstanding billing issues with insurance company partners.

Responsibilities

This position involves:

  • Managing billing work inventories related to mental health and substance use disorder services with commercial health plans, state Medicaid, and managed-care organizations, and Medicare.
  • Proactively identifying situations requiring intervention (i.e., denials, underpayments, and other issues). Planning, preparing, and conducting corrective course of action(s) in partnership with key stakeholders.
  • Maintaining process excellence by making corrections to staff execution and/or business process challenges that lead to revenue collection delays.
  • Ensuring patient insurance eligibility is actively managed to guarantee smooth billing experience for patients and effective submission to applicable insurance companies.
  • Utilizing available data to identify key performance themes and trends.
  • Coaching and developing teammates as it relates to their direct performance of defined objectives and professional development.
  • Fostering a team environment promoting performance, belonging, and engagement.
  • Ensuring the Revenue Cycle team executes defined processes in accordance with applicable regulations, policies, and procedures.