Mgr, Cash App Payer Enrollments

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Work Shift

Job Summary:

The Manager Cash Applications Payer Enrollments is responsible for managing daily operations of the hospital-based payer enrollments. Providing direction to ensure timeframes are met for payer Claims, ERA, and EFT enrollments for the hospitals, and ensure daily processes and reports are completed in a timely and accurate manner. Hospital (HB) Claims, Electronic Remittance Advice (ERA), and Electronic Funds Transfer (EFT) payer enrollments process is under the direction of the Executive Director Cash Applications. Responsible for the completion of the payer enrollments, enrollment follow-up, tracking, and reporting of the HB Claims/ERA/EFT payer enrollments. Coordinates staff training and quality assurance. Completes and maintains policies and procedures. Completes and reviews productivity and departmental reports. Collaborates with the Manager Cash Applications to identify payer enrollments for completion. Ensures timely and accurate payer enrollments and provides reporting to leadership on a daily, weekly, and monthly basis. Responsible for identifying and completing payer Claims, ERA, and EFT enrollments. Management skills are required in the daily operations of assigned area and in the supervision of subordinate staff. It is imperative to maintain a good working relationship with management, staff, and external contacts such as insurance representatives. The Manager Cash Applications Payer Enrollments requires the use of independent judgement and decision making; as well as strong analytical, problem solving, and leadership skills. Internal contacts include all levels of staff and management. External contacts include insurance companies, state and federal agencies, outside firms and auditors; resolving problems and issues, and discussing sensitive and confidential information.

Core Responsibilities And Essential Functions:

Responsible for day to day operations of the department.
*Keeps management abreast of all issues and concerns of the department.
*Maintains payroll responsibilities.
*Oversees staff productivity and accuracy to ensure accurate and timely completion of payer enrollments.
*Conducts regular performance reviews for staff and recommends salary adjustments or disciplinary actions.
*Conduct the interviewing and screening process of staff hires.
*Holds regular meetings with staff and promotes positive staff morale.
*Maintain excellent customer relations for all internal and external customers.
*Requires proficiency in MS Office applications.
*Coordinate Connect and IT tickets related to department functions.
*Create/update department policies, procedures, and job aids.
*Demonstrate effective departmental leadership and provide appropriate direction to the staff.
*Utilize quantitative production reports and providing consistent feedback to staff.
*Maintain effective communication with other Revenue Cycle departments.
*Apply appropriate supervisory, management and leadership techniques in an operational setting.
*Work effectively with difficult people and/or difficult situations.
*Evaluate best practice suggestions for possible outcomes in the revenue cycle.
*Demonstrate effective functions by assisting with daily planning, organizing, prioritizing, and management of operations, evaluating trending, optimizing workflows and processes, creating action plans, and resolving issues.
*Create a team environment through training, recognition, and evaluation.
*Set obtainable strategic and short-term goals maintaining expected level of staff productivity as well as conducting performance studies to improve productivity, streamline operations, and gain efficiencies.
*Measures team member system gap time against timecard entries and downtime logs.
*Implements projects aligned with Revenue Cycle and executive leadership direction.
*Completes other duties and responsibilities as assigned by leadership.
Responsible for HB Claims, ERA, and EFT payer enrollments.
*Consistently and accurately identify and complete the hospital Claims/ERA/EFT payer enrollments in the clearinghouse payer enrollment platform and payer websites.
*Maintain electronic copies of completed Claims/ERA/EFT payer enrollments.
*Daily follow-up on the payer enrollments to ensure completion of the enrollment.
*Review, maintenance, and completion of payer enrollment renewals as applicable.
*Daily maintenance, and completion of payer enrollment renewals as applicable.
*Daily maintenance of the payer enrollment tracker, providing status of each enrollment.
*Provide a weekly reporting to leadership on enrollment statuses.
*Cash Applications reporting as assigned.
*Maintain current payer website accesses and reporting as applicable.
*Provide ERA accessibility information to Cash Applications leadership.
*Provide research support and payer trending analysis.
*Serves as intermediary with the clearinghouse in relation to payer enrollments.
*Responsible for working with the Manager Cash Applications with communications on payer enrollments and necessary RMO builds within EPIC.
*Maintains and completes ServiceNow payer enrollment requests.
*Responsible for completion of payer Claims/ERA/EFT enrollments on new payer plans created in EPIC.
*Responsible to work with out of state Medicaid vendor and internal departments for completion of Claims/ERA/EFT out of state Medicaid payer enrollments including notification to Wellstar Connect of completed enrollments.
Responsible for implementation of new technology and training.
*Reviews, researches, and implements new technology impacting Cash Applications.
*Coordinates training and quality assurance feedback to staff.
*Develops and maintains policies, procedures, and job aids.
*Maintains a thorough knowledge of Wellstar's Compliance department policies as they relate to the payment posting and reconciliation processes.
*Maintains a working knowledge of the ASCX12N 835 implementation information.
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

• Bachelors Business Administration/Management

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 4 years Four (4) years healthcare management experience Required and
• Minimum 4 years Four (4) years proven track record of successful performance management and progressive growth within the Revenue Cycle Required and
• Minimum 10 years Ten (10) years healthcare management experience in lieu of bachelors degree Required or

Required Minimum Skills:

• Knowledge of hospital payer enrollment process and revenue cycle environment High
• Knowledge of state and federal regulations as they pertain to collection processes and procedures High
• Knowledge of and skill in the use of computers and related systems and software High
• Knowledge of insurance plan payment practices and billing requirements High
• Knowledge of and detailed understanding of managed care agreements High
• Knowledge of 835 payment file processing High
• Skill in problem solving in a variety of settings High
• Skill in motivating and directing the work and activities of staff with the ability to effectively delegate High
• Skill in technical and professional accounting High
• Skill in good oral, written, and interpersonal communication, grammar, and spelling High
• Skill in time management and project management High
• Ability to effectively conduct regular department meetings High
• Ability to work cooperatively in a team environment High
• Ability to set climate for performance at optimum levels High
• Ability to establish and maintain a cohesive work team High
• Ability to work efficiently under pressure High
• Ability to apply appropriate supervisory, management, and leadership techniques in an operational setting High
• Ability to work independently and take iniative High
• Demonstrates a commitment to continuous learning and to operationalize that learning and top operationalize that learning High
• Ability to willingly accept responsibility and/or delegate responsibility High
• Ability to deal effectively with constant changes and be a change agent High
• Ability to deal with difficult people and/or difficult situations effectively High
• Ability to set priorities and use good judgement for self and staff High
• Strong interpersonal, mathematical, analytical, computer, problem solving High

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