Job Details
Qualifications
- Bachelor's degree
- Epic
- Management
- Supervising experience
Job Description
JOB PURPOSE:
Providing leadership and overseeing the daily operations of the Credit Resolution function for Piedmont Healthcare. Functions under the responsibility of Credit Resolution include: resolving refund requests and credit balances in all of Piedmont Healthcare’s financial systems by reviewing the accounts, remittance advices, the common working file, coordination of benefits, and working with third-party payors and patients to determine and perform the correct course of action on the account. Compiling and submitting quarterly, annual, etc. governmental, managed care and other payer credit balance reports. These activities shall be performed in a timely and accurate manner. The Credit Resolution Manager reports to the Director of Payment Applications.
KEY RESPONSIBILITIES:
1. Support, oversee, and manage the performance and productivity of the team as it relates to credit resolution activities and pre-defined goals/targets, while providing continual feedback and guidance to the team.
2. Oversee credit resolution activities to ensure they are performed on the appropriate hospital accounts and are reflected and accounted for in the system, accurately and timely at month’s end, or within appropriate timeline.
3. Strive to have no backlog and meet credit resolution goals by the end of each week/month.
4. Monitor credit balance and refund work queues to ensure accurate and timely completion of credit and refund processing.
5. Compliance with all payer reporting requirements
6. Research trends and identify root causes of credit balances in the system. Make recommendations and develop plans on how to address.
7. Develop and maintain “super user” capabilities in Epic applications and all other related information systems, tools, technologies, and processes; assist other employees as needed to ensure all tools are fully utilized to create an efficient and effective department.
8. Create a work environment for employees through team building, coaching, constructive feedback, work delegation, personal example and goal setting that encourages creativity, open dialogue on work issues, professional growth, and a consistent, high level of performance; encourage and support employee decision-making within his or her scope of responsibilities.
9. Work with the Training and Education department to develop and deploy training for new employees and provide ongoing training as needed.
10. Complete annual performance reviews for employees and provide timely feedback to employees and address performance/quality and training issues as appropriate.
11. Develop and revise department policies and procedures as required.
12. Deliver positive patient experience.
13. Liaise appropriately with peers across the system.
14. Complete disciplinary action as required.
15. Adhere to Piedmont organizational policies and procedures for relevant location and job scope.
16. Perform any special assignments as requested.
Requirements
MINIMUM EDUCATION REQUIRED:
A bachelor’s degree in Business, Finance, Information Systems or a related field is required. In lieu of bachelor’s degree, six (6) years of related Revenue Cycle experience may be substituted in addition to the minimum experience requirement.
MINIMUM EXPERIENCE REQUIRED:
Five (5) years of Financial Operations and/or Information Systems experience preferably within the Revenue Cycle functional area in the Healthcare Industry. Three (3) years of management/supervisory experience.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
N/A
PREFERRED QUALIFICATIONS:
At least eight (8) years of related Revenue Cycle healthcare experience, preferably within Credit Resolution function. At least five (5) years of management experience. Prior Epic experience. Experience with any of Piedmont Healthcare’s legacy financial systems.
#GD
KEY RESPONSIBILITIES:
1. Support, oversee, and manage the performance and productivity of the team as it relates to credit resolution activities and pre-defined goals/targets, while providing continual feedback and guidance to the team.
2. Oversee credit resolution activities to ensure they are performed on the appropriate hospital accounts and are reflected and accounted for in the system, accurately and timely at month’s end, or within appropriate timeline.
3. Strive to have no backlog and meet credit resolution goals by the end of each week/month.
4. Monitor credit balance and refund work queues to ensure accurate and timely completion of credit and refund processing.
5. Compliance with all payer reporting requirements
6. Research trends and identify root causes of credit balances in the system. Make recommendations and develop plans on how to address.
7. Develop and maintain “super user” capabilities in Epic applications and all other related information systems, tools, technologies, and processes; assist other employees as needed to ensure all tools are fully utilized to create an efficient and effective department.
8. Create a work environment for employees through team building, coaching, constructive feedback, work delegation, personal example and goal setting that encourages creativity, open dialogue on work issues, professional growth, and a consistent, high level of performance; encourage and support employee decision-making within his or her scope of responsibilities.
9. Work with the Training and Education department to develop and deploy training for new employees and provide ongoing training as needed.
10. Complete annual performance reviews for employees and provide timely feedback to employees and address performance/quality and training issues as appropriate.
11. Develop and revise department policies and procedures as required.
12. Deliver positive patient experience.
13. Liaise appropriately with peers across the system.
14. Complete disciplinary action as required.
15. Adhere to Piedmont organizational policies and procedures for relevant location and job scope.
16. Perform any special assignments as requested.
#LI-POST
Diversity & Inclusion
At Piedmont Healthcare we embrace diverse ideas, perspectives, and skills to create a collaborative workplace where the best talent wants to succeed. We celebrate differences and recognize that they allow us to care for our community.
Excellence at Work
Piedmont is a certified Great Place to Work™- a national designation based on employee feedback about trust, workplace culture and experience. In 2019, Forbes named Piedmont one of Georgia’s 10 best employers and the highest-ranked healthcare provider.