at Help at Home in Chicago, Illinois, United States
Job Description
Help at Home is the leading national provider of in-home personal care services, where our mission is to enable individuals to live with independence and dignity at home. Our team supports 66,000 clients monthly with the help of 49,000 compassionate caregivers across 12 states. We’re focused on serving people and the communities we are part of.
Job Summary:
Overall responsibility for the Authorization and Eligibility teams within assigned markets as well as shared partnership in global company-wide Revenue Cycle Management responsibilities. Directs the activities of an assigned team, resolves moderately complex problems and is accountable for the accuracy and timeliness of data generated by this function. Primary responsibilities include managing and directly overseeing authorization, eligibility, ensuring client access to care, reducing revenue risk to the company, identifying and implementing necessary controls, coaching employees, and general oversight of all people and processes. This position reports to the RCM Director (Client Access), who leads the front-end revenue cycle operations and strategy for Help at Home.
As a People Leader:
+ You lead with empathy, vulnerability, and honesty.
+ Must have a love of learning.
+ Endless curiosity and an enthusiasm for continuous improvement
+ Team-first mindset
+ Empower and inspire full time associates through coaching.
+ Hold others to high standard.
+ Knows how and when to celebrate success.
Supervisory Responsibilities:
+ Directs growing team of RCM Representatives specialized in authorization, eligibility, and account maintenance
+ Supervising assigned personnel, mentoring, and coaching to achieve highest level of competency of staff
+ Providing constructive feedback, corrective action plans, reviews, and professional development, when appropriate
+ Conducting staff meetings at regular intervals for informative and educational purposes
+ Incorporate company or departmental changes effectively and timely
+ Ensure departmental goals are met by providing daily guidance to staff to ensure work is done efficiently and timely
+ Identify deficiencies and work to improve them through collaboration within the team and with other departments
+ Manage day to day issues and problems, escalating in a timely manner as necessary.
Essential Duties/Responsibilities:
Responsibilities include, but are not limited to:
+ Demonstrate ability to work effectively at both granular and big-picture levels
+ Think analytically with the ability to perform root cause analysis, prepare and implement action plans, and lead improvement initiatives
+ Ensure client authorization data is accurately entered into the system, including payor information and service charges
+ Communicate with payors in accordance with payor requirements and agency policy
+ Supervise missing authorization and loss of Medicaid eligibility processes to limit revenue risk
+ Analyze daily reports and worklists. Must be able to:
+ Identify missing or pending authorizations
+ Create follow-up reporting
+ Maintain accurate authorization analysis reports and communicating implications promptly to the appropriate parties
+ Communicate with contracted payers for resolution of issues and submission of exception requests, disputes, and appeals
+ Communicate and partner with market operations and other divisions to drive improvements, increase client access, and reduce revenue risks.
+ Create SOP documentation and process maps, updating with any process changes
+ Develop reporting tools to track key performance indicators to monitor and manage overall performance. Present KPIs to leadership team regularly.
+ Set department goals, measuring performance at regular intervals to track, monitor, and coach to ensure standards are met and maintained.
+ Partner in the creation, refinement, and management of new business lines and/or processes, integration of new acquisitions, and expansion into new markets.
+ Help drive Revenue Cycle Management projects to create efficiencies and streamline processes.
+ Actively contribute to and/or lead company-wide Revenue Cycle Management related activates and visioning.
+ Support the planning of strategic direction and future state of the organization as it relates to revenue cycle management operations.
+ Performs other related duties as assigned.
Required Skills and Abilities:
+ Analytic and persistent; able to get to the root of problems. Self-motivated; reliable; strong attention to details; maintains confidentiality; complies with all policies and procedures.
+ Demonstrates maturity and the ability to function as a team member; good communication skills.
+ Able to supervise staff and coach them to improve functioning and overall agency services. Organized, assertive, mature, approachable and open-minded. Willing to take initiative. Identifies and progresses toward meeting personal and professional goals.
+ Able to deal with stress and conflict appropriately.
Education and Experience:
+ Bachelor’s degree and/or 5+ years of revenue cycle experience preferred.
+ Prior healthcare revenue cycle management/billing experience is required and knowledge of Home Care service technology, Long Term Care Insurance, Medicaid and Medicare is preferred. Advanced computer skills, including the use of Microsoft Office applications (e.g. Word, Excel). Ability to generate and utilize Microsoft Excel advanced formulas, pivot tables, power queries and advanced charting required.
