Manager, Cash Management and Claims - Ross Hall
This position is within the Office of Business Operations and Financial Affairs at the ECU School of Dental Medicine (SoDM). This position reports to the Director of Revenue Cycle and serves as the Manager, Cash Management and Claims. This position is responsible for the core functions including submission of claims (~$16 million annually), claim edit resolution, processing of refunds, interfacing with contracted clearinghouse and charge capture.
The Manager, Cash Management and Claims manages centralized and decentralized business activities related to billing and compliance with government and commercial payers and works in collaboration with the Manager, Accounts Receivable and Coding. The clinical enterprise is composed of six clinical operations within Ross Hall (Student Clinic, Student Learning Center (SLC), Pediatric/Orthodontic Clinic, Faculty Practice Clinic (FP), Advanced Education in General Dentistry (AEGD) and the Clinical Research Center); the General Practice Residency Clinic (GPR); as well as eight Community Service-Learning Centers (CSLCs) located across the State of North Carolina.
Core Process Management: The Manager of Cash Management and Claims manages the business functions of insurance, billing, prior authorizations, accounting reconciliation of patient accounts, and the reporting and compliance components of these elements of SoDM's Revenue Cycle. This includes charge capture, claim submission, refunds, payment plans, and bankruptcy. This position must translate broad policies and procedures from State and Federal Governments and University Departments to develop and maintain sustainable operating procedures. The position develops and analyzes financial data to improve SoDM pre-claim submission processes which will facilitate improved revenue collection; and must have current knowledge of billing regulations, clinical coverage policies and insurance industry changes. This position is responsible for the cash operations and monitors processes, procedures and business activities as it relates to Cash
Management and Payment Card Industry (PCI) compliance. The position completes the close-out and reconciliation of clinical revenue activity monthly, quarterly and at year-end by generating and preparing reports. Journal entries are prepared and completed daily, monthly, quarterly and at year end to ensure financial transactions are properly accounted for in Banner, the University's Accounting System of Record. The position develops financial and billing interfaces for numerous clinical programs which incorporate grants or alternative funding programs and assures fiscal rules and regulations are applied correctly. The position supervises one FT Accounting Technician-Advanced and three FT Admin Support Specialists.
Business Administration: The position provides leadership, administrative direction and training in the development of processes, policies and systems that contribute to successful business operations. The position is a "super-user" of axiUm, the School's Dental Management Software System, as well as versed in university systems such as Banner 9, Finance Self-Service, Self-Service, e-print, ecuBIC, ODS and PORT. The position applies techniques, practices and procedures and robust continuous improvement efforts in both dental/clinical operations and financial operations to optimize performance in a rapidly changing regulatory and operational environment. Promotes employee engagement, motivation, retention and optimal performance in a cooperative, goal-oriented culture. The position develops policies and procedures to insure appropriate internal controls of all clinical billings and appropriate designation of expenditures to meet generally accepted accounting principles and the application to cost, governmental accounting, and non-governmental accounting. Maintains job descriptions that reflect the current work responsibilities of staff. This position requires an in-depth knowledge of current dental and medical insurance payor guidelines and regulations, as well as dental business office operations. Incumbent should understand and be able to optimize processes for point-of-service collections, registration, and eligibility verification. It is imperative that the role works with faculty, students, other Managers and staff in a highly collaborative manner. Working with the support of the Director and with the Manager of Accounts Receivable and Coding in Business and Finance, apply monitoring tools and meet established metrics for performance standards under position's control. Such standards include but are not limited to; timely submission of claims, timely response to patient calls/inquiries, compliance with CMS or other regulatory refund regulations, point-of-service collections. Supporting the Director, and working with the Manager, Accounts Receivable and Coding, work to meet overall departmental and organizational standards such as, but not limited to: Days in AR, AR aging, percentage of denials, net collections and overall collections. Role requires a super-user level of expertise with the axiUm system, the School's Dental Management Software System, as well as competence in university systems such as Business Intelligence, to link technology to process to people most efficaciously in accomplishing all of the above.
Departmental/Vendor Liaison: Work effectively in a team environment, with other B&F management staff, Clinical Affairs and CSLC management and their staff, with other internal University Departments (e.g. Depository Services, Office of Institutional Integrity (OII), Internal Audit, Financial Services) and external stakeholders such as banking and financial services entities (e.g. Wells Fargo, Loomis, Availity) and private and public (e.g.North Carolina Department of Revenue) entities. This position independently resolves, collaborates with peers, and makes
recommendations to resolve complex issues and problems, and serves as a trainer and resource to SoDM. This position provides support and training for all pre-claims submission revenue cycle related issues both for all SoDM clinics at Ross Hall as well as at remote operations including Community Service Learning Centers (CSLCs) and GPR. Role requires a focus on best practices in terms of processes and operations, as well as working towards standardization of practice across all SoDM clinics and continuous improvement. This position oversees all customer service elements of the revenue cycle, insuring staff provide accurate, professional and customer centric service to internal stakeholders or patients with questions or issues with their SoDM accounts.
Research and Analysis: In support of the Director and B&F, conduct analyses, document findings, prepare presentations, provide recommendations and execute agreed upon plans. Keep current knowledge of the payor, regulatory issues and active in applying operational changes necessary to optimize functions in this changing environment. This position anticipates problems and develops
recommendations for management resolution.
DENTAL MEDICINE SUPPORT POSITION - NOT SUBJECT TO STATE HUMAN RESOURCES ACT
Employment in this position provides eligibility to participate in the UNC Optional Retirement Program (ORP) which offers matching employer contributions and employee control of investment choices, along with eligibility to participate in various Voluntary Supplemental Retirement Plans (401k, 403b. 457). This position is not eligible to participate in the NC Teachers' and State Employees' Retirement System (TSERS). Additionally, this position offers multiple voluntary options for Medical, Dental, Vision, and Life Insurance as well as various supplemental plans including Critical Illness, Flexible Spending Accounts, Cancer, and Disability.
Special Instructions To Application:
- Please ensure your full range of knowledge, skills, abilities, experience and education are listed on your application. Do not write 'see resume' on your application when completing the job duties section.
- If you answer the questions at the end of the application, please ensure your application reflects the knowledge, skills, abilities and experiences to support your answers (see job duties section of previous employment).
- Failure to answer the questions at the end of the application will not preclude your application from being considered but may result in your application not receiving full consideration of your knowledge, skills, and abilities.
- Applicants must be currently authorized to work in the United States on a full-time basis.
High school diploma or equivalency and one year of experience in accounting work; or equivalent combination of training and experience.
Full time or Part time: Full Time
Position Location (city): Greenville
Position Number: 002254
Organizational Unit Overview:
The School of Dental Medicine is composed of ten administrative offices and four academic departments. The Administrative units include the Offices of the Dean, Vice Dean, Associate Dean for Student Affairs, Associate Dean for Research, Associate Dean for Clinical Affairs, Associate Dean for Extramural Clinical Practices, Assistant Dean for Dental Education and Informatics, Assistant Dean for Educational Support and Faculty Development, Assistant Dean for Academic Success and the Assistant Dean for Business Operations and Financial Affairs. The four academic departments are Surgical Sciences, Pediatric Dentistry, Orthodontics and Dentofacial Orthopedics, General Dentistry and Foundational Sciences.
Included in the mission of the School of Dental Medicine is to educate dental care providers (both dental students and dental residents) and to address the oral health care needs of the underserved population of North Carolina. The School of Dental Medicine meets these missions by operating dental clinics that provide both educational experiences for the dental students and residents and provides dental care to the residents of North Carolina. These clinics occur in both Ross Hall in
Greenville, North Carolina, as well as Community Service-Learning Centers located throughout North Carolina. In order to operate these clinics, appropriate dental auxiliaries and clinical staff are needed.