Job details

Revenue Cycle Affiliate Lead

The vision of Clinical Health Network for Transformation (CHN) is to better fulfill the mission and promise of Planned Parenthood to bring high-quality, affordable care to every member of our communities. CHN is a collaboration between Planned Parenthood affiliates across the United States.

CHN is looking for individuals who are committed to supporting our shared goal of strengthening and enhancing our awareness and commitment to advancing the cause of health and race equity in our organization.

The Revenue Cycle Affiliate Lead is responsible for working with the Revenue Cycle team to monitor performance for assigned member affiliate and provide process improvement recommendations for the affiliate. The Revenue Cycle Affiliate Lead is familiar with data analytics, understands revenue cycle, payer reimbursement, fee schedules, payer contracts, patient access, and financial verification metrics, and is skilled at creating information-based narratives to guide and improve processes.

Essential Functions

Establishes strong partnership with assigned member affiliate that is built on transparency, professional knowledge and credibility, and a commitment to identifying ideas and actions that deliver the best patient experiences
Develops expert level technical knowledge of revenue, patient access, and financial verification business processes at assigned affiliate
Proactively share feedback on Epic build and workflow configurations, request changes for optimized workflows
Manages annual external coding audit, reviews findings and works with affiliate clinical staff to incorporate into provider training
Develop deep understanding and proactively manage workflows for affiliate work queues. Develop process workflows to ensure the teams are working efficiently
Resolve accounts assigned to affiliate owned work queues within 14 days of work queue entry
Manage payor contract document retention and use these contracts and fee schedules to assist the CHN RCM team with underpayment and overpayment analysis
Act as a liaison between CHN and payor provider representatives building relationships to troubleshoot payor issues
Review/Approve patient refunds and assist affiliate team to ensure refunds are sent to patients timely and in compliance with state regulations
Assist revenue cycle teams with special projects as assigned by Revenue Cycle Manager
Submit Jira tickets and track progress, communicate progress with Revenue Cycle Manager and affiliate
Collaborates with affiliate on process improvement opportunities, specifically with the health center managers on front desk revenue cycle responsibilities. Facilitates the development and implementation of solutions
Participates in affiliate business meetings where patient care and revenue opportunities are discussed
Identify training gaps for front desk or provider staff members that can improve the RCM cycle
Identify affiliate reporting needs and request ad hoc reports through the established CHN team
Identify/trend revenue cycle issues and engage in problem solving activities when needed. Specifically bringing forward trends identified in front desk and provider workflows that impact the overall RCM cycle
Ensures compliance with all CHN and affiliate policies, as well as all state and federal regulations
Demonstrates a commitment to CHN and Planned Parenthood’s mission related to health equity, especially centering racial equity, and deep sense of accountability to community
Demonstrates a commitment to learning about and enhancing practices related to racial equity and the impact of structural racism on healthcare systems
Provides positive and development feedback and accountability related to practices including, but not limited to, equity

The above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at any time

Qualifications and Experience (Required)

Bachelor’s degree in a Health Care Management or Health Care Administration or a related field or 5+ years equivalent experience in lieu of education requirement
3-5 years of experience in health care revenue cycle management and medical billing office setting, with a successful record of accomplishment of analyzing and reporting key performance indicators to management and/or leadership
Strong interpersonal skills and the ability to build relationships across organizational boundaries
Demonstrated experience in revenue cycle business analysis and communicating and presenting data and findings to Senior and/or Executive Leadership
Possess excellent working knowledge of all revenue cycle, patient access, and financial verification business processes
Strong analytical and problem-solving abilities to include extracting data from billing systems
Excellent written and verbal communication skills and ability to collaborate and interact with all levels within CHN and member affiliates
Demonstrated dedication to Planned Parenthood’s mission, vision, and values
Willingness to travel in accordance with the position's needs, as outlined in the essential functions. Compliance with all CHN travel policies, including safety guidelines while operating a personal vehicle

Qualifications and Experience (Preferred)

Bachelor’s degree in Health Care Management or Health Care Administration, or in a related field
Coding Certification through AHIMA (CCS, RHIT) OR AAPC (CPC) OR equivalent certification
Revenue Cycle Certification: AAPC Certified Professional Compliance Officer (CPCO), OR HFMA Certified Revenue Cycle Representative (CRCR), OR equivalent experience

Key Requirements

Commitment to advancing race(+) equity in one’s work: interested in expanding knowledge about the role that racial inequity plays in our society
Awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactions
Demonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learn
Strong sense of accountability to equitable practices
Understanding of the impact of identity dynamics on organizational culture
Commitment to CHN and Planned Parenthood’s In This Together service ethos, workplace values, and service standards

$52,882 - $79,323 a year

CHN believes in fair and equitable pay. Above is the pay range for this role. Please note that actual salaries may vary within the range, based on factors including, but not limited to, education, training, experience, professional achievement, and business need.

CHN provides employees with a competitive benefits package; some highlights include the following:

- Health Care Coverage (Medical, Dental, & Vision); eligibility for full-time, regular employees on date of hire

- Flexible Spending Accounts and Health Savings Account

- Short-Term Disability and Basic Life & AD&D Insurance provided by CHN

- Voluntary elections for Long Term Disability and Additional Life & AD&D Insurance available at cost

- Employee Assistance Program

- Retirement Plan, 3% employer match after one year of service

- Paid Time Off Program includes accrual-based PTO, Health Time Off (HTO), and nine (9) paid Holidays

Clinical Health Network for Transformation (CHN) is an equal employment opportunity employer. We comply with all applicable laws prohibiting discrimination based on race, color, religion, gender and gender expression/identity, age, ethnicity, national origin, ancestry, physical or mental disability, uniformed service member/veteran status, marital status, medical condition, pregnancy, sexual orientation, citizenship status, genetic information, as well as any other category protected by federal, state, or local. We are committed to building an inclusive workplace that values racial & social justice. We strongly encourage all persons to apply, including people of color and members of the LGBTQ community.