Job Board

Manager Business Office, Health Information Management

Position Summary

The Manager, Business Office and HIM, is a tenacious revenue cycle enthusiast who collaborates with the clinical, financial, billing, and coding teams to drive outcomes and assure appropriate reimbursement.  Responsible for overseeing and directing the activities and staff in business office and health information management departments.  Enjoy moving between understanding current processes and leading the team to drive outcomes. Ideally has experience in clinical care setting, telehealth, remote patient monitoring, and understands the intricacies of fee-for-service and value-based payment methodologies, along with systems that care for vulnerable populations.  Comfortable working independently in an ambiguous environment that can experience rapid growth and changes quickly.

Our team is passionate, driven, collaborative, intellectually curious, and excited about the opportunity to be a part of a Patient Centered Medical Home (PCMH) organization during a time of transformational change in healthcare.  We're inspired by our medical providers and seek to create a platform that recognizes, utilizes and supports their vital role caring for the patients and communities we serve. We strive to continuously explore, learn, and achieve results.

Dimensions

  • Establish standards of excellence and quality for Brown Clinic business office and health information.
  • Work with leadership to develop policies to ensure revenue cycle efficiency
  • Create “key performance indicators (KPIs) for revenue cycle management, monitor performance and implement improvement
  • Takes ownership of billing and collections and collaborates with leadership to resolve issues/problems in a timely manner and prevent their recurrence
  • Drive processes that achieve financial results for billing, collections and payment processing. This will include timely charge entry/capture, billing/claims submission and payment posting
  • Review and ensure timely follow-up on outstanding items and assist in the resolution of billing audits
  • Conduct and oversee denial analysis, implement denial reduction initiatives and reduce overall denials
  • Partner with others to ensure timely, accurate, and compliant billing and coding activities
  • Negotiate/Manage various health plan contracts and associated credentialing processes for timeliness and appropriate payment objectives
  • Assist in hiring, training, and measuring and managing productivity of the team
  • Help identify inefficiencies and create and implement process improvement activities
  • Serve as an internal consulting resource on revenue cycle management
  • Must be able to communicate effectively verbally and written.
  • Excellent customer service and phone etiquette skills.
  • Must be able to maintain a high degree of confidentiality and work well under productivity standards.
  • Able to prioritize and balance workload on short and long-term company needs.
  • Must be able to work independently and be able to solve problems efficiently and accurately.
  • Able to create channels of communication to obtain information necessary to perform job tasks.
  • Strong organizational skills with the ability to prioritize a high-volume workload.
  • Advanced computer knowledge and proficiency required.
  • Highly proficient Excel user necessary for analyses and reporting, including proficiency with Excel pivot tables.
  • Familiarity with preparing dashboard reports that track performance indicators

Primary Responsibilities and Duties

  1. Continually looks for opportunities to automate routine RCM tasks through technology. In conjunction with leadership, oversees the implementation of automation/technology projects.
  2. Utilize and become highly proficient with the EMR, the principal EMR and practice management/billing system, as well as become proficient with clearinghouse systems.
  3. In conjunction with leadership, develop KPIs and dashboard reports to monitor and benchmark RCM performance. Set internal goals for KPI metrics. Prepare and distribute monthly KPI reports to leadership, flagging performance metrics that are lagging benchmarks or internal goals.
  4. Develop and implement improvement plans for underperforming KPI benchmarks and internal goals.
  5. Monitor credit balance reports to ensure accurate and timely refunds. Monitor RCM Department to ensure compliance with applicable timely refund requirements.
  6. Develop and monitor denial management system, whether automated or manual.
  7. Develop and/or monitor system to confirm payer reimbursement conforms to contracted (expected) rates or governmental fee schedules.
  8. Serve as the subject-matter expert (SME) on regulatory, compliance, and legal requirements associated with medical billing. Ensures compliance with relevant regulations, standards, and directives from regulatory agencies, governmental and third-party payers.
  9. Communicate relevant payer policy changes and updates to clinic operations.
  10. Assist in the development, periodic revision, and implementation of the Billing & Collection Policies and Procedures Manual.
  11. Supervise others to contact payers to identify and resolve account collection problems for maximum collection results.
  12. Work with Team Leads and HR Department in managing activities of the department in regards to recruiting, hiring, termination, training, professional development, mentoring, counseling, and performance evaluations.
  13. Foster a strong culture of accountability, teamwork, collaboration, and operational excellence within the department.
  14. Promote relevant continuing education and training for team leads and staff members.
  15. Assume responsibility for analyzing existing payer agreements for appropriate reimbursement and initiating prioritized contract renegotiations with payers when appropriate.
  16. Other duties as assigned or needed.

Qualifications

  • Bachelor’s degree in Business Administration, Accounting or related field is required.
  • Minimum of two years of progressively responsible supervisory experience in a business
  • A working knowledge of insurance diagnosis coding, accounts receivable, claim requirements, electronic billing procedures, and cash posting functions, managed care  contract reimbursement, secondary billing, unidentified cash, and patient liability.
  • Respect for and ability to follow Clinic’s Confidentiality Policy.

Please apply online at www.brownclinic.org/careers/job-opportunities


Practice Administrator

Reports to: Stockholders

Work Schedule: Monday-Friday

Job Summary:

Clinical Laboratory of the Black Hills is seeking a Practice Administrator to be an integral part of the management team. We are looking for an energetic professional who is well organized, flexible, and enjoys the administrative challenges of supporting an office of diverse people with optimal coordination and production. The individual should project strong leadership and a positive image through excellent communication and service skills and has the key ability of being able to manage multiple competing priorities.

This position is responsible for providing leadership and management direction to a group of six pathologists and a pathology assistant. This position will oversee the operation of the medical group to ensure accomplishment of the group’s strategic goals and objectives. This position works with physician shareholders, practice staff, referring physicians, vendors, consultants, payers, and hospital administration. The Practice Administrator is responsible for the overall operational and financial performance and associated endeavors of the physician’s group. In addition, the Practice Administrator plays a key role in new business development including physician recruitment.

Essential Duties and Responsibilities include the following:

· Human Resources

· Facility Management & Inventory Control

· Billing and Collections

· Credentialing

· Accounting

· Payer Contracting

· Practice Operations

· IT Management

Required Education, Experience and Skills

· Minimum Qualifications are a Bachelor’s Degree in Business, Health Administration, or related field, Master’s Degree preferred or an equivalent combination of education and experience. A minimum of 3 years’ experience with group practice management in the private sector.

· Must be a self-motivated individual who can organize, lead, and manage a fast-paced practice. Must be able to effectively communicate both verbally and in writing with partners, office staff, hospital administration, referring physicians, health care professionals, and consultants.

· Must be skilled at reading and interpreting financial statements, and other basic accounting reports.

· Ability to handle sensitive information in a confidential and professional manner and must demonstrate tact, diplomacy and good judgement in all dealings.

· Must possess a detailed knowledge of Information Technology Systems including multiple interfaces with Electronic Medical Records and ancillary support software. Must be able to work with remote IT consultant when necessary.

· Must possess excellent written and oral communication skills.

Salary Range

Highly competitive compensation package including PTO, paid holidays, group insurance coverage options, including health, life, dental, and vision. Retirement Plan – 401K and profit sharing.

Applicants:

Applicants must submit a resume and cover letter.  Candidates will be evaluated on a rolling basis and notified of their status.

Please send resume to jmcgough@clinlab.com or contact him at 605-343-2267.


Director of Managed Care Contracting

Join our growing team! Sioux Falls Specialty Hospital seeks a Full-Time Director of Managed Care Contracting that is responsible for negotiating and implementing contracting strategies for Independent Healthcare Associates.

Responsibilities:

  • Negotiate all contracts with commercial and government payers.
  • Identify and develop strategies for payer and employer partnerships.
  • Lead the planning and implementation of managed care strategy including value based contracting
  • Monitor payer environment for emerging payment models and trends.
  • Analyze and report reimbursement information to members.

Education and Experience:

  • Bachelor’s Degree in Healthcare or Business Administration.
  • Three to five experience in insurance or healthcare administration, including experience in negotiating managed care contracts.
  • Friends and Family CPR required; can be obtained upon hire.

Sioux Falls Specialty Hospital is pleased to offer a comprehensive array of valuable benefits to protect your health, your family, and your way of life. As a Sioux Falls Specialty Hospital team member, you will have many benefits available to you, including medical, dental, and vision insurance, paid time off, generous 401(k) match, monthly fitness stipend, business perks and discounts, fun team member events, and more!

Sioux Falls Specialty Hospital is proud to be physician-owned and operated.

We are an EO employer – Minority/Female/Veteran/Disability.

Please apply online at www.sfsh.com/careers contact:

Sioux Falls Specialty Hospital
Human Resources
910 E 20th Street
Sioux Falls, SD 57106
Email: careers@sfsh.com

Phone: 605-334-6730
Fax: 605-444-8410

Contact Us

South Dakota Medical Group Management Association
2600 W. 49th St. Suite 100
Sioux Falls, SD 57105
605.336.1965

tmarks@sdsma.org


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