Revenue Cycle Operational Improvement, Specialist

Responsible for delivery of multi-network training and quality assurance for hospital and SLPG revenue cycle departments. Ensure staff receives consistent and accurate training on network hospital workflow, processes, and policies and procedures. Reviews regulatory and third party payer changes impacting revenue cycle operations. Functions as a resource and super user for operational leadership and revenue cycle staff for best practices and standardization. Responsible for knowing and training on all system software utilized by revenue cycle departments. Provide quality assurance feedback to operational leadership and staff through monitoring of work queues and dashboard reporting.

• Coordinates the revenue cycle operational needs for new programs and sites to ensure effective capture of patient information for billing requirements.
• Reviews incidents/demands for hospital business offices, Single Business Office, Case Management, Pre Encounter Center, etc. sent to department to recommend approval or disapproval to Revenue Cycle Operational Improvement management team prior to Information Technology submission. Specialists are instrumental in maintaining the integrity of the health information system build and functionality.
• Performs quality assurance audits within the revenue cycle departments. Includes monitoring of new hire and current staff. Monitors work queues, ad hoc reports, identifying any performance improvement trends to manager.
• Performs sites visits upon request to network hospital locations to assist with education, workflows, and implementation of new processes.
• Schedules and performs Revenue Cycle Workshop for hospital new hire and existing employees to explain the impact various departments have on the revenue cycle and gain a stronger understanding of their individual roles within the revenue cycle.
• Helps create and maintain eLearning educational materials for education and yearly competencies. Requires creation of PowerPoint materials, automation, and voice recordings working in conjunction with LMS support team.
• Performs new hire and remedial training on processes and policy and procedures for hospital business and revenue cycle impacting departments which includes, to business offices, hospital verification, financial counselors and visiting nursing billing office. Content includes but is not limited to the following: registration, insurance, online eligibility, address verification, financial clearance, financial counseling, price estimates, price transparency, business office procedures, work queue’s, customer service, referral/authorizations, etc.
• Routinely reviews regulatory and third party payer changes impacting revenue cycle operations. Prepares assessment of process and technical changes and coordinates updates for system changes and policy and procedure changes. Will specialize in their respective area of responsibility: scheduling, patient registration, patient accounting, medical records, and coding.
• Coordinates with operational areas ensuring policies and procedures are maintained to support revenue cycle areas.