Mgr RC Billing & Claim Edits

Job Summary

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful : to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift : Day (United States of America)

Core Responsibilities and Essential Functions

Primary Responsibilities :

• Ensures staff follow-up on claim edits promptly and is held accountable for aged unbilled receivables.
• Conducts regularly scheduled staff meetings to discuss new or modified procedures within department.
• Reviews and approves staffs time and attendance records.
• Plans work schedules and assigns work to staff to ensure adequate service and coverage.
• Ensures WellStar policies and procedures are current and updates them as necessary.
• Approves administrative write-offs in accordance with the WellStars Adjustment Approval Policy, and audits staff level write-offs to ensure appropriateness.
• Addresses / resolves issues relating to patient accounts.
• Assumes responsibility for resolving inter / intradepartmental issues quickly and effectively.
• Sets productivity and quality standards and holds staff accountable. Responsible for direct report staff education and provides staff training and education.
• Appropriately administers praise or disciplinary action, completes performance evaluations on time, resolves conflict positively / constructively, creates a positive work environment, and encourages / respects / values the contributions of all individuals.

Secondary Responsibilities :

Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education :

Required Minimum License(s) and Certification(s) :

All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s) :

Required Minimum Experience :

Minimum 15 years commiserate work experience. Required

Required Minimum Skills :

Broad proven practical experience in hospital billing, follow up, and customer service Knowledge of hospital billing process and revenue cycle environment Knowledge of hospital based billing is preferred Knowledge of state and federal regulations as they pertain to collection processes and procedures Knowledge of and skill in the use of computers and related systems and software Knowledge of insurance plan payment practices and billing requirements Knowledge of and detailed understanding of managed care agreements Skill in problem solving in a variety of settings Skill in motivating and directing the work and activities of staff with the ability to effectively delegate Skill in technical and professional accounting Skill in good oral, writen, and interpersonal communication, grammar, and spelling Skill in time management and project management Ability to effectively conduct regular department meetings Ability to work cooperatively in a team environment Ability to set climate for performance at optimum levels Ability to establish and maintain a cohesive work team Ability to work efficiently under pressure Ability to apply appropriate supervisory, management, and leadership techniques in an operational setting Ability to work independently and take initiative Demonstrates a commitment to continuous learning and to operationalize that learning and top operationalize that learning Ability to willingly accept responsibility and / or delegate responsibility Ability to deal effectively with constant changes and be a change agent Ability to deal with difficult people and / or difficult situations effectively Ability to set priorities and use good judgement for self and staff

Join us and discover the support to do more meaningful workand enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.