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Revenue Cycle Account Manager - Providence, RI

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City:Providence
Zip:02901

Description

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Position Description:

Optum360 is a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage all our resources to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.

If you want to achieve more in your mission of healthcare, you have to be really smart about the business of healthcare. Challenge yourself, your peers, and our industry by shaping what healthcare looks like and doing your life's best work.SM

The Account Manager is the liaison between the Practice/Client and the Optum360 Revenue Cycle Department. S/he works with the Practice Managers and Senior Leadership to optimize the practice's revenue through analysis of practice statistics. S/he will perform analysis on denial trends and work with the billing staff and/or practice staff to reduce denials. S/he is a super user in the Optum PM and Physician EMR and ensures that practice staff are utilizing the system's functionality to gain maximum efficiency and optimize revenue. The Account Manager will also provide practice staff training in system release changes ensuring that the staff understands and is ready to use the revised functionality.

The Account Manager is responsible for the creation and distribution of weekly and monthly reports to the practice/client and for completing a scheduled weekly call with each practice/client to review the Accounts Receivable status. Call agenda items for discussion typically include average days in AR, % of AR over 90 days, payer specific AR issues, specific claims processing and payment issues and specialty coding and provider credentialing topics as necessary. Preparation for these calls will include an in-depth analysis of the reports and metrics for the practice/client.

S/he will work with the Billing Manager and focus on client satisfaction and continuous improvement. S/he will work with the Billing Manager in evaluating processes with the intent of improving productivity, quality and results for all practices/clients. S/he will work with the practice to investigate issues and provide education on best practices as needed. The Account Manager works independently and is responsible for timely follow-up of all practice/client issues or concerns pertaining to Revenue Cycle Management. Company compliance guidelines and policies are followed and enforced through the Account Manager's oversight of defined billing and medical coding practices.

The Account Manager works collaboratively with other departments to ensure optimal practice/client service. S/he meets deadlines from Finance for invoicing preparation and timely responds to inquiries.

Primary Responsibilities:
  • Work collaboratively with the Billing team to implement best practices for Optum PM and Physician EMR.
  • Provide oversight of Billing and Claims items related to the operations of the practices.
  • Analyze the practice efficiencies and provide feedback for improvements in operations.
  • Being a member of a cohesive team that is focused on meeting the metrics for the practice/client.
  • Oversee and streamline Revenue Cycle Management processes.
  • Provide Denial trend analysis and Denial Reduction work plans.
  • Plan and implement Quality Assurance for all processes.
  • Understand and educate staff on Payer-specific Medical policy.
  • Manage ongoing contract relationships and service delivery to clients for one or more accounts.
  • Extensive work experience within own function.
  • Work is frequently completed without established procedures.
  • Work independently.
  • May act as a resource for others.
  • May coordinate others' activities.


Requirements Required Qualifications:
  • High School Diploma/GED.
  • 2+ years of Revenue Cycle experience.
  • 2+ years of experience in Medical Billing or Medical Billing Training Certification.
Healthcare isn't just changing. It's growing more complex every day: ICD-10 Coding replaces ICD-9; Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that's what fueled these exciting new opportunities.

Who are we? Optum360. We're a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.

If you're looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work. â„ 

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

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