Description

Department:

70001 Wake Forest University Health Sciences - Ambulatory Services

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

M-F, 8-5; although, lead teammates who work extended hours and weekends.

Pay Range
$57.85 - $86.80

Major Responsibilities:

Oversee and direct the coverage assistance process to increase gross self-pay charges converted to Medicaid or other coverage while providing excellent customer experience throughout.

Direct operations contributing to the collective review of over 45,000 patients annually to secure coverage opportunities, generating $1B+ in gross self-pay charges converted to Medicaid.

Ensure compliance with Medicaid, marketplace or other regulations related to the eligibility and en rollment process.

Manage, direct, and evaluate all processes to adhere to quality, productivity, and effectiveness standards.

Demonstrate accountability through continuous quality improvement ensuring metrics and key performance indicators are met and exceeded. Specifically increased reimbursement by securing Medicaid or other coverage opportunities for patients.

Build and develop a highly effective team to provide oversight for staffing, performance management and regulatory support.

Participate in the design and continuous improvement of all processes that ensure accounts are managed promptly and effectively to secure Medicaid or other coverage.

Collaborate and build synergies with internal and external partners

Ensure optimal resource utilization and institute measures that result in greater cost effectiveness and efficiency in operations while ensuring high patient satisfaction.

Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations, and overall employee morale.

Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives .

Licensure, Registration, and/or Certification Required:

None required.

Education Required:

Bachelor's Degree.

Experience Required:

Typically, requires 7+ years of experience in revenue cycle operations, preferably in scope with health coverage eligibility and enrollment. Minimum of 5 years in supervisory role managing staff, budgets, reimbursement and receivables management.

Knowledge, Skills & Abilities Required:

Demonstrated leadership skills including project management, process improvement, problem-solving, decision making, prioritization, delegation, team building, customer service and conflict resolution.

Strong interpersonal, communication and organizational skills.

Strong financial analysis and management, long range planning and forecasting, and negotiation skills.

Strong background and knowledge in both hospital and revenue cycle operations/principles preferred.

Strong background and knowledge in program management, government health plans and regula tory compliance

Experience in executing change and results based upon data analytics and directed goal sets of the leader of billing operations.

Previous experience with system conversion and office re-structure

Demonstrated interest in employee development, ability in interpersonal communications and sensitivity to teammate needs.

Physical Requirements and Working Conditions:

This position requires travel, therefore, will be exposed to weather and road conditions.

Operates all equipment necessary to perform the job.

Exposed to a normal office environment.

Occasionally lifts up to 20lbs

DISCLAIMER

All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.

This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position. Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

Regional leader responsible for the operational oversight of Medicaid eligibility and other coverage enrollment functions. Directly responsible for adding millions to regional reimbursement by ensuring the team maximizes opportunity to help patients qualify for Medicaid or marketplace coverage. Oversight of self-pay pre-arrival and point of service operations for all encounters in the region that may qualify for Medicaid or other coverage opportunities. Support maintenance and modifications of applicable policies and workflows as needed.