Revenue Cycle System Applications Supervisor – Providence Community Health – Warwick, RI

Job title: Revenue Cycle System Applications Supervisor Company: Providence Community Health Job description: Providence Community Health Revenue Cycle System Applications Supervisor Employee - Full Time Leadership-Superviso Warwick, Warwick, RI, US Summary: This role is responsible for the maintenance of Revenue Cycle system applications: (including Provider Maintenance, Service and Procedure tables, Charge Masters, Fee Schedules, and researching and building of future system applications including Credentialing & Contract Management, this role will act as liaison between Revenue Cycle department and all PCHC management and providers to research and resolve requests related to their position. This role is responsible to streamline the end-to-end credentialing process, including overseeing Credentialing staff; automating credentialing functions to assure operational efficiency and meet strategic goals; build and implement a Contract Management system in collaboration with the Chief Financial Officer, Controller and Director of Revenue Cycle and others; and effectively resolve reimbursement issues. Under the direction of the Director of Revenue Cycle this role is responsible to develop and implement organizational policies and procedures in areas of responsibility and will ensure organizational compliance. This role will apply in-depth functional knowledge, managerial and leadership expertise to achieve focused business goals. This role is responsible to identify long term solutions to utilizing systems to improve operations and will implement short term solutions to allow the organization to operate at peak performance. Essential Duties & Responsibilities: • Effectively manage credentialing staff. • Manages and maintains Revenue Cycle applications. • Research, build and implement new applications to improve organizational efficiency and reimbursement outcomes. • Responsible for oversight of provider and credentialing databases, and associated modules, ensuring accuracy of data and reporting to downstream systems. Ensure distribution, receipt, processing, and timely delivery to appropriate internal and external individuals/entities. • Responsible to create and maintain procedure manual documenting credentialing processes. Monitor critical data for extensive analysis and report generation. • In coordination with Controller & Revenue Cycle Managers, review financial viability of new services and/or programs as directed. • Identify reimbursement and/or contractual issues, associated data collection and development of recommended actions for improvement for presentation to management. • Review and develop recommendations for management on areas for improvement for Credit Balance issues. • Leverage analytical knowledge and team leadership skills to drive the development of automated improvements in the electronic health record(s). • Establish developmental and individual improvement plans for staff consistent with organizational mission, vision, and values, as needed. • Proactive in the collection of all pertinent information from internal and external sources to assure the tables/systems are processing information correctly and timely. • Communicates consistently with internal and external stakeholders to obtain and verify information. • Identify opportunities for efficiency and implement initiatives, including new procedures, to improve process in areas of responsibility. • Responsible to review and respond to issues related to Compliance, Internal and External audits related to areas of responsibilities. • Remain current in regulatory and compliance aspects of billing, reimbursement, coding, and credentialing, including State & Federal laws, regulations, and contractual agreements. • Serve on project work groups and subcommittees as assigned. • Other duties as assigned. Essential Skills / Qualifications: • Strong problem solving and business acumen skills with an ability to work independently, manage priorities, develop strong relationships with internal and external stakeholders. • High degree of proficiency in Microsoft Excel and other Microsoft Office suite products. • Strong data management skills. • Highly motivated and results oriented with excellent prioritization, critical-thinking, multi-tasking and communication skills. • Must demonstrate strong analytical skills and attention to detail. • Ability to train, coach and mentor staff. • Ensures staff evaluations include targeted goals and oversees completion in a timely manner. • Excellent interpersonal skills. Direct Reports: • Credentialing Specialist. • Other staff, as applicable. Education Required: · Associate degree in Health Care Administration, Business Administration, or a related field, or an equivalent amount of education and experience. Experience Required: · 2+ years experience with provider credentialing or related experience. · 1+ years of experience with health care reimbursement. · 2+ years’ experience with Healthcare Patient Accounting systems. · 2+ years supervisory/management experience preferred. · 2+ years’ experience in managing financial tables preferred. PCHC is EOE/M/F/D/V/SO PI195064447 Expected salary: Location: Warwick, RI Job date: Tue, 25 Oct 2022 05:10:44 GMT Apply for the job now! Apply tot his job Apply To this Job