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1.REVENUE AND RECOVERY Unit Manager
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EDUCATION AND EXPERIENCE
- A Bachelor’s degree in healthcare administration, business administration, finance, or a related field is typically required for this role.
- A Master’s degree in healthcare administration, business administration, finance, or a related field, and ACCA or CPA, can be an advantage
- At least 5 years of experience in healthcare revenue cycle management, finance, or related fields.
- Experience in managing revenue cycle operations, including billing, collections, and denials management.
- Experience in leading a team of billing and recovery officers and other staff members.
- Experience in negotiating with insurance companies and other payers.
- Knowledge of healthcare regulations and compliance requirements.
- Strong analytical and problem-solving skills.
SKILLS AND ABILITIES
- KFH unit manager of revenue and recovery should have the following essential skills and competencies
- Financial management: The unit manager must have a strong understanding of financial management principles, including budgeting, forecasting, and revenue cycle management.
- Problem-solving skills: The unit manager must be able to identify problems and develop solutions to address them. This includes developing strategies to reduce denials, minimize bad debt, and improve collections
- Analytical skills: The manager must analyze data, identify trends, and make informed decisions based on financial reports and other data sources.
- Communication skills: Effective communication skills are necessary to interact with other departments, staff, patients, and insurance companies. The manager must be able to explain complex financial concepts in simple terms and negotiate with insurance companies and other payers.
- Leadership skills: The unit manager must lead and motivate a team. This includes setting goals, providing feedback, and ensuring that team members have the necessary training and resources to perform their jobs effectively.
- Knowledge of healthcare regulations: The manager must have a strong understanding of healthcare regulations. They must ensure that the organization complies with these regulations and can navigate complex billing and reimbursement processes.
- Customer service skills: The manager must provide excellent customer service to patients and other stakeholders. This includes addressing complaints, resolving issues, and ensuring patients have a positive experience with the billing process.
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Key Responsibilities:
- Managing the Revenue Cycle: The unit manager oversees the entire revenue cycle process, from patient registration to billing and collections. He/she must ensure that all services rendered by the hospital are billed accurately and that all payments are collected on time.
- Billing: The unit manager is responsible for overseeing the overall billing process, managing billing staff, implementing billing policies and procedures, and ensuring compliance with relevant regulations and guidelines.
- Claims Management: Claims management refers to submitting, processing, and managing insurance claims for healthcare services provided to patients. The claims management process is a critical component of the revenue cycle for KFH, as it directly impacts its ability to receive payment for the services it provides. The unit manager must submit claims to insurance companies promptly and accurately to ensure that the claims are processed quickly and accurately. This can help reduce the likelihood of claim denials or delays.
- Denials and appeal management: Effective denials and appeal management require a thorough understanding of the payer’s policies and procedures and the ability to identify and address the underlying causes of denials. The revenue and recovery unit manager must implement various strategies to improve KFH denials and appeal management, such as tracking denials, establishing an appeals process, training staff on coding and billing practices, and leveraging technology to automate workflows and reduce errors.
- Managing collections: Effective collections management requires a combination of good communication skills, and effective collection strategies, to track and manage outstanding balances. The unit manager must work to develop and implement a comprehensive collections management plan that includes regular monitoring of accounts receivable, timely and effective communication with patients, and the use of payment methods to recover outstanding balances.
- Reporting: Revenue and recovery reporting refers to the process of monitoring and reporting on the hospital’s financial performance, including its revenue and recovery of outstanding balances. Effective reporting can provide valuable insights into the financial health of the hospital and help identify areas for improvement. The unit manager is responsible for producing regular reports on revenue and collections (Net revenue, gross charges, account receivable, days in accounts receivable, collection rate, and other performance metrics.
- Compliance: The unit manager must ensure that all billing and collections activities comply with laws and regulations. They must stay up-to-date with changes to regulations and ensure that their team is trained and knowledgeable.
- Client contract management, those include insurance, Public and private companies.all confidentiality guidelines are adhered to.
- Ensure that audited perceptions of the newsletter: suggestions and comments acted on to improve product/ viewership/ accessibility
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