University of Florida Jacksonville Healthcare, Inc.
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Business Group Manager
at University of Florida Jacksonville Healthcare, Inc.
Under the direction of the Director of the Business Groups, the Physician Medical Billing Partner will be fully dedicated to an assigned Business Group specialty to provide substantial expert knowledge and understanding of the revenue cycle and regulations. While maintaining the highest level of compliance and ethics, will be responsible for managing Business Operations Team members, leading revenue cycle activities for specialties assigned, and ensuring all revenue is captured and reimbursement is maximized.
Establishes and manages revenue cycle goals for assigned Business Group based on practice-specific indicators, and track progress according to set goals. Provides leadership and guidance of Business Operations staff to maximize revenue and improve cash flow.
• Reviews revenue cycle diagnostic reports each month and provides feedback to appropriate parties. Performs rejection and revenue cycle analysis on a weekly - monthly basis.
• Monitors and provides oversight to ensure budgetary targets are achieved. Develops department revenue cycle metrics to meet standards and benchmarking for all stages of the revenue cycle process.
• Identifies and analyzes trends in A/R by payor as well as turnaround times by payment source. Meets with representatives of Manage Care and/or other third party representatives to resolve revenue cycle issues. Participates in meetings and work groups with a variety of levels of personnel within and outside the organization and coordinates any action as needed.
• Provides effective communication and interpersonal skills with all levels of the organization including but not limited to Deans, Vice Presidents, Department Chairs, Medical Directors, Physicians, Director of Business Groups and Administrators on a routine basis to keep them apprised of opportunities and work collaboratively to resolve issues and implement process changes where appropriate.
• Analyzes and presents reports of accounts receivable, monthly financial reports and billing department operations issues to Department Chair(s), Director of Business Groups, Department Administrators, Finance and Compliance.
• Establishes and develops staff performance criteria, maintains policies and procedures for Charge Entry, Registration, Coding, and Follow-up for Business Groups to include quality audits that meet compliance guidelines to increase efficiency, workflow improvements and responsibilities for consistent efficient revenue cycle operations. Develops and directs quality assurance and quality improvement plans. Directs and develops the implementation of procedures and controls to increase efficiency in revenue cycle operations. Ensures that all policies and procedures related to revenue cycle responsibilities are performed in such a manner as to ensure a consistent efficient and cost effective billing operation.
• Communicates with Information Systems regarding system issues, and CDQ regarding reporting and surgical coding needs. Monitors and tests resolution of issues sent to IS. Continually monitors the functionality and efficiency of the billing system and makes recommendations for automated procedures or system modifications as needed. Communicates issues to IS system personnel along with recommendations and verifying accuracy of data received from various departments.
• Works with Senior Leadership to develop goals and objectives from strategic plans that include formulating, planning and assessing annual budgets through relevant trends and makes recommendations to ensure the viability of annual budgets and projections, establishing policies and procedures, and implementing processes to execute revenue cycle operations. Collaborates with Finance Department personnel as well as key department personnel in the planning and assessment of annual budgets. Researches relevant trends and makes recommendations to ensure the viability of budget projections.
• Effectively implements and actively monitors coding, billing and payment related data to identify patterns to represent compliance with local, state, and federal laws and regulations. Ensures staff are informed of all corporate policy changes affecting billing related issues and guidelines while working with the Office of Compliance and Federal Agencies as questions and concerns arise. Ensures that Business Operations staff, billing routines and functions meet compliance guidelines from a fiscal, financial and operational standpoint.
Adhere to company policies and procedures, demonstrate the core values and Hospitality behaviors, resolve conflict through open, honest, professional communication, demonstrate positive and enthusiastic attitude, keep supervisor and leadership apprised of issues, and seek opportunities to recognize others.
SKILLS, QUALIFICATIONS, AND REQUIRED EXPERIENCE
Skills, Knowledge, Abilities
• Possesses strong consulting skills.
• Strong interpersonal skills including a professional and positive demeanor.
• Ability to communicate effectively and courteously, both orally and in writing.
• Requires expertise with standard concepts, practices, and procedures within the healthcare-billing field.
• Relies on experience and judgment to plan and accomplish goals. Scope, plan, and prioritize multiple projects.
• Knowledgeable of all governmental/regulatory agencies and third-party insurance regulations and policies to ensure compliance.
• Knowledge of all pertinent Federal, State regulations and policies, as they presently exist and as they change or are modified. Maintains knowledge of private and governmental third party insurance company operating procedures, regulations and billing requirements.
• Ability to produce statistical reports is required. Ability to understand and use metrics for business intelligence.
Critical Thinking/Sound Judgement
• Must have strong analytical and problem solving skills.
• Demonstrates effective communication with senior management, peers and subordinates both within and external to the department.
Length of Experience
Type of Experience
Management experience in physician revenue cycle operations or related healthcare experience
Significant knowledge of, and experience with revenue cycle processes, rules, and regulations
Managed care contracts
Managing a group of 10 or more employees
Program of Study
High School Diploma or GED equivalent