Revenue Cycle Systems Administrator

Job Description

ESSENTIAL FUNCTIONS

Develops a mastery of the RCM systems to provide training, implementation, best practices and analysis of system performance and for end users and stakeholders.

Maintains RCM system performance through system monitoring, reconciliations and work closely with IT and RCM for efficient and expected operations.

Regular audits end to end claim through put accuracy and compliance from order to template, charge entry, billing and payment posting. Develops recommendation plans for improvement based on trends.

Assesses reports of billing system or workflow disconnects that have created financial or compliance consequences. Investigates the report of charge, claim or payment posting disruptions.

Provides billing implementation support and system reviews.

Provides regular billing system maintenance including table updates, enhancement and upgrade implication assessments, charge master hygiene, transactional code set up and maintenance and database updates.

Answers, resolves and trends the root causes of RCM support tickets to identify system enhancement opportunities to minimize work disruption, system bugs and inefficiencies.

Participate in various ad-hoc revenue cycle optimization initiatives as assigned.

EDUCATION

Bachelors degree in HIM, IT or related field, preferred.

Experience will be considered in lieu of education.

EXPERIENCE

8+ years’ experience in revenue cycle management operations with a progressive track to and / or interface to billing system implementations, structure and / or maintenance.

4+ years’ experience in operational planning, operational excellence, change management or similar experience.

2+ years experience in direct HIT system related work.

REQUIREMENTS

Travel up to 5% of the time to stakeholder markets in the US

Meeting facilitation both virtually and in person

Creating and presenting operational outcomes

Gathering and organizing meaningful market stakeholder data

KNOWLEDGE

Strong knowledge of healthcare billing claim operations and payment models.

Knowledge of executing large, complex projects with competing priorities and deadlines.

Charge master administration and maintenance required.

Knowledge of implementation, planning and execution with systems and processes.

SKILLS

Communication: Communicates well, both verbally and in writing with strong conflict resolution skills in both

Team building: Motivates others and works well with a team

Decision making: Can make quick and informed decisions, even when all the necessary information isn't available

Emotional intelligence: Can understand, manage and express emotions dependent on the situation and recognize appropriately the emotions of others.

Business acumen: Uses company resources efficiently and in line with the organization's goals

Risk management: Can assess risks and know when to take them

Interpersonal skills: Can work well with others

Leadership development: Can lead others and drive business growth

ABILITIES

Effective time and reputation management

This role must be able to manage their resources wisely, prioritize and gain respect within the organization

Implement strategies

This role must be able to implement strategies to help the organization succeed

Develop long-term plans

This role must be able to think long-term and create plans to help the organization grow

Align with company goals

This role must have the ability to think creatively on self-driven initiative to make sure their plans align with the company's goals and vision

Communicate effectively

This role must be able communicate well with their teams and other stakeholders even under pressure

Empathize and negotiate

This role must be able to empathize with others, negotiate, and compromise calmly with a focus on problem solving

Analyze data

This role must be able to collect, analyze, synthesize and interpret data from a variety of sources

Make decisions

This role must be able to make decisions in an efficient time frame

ENVIRONMENTAL WORKING CONDITIONS

Primarily remote in nature with travel to HOPCo offices and sites

PHYSICAL/MENTAL DEMANDS

Sitting for long periods of time.

Stress from competing priorities, financial pressure and escalated expectations

ORGANIZATIONAL REQUIREMENTS

HOPCo Mission, Vision and Values must be acknowledged and adhered to

List additional organization requirements such as training conducted by organization

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Full-time

Fully remote