Familiar with and interpret insurance benefits and possess the ability to explain insurance benefits as well as the adjudication process to others
Experience in and understanding of a large scale production environment in a Payor or provider organization that would include systems and reimbursement methodologies for both payers and providers
Intermediate skills in Access, Excel, PowerPoint, Word, Vision, MS Project
Intermediate data entry skills
English (reading, writing, verbal)
Intermediate level of mathematical proficiency
Strong ability to understand, interpret, modify and develop spreadsheet data
Responsibilities
Evaluate and lead efforts to improve revenue cycle key performance indicators (KPIs)
Drive process and quality enhancements in an agile environment, to improve revenue cycle KPIs
Manage large portfolio of Account Receivables (AR) through payment resolution
Manage cross-functional teams within revenue cycle to resolve reimbursement related issues or opportunities
Lead and support continuous process improvement initiatives to enhance operational efficiency, optimize workflows, and foster innovation within the revenue cycle
Partner with Managed Care on ongoing payor issues and resolution
Work directly with payor entities on ongoing claims/payment issues through resolution
Manage/partner with external/offshore vendor relationships and performance on revenue cycle KPIs
Foster cross-functional organizational relationships to identify and resolve reimbursement issues or opportunities
Develop and analyze reports to identify opportunities, trends, and implement action plans to improve revenue cycle KPIs
Direct and monitor the financial performance of the department, ensuring alignment with budgetary targets and minimizing operational losses
Comply with all compliance, legal and regulatory requirements
Effectively coach and develop new and existing teammates within the reimbursement organization to achieve continued success and meet business challenges in addition to maintaining Byram’s mission, values, and strategies
Performs other duties as required
Manages all subordinate teammates of the department and is responsible for the performance management, hiring, and discipline of subordinate teammates within the department