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Mgr RC Correspondence & Compl Resol

Wellstar Shared Services • Marietta, GA • Leadership • 105912 • Days • Full-Time


Manager RC Correspondence and Complaint Resolution reports to Director Customer Service. Develops and implements policy designed to expedite cash flow, and streamline processes pertaining to referral, working, and resolution of accounts. Responsible for resolution, tracking, and reporting of all customer concerns/complaints. Must be a diplomat, speaker, trainer, motivator, and coach. Assists with Revenue Cycle tasks and requests as needed and other duties as assigned. 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 Correspondence and Complaint Resolution position requires the use of independent judgement and decision making; as well as strong analytical, problem solving, and leadership skills. Ixternal contacts include all levels of staff and management, including physicians, management, and staff. External contacts include insurance companies, state and federal agencies, outside accounting firms and auditors; resolving problems and issues, and discussing sensitive and confidential information.


Core Responsibilites and Essential Functions

  • Responsible for day to day operations of the Customer Service 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 postings in managing daily unposted cash.
    * 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
    * Demonstrate proficiency in document production for the following applications: Word, Excel, and Power Point
    * Coordinate Connect tickets related to department functions
    * Create/update department policies and procedures
    * 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 Patient Financial Services and 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 into the revenue cycle
  • Responsible for implementation of new technology and training.
    * Reviews, researches, and implements new technology impacting Customer Service.
    * Coordinates training and quality assurance feedback to staff.
    * Develops and maintains policies and procedures.
    * Maintains a thorough knowledge of WellStar?s Compliance department policies as they relate to the payment posting processes.
  • Monitors department?s productivity, comparing results to national and local best practice.
    * Assures that collection techniques, methods, and documentation are reviewed, monitored, and evaluated for effectiveness and consistency
    * Manage individual productivity in order to maximize department output
    * Monitors department?s productivity, comparing results to national and local best practice.
  • Compliance
    * Maintains a current working knowledge of relevant patient billing regulations from Medicare, Medicaid, Champus/Tricare and any other Federal or State program.
    * Maintains a working knowledge of all related HIPAA regulations and communicates all necessary requirements to staff
    * Maintains effective communications with the WellStar Compliance Department regarding new and relevant issues.
    * Communicate with and obtain assistance from various type claims processing, governmental and regulatory agencies, in the interpretation of critical regulations and procedures.
    * Ensure that Policy and Procedures are comprehensive in nature and current/updated.
    * Respects and maintains the privacy of patients protected health information
    * Educates staff about the importance of HIPAA.
    * Performs periodic HIPAA audits
    * Reports HIPAA infractions to Compliance
    * Maintains a current working knowledge of the FDCPA, TCPA and HIPAA regulations
  • Correspondence and Complaint Resolution
    * Accurate and timely resolution of customer complaints
    * Tracking and reporting of customer complaints

  • Required for All Jobs

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

  • Qualifications

    Required Minimum Education

  • BA or BS, preferably in Business, Accounting, Finance, Required

  • Required Minimum Experience

  • Minimum 10 years commensurate work experience Required and
  • Minimum 4 years experience in healthcare preferred, claims processing management, or other management, or other management role in a healthcare environment. 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 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

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

    Additional Licenses and Certifications

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