Position Summary

At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida’s east to west coasts and beyond.

Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin  benefits on day one and offer flexibility wherever possible so that you can be present for your passions. “Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you.

Position Summary:The Manager, Hospital Revenue Management is responsible for the resolution of hospital accounts receivable. This includes daily oversight of insurance collections, cash posting, denial and appeals management, and variance review.

Responsibilities

Essential Functions:• Develops goals and objectivesfor the department and teammembers• Responsible for the orientation and training of new Assistant Managers• Ensures Assistant Managers are compliant with productivity standards, performance evaluations, team member development, core competencies, and the daily motivation and coaching of team members.• Responsible for monthly review of the accounts receivable for all assigned payers, as well as, optimizing reimbursement and achieving pre-set cash to net collection goals.• Reviews and validates overpayment requests as necessary.• Develops and maintainstracking of all payer-related issuesimpacting the accounts receivable for assigned payers.• Facilitates and presents at task force meetingsthe status of payer issues, outstanding accountsreceivable, action plans underway to attain goals for cash collections and accounts receivable days.• Providesfeedback to the Managed Care team regarding issues and trendsthat cause the accountsreceivable to age.• Ensures that state and federal legislative changes are communicated to the appropriate team members throughout the Patient Accounting Department.• Develops and maintains standard process workflows for account review to be followed by the Assistant Managers and team members within the Patient Accounting Department.• Works closely with all departments within Revenue Management to increase the clean claims percentage, first pass denial rate, and to root cause problems that hinder timely account resolution.• Establishes and implements policies and proceduresfor department operations.• Responsible for the management of all team membersin Human Resource related functions.• Reviews departmental performance and implements changes as necessary to improve services and simplify workflows.• Develops and implements appropriate new businessrelative to new insurance contracts and/or newfacilities.• Maintains good payorrelationships• Works closely with the contract managers and the revenue integrity team in maintaining good payor relationships and ensuring compliance with regulatory requirements, fraud and abuse laws.• Develops and implements rules within the electronic health record to facilitate cleaner claims.• Completesspecial projects as assigned.• Establishes and maintains intra/interdepartmental communication. Participates in management meetings and attends other meetings as necessary.• Meets with team members on a regular cadence.• Establishes and maintains safety, policies, procedures, objectives, and infection control in the department.• Ensuresimplementation of processimprovements.• Manages various personnel functionsincluding hiring, work assignments, coaching plans, and disciplinary actions.• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.• Maintains compliance with all Orlando Health policies and procedures.

Other Related Functions:• Assumes responsibility for professional growth, development, and continuing education.• Conductsspecial trainingsfor mentoring as necessary. .• Performs other duties as assigned.• Completes all mandatory education.

Qualifications

Education/Training:• Bachelor’s degree in business, Healthcare Administration, Communications, Business, Finance, or related area of study is preferred. • Associates’ Degree and two (2) years of experience in a related field (medical billing/collections/managed care) may substitute for the Bachelor’s Degree. • Four (4) years of experience in a related field (medical billing/collections/managed care) may substitute for the bachelor’s degree.

Licensure/Certification:• HFMA or AAHAM certification is preferred.

Experience:• Four (4) years of experience in revenue cycle is required. • Two (2) years of prior supervisory experience or 2 years of a lead/preceptor role is required.