Benefit Manager

Summit Medical Center is looking for a Benefits Manager to join our Quality Care Team.  

Summit Medical Center has established an outstanding reputation for quality services. Credit for this goes to every one of our employees. We are committed to doing our part to ensure each employee has a satisfying work experience and can take pride in working at Summit Medical Center.

Position Summary:

Leads the oversight, directing, management and review, planning, organizing, and evaluation of activities for the Benefits and Authorization activities of the facilities; assists with development, implementation and evaluation of all business office processes, policies and procedures; monitors, advises and trains the staff members within area of responsibility to achieve optimum financial performance of the facility. 

The staffing of Summit Medical Center is based on a teamwork concept. Employees may be cross-trained in other administrative areas and may be expected to perform duties other than their normal ones as staffing and patient needs change.

Responsibilities:

1. Maintains established departmental policies and procedures, objectives, quality assurance program, safety, environmental and infection control standards. 
2. Assist in direction and training of the activities and oversight of the Benefits, Insurance Verification and Authorization activities necessary to ensure coverage for all services provided at our facilities.
3. Possess the ability to provide back up for the job descriptions related to the listed functions.
4. Lead coordination and participation of events involved in the review and analysis of area activities for facility patient accounts, identification of issues and areas of improvement proactively.
5. Perform consistent reviews to stay apprised of industry changes (LCDs) as related to case/service performance within our facilities.  Transfer related information to Senior Management for proper address and implementation.
6. Lead the determination and enforcement of corrections required for identified problem resolution.
7. Support Revenue Team members in answering a variety of correspondence from respective facility staff members, insurance companies and other concerned parties regarding Business Office related inquiries, processes and issues.
8. Oversee and ensure timeliness and accuracy of daily/monthly routines of the entire accounts receivable process.
9. Lead preparation and review of financial reports and business office performance analysis, setting forth progress, adverse trends and appropriate recommendations or conclusions. Monitor, analyze and report metrics in place for each facility.
10. Perform review and analyzation of weekly/monthly reporting procedures, as well as the month-end close process.
11. Analyze and evaluate the viability of procedures/services performed within our facilities.
12. Perform annual review, development and recommendations and implementation of policies and procedures for related Business Office functions and monitor compliance of such.  Ensure compliance with policy and procedures as related to internal controls.
13. Is thoroughly familiar with each facility’s third party payer contracts and ensures the business office staff is provided the information and training to also understand the contract terms as is appropriate to their position.
14. Ensure proper performance of system maintenance for areas relating to the Business Office and Revenue Cycle Management.
15. Maintain expert knowledge of A/R system and A/R system reporting.
16. Ensure each facility’s fee schedule is accurately loaded into the billing software.
17. Ensure proper maintenance and completion of all forms for documentation in the patient’s medical records.
18. Assist with compilation of statistics for running required state reports each quarter.
19. Participate in loss prevention by protecting company assets and maintaining a safe environment.  Participate in and initiate the training of the Business Office Staff as is appropriate to their duties.
20. Support the use of new technology; attend technology training sessions; demonstrate skill in using technology.
21. Maintain compliance requirements without reminder or follow-up, including annual compliance training; license/certification renewal; specialized training requirements; etc.
22. Demonstrate the safe operation of equipment and machinery and follows procedures for reporting and correcting an unsafe situation.
23. Integrate knowledge, attitudes, and skills and behaviors to maintain consistent standards of care and competency-based practice following standards of care and center policy.
24. Explain procedures in terms others understand; shares resources with other (ex: computers, knowledge); provides information in a timely manner; informs patients or coworkers of any delays; tries to find a solution to patient or coworker issues.
25. Look for ways to continually improve work methods that will benefit patients, physicians, and coworkers; respects coworkers and works cooperatively as a team to improve patient care/services excellence; avoids all contact with patient information that does not involve role at the center; practices good personal hygiene, including keeping nails trimmed; identifies the center, department and self when answering outside calls.
26. Maintains department records, reports, and files as required.
27. Maintains and cares for department equipment and supplies.
28. Participates in educational programs and in-service meetings.
29. Performs other duties as assigned or requested.
30. Maintains confidentiality of patient and center related business.
31. Develops and maintains an effective working relationship with patients, families, visitors, and other center employees.
32.  Documents concisely, precisely, and accurately on all records or documents as indicated by policy.
33. Participates in Quality Assessment activities as directed for the continuous improvement of patient care and center business.

SMC offers a competitive benefits program to full-time employees and their families. SMC pays the majority of the benefit, while a low premium cost is deducted from the employee's paycheck on a pretax basis.

Job Type: Full-time Exempt 

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Vision insurance
• Bonus opportunities

Work Location: In person

Qualifications:

1. High school diploma or equivalent required.
2. Bachelor’s degree preferred.
3. Previous supervisory experience preferred.
4. Two or more years’ experience in patient account management in a facility, hospital or physician practice setting preferred.
5. Good personal credit report required.

Special Skills and Knowledge:

1. Word processing and spreadsheet software experience.
2. Knowledge of correct bookkeeping, billing and collection practices.
3. Good communication, organizational and interpersonal skills.

Essential Functions:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

1. Compliance with the attendance policy
2. Compliance with continuing and mandatory education programs
3. Ability to respond quickly, physically and mentally when priorities and /or the patient’s condition changes

Physical/Mental Requirements for Position:

1. Ability to read and write (legibly)
2. Ability to communicate appropriately and effectively
3. Ability to understand and resolve simple problems
4. Ability to understand simple to complex instructions
5. Ability to respond quickly, physically and mentally as the need arises
6.  Ability to frequently utilize full range of motion, including crouching, stooping, reaching, bending and twisting
7. Ability to lift to 25 pounds
8. Ability to see and hear and distinguish color
9.  Ability to prioritize and handle multiple tasks
10. Ability to function independently without constant supervision
11. Ability to constantly utilize manual dexterity
12.  Ability to prioritize and handle multiple tasks

Bloodborne Pathogen Classification:

Category 3- No occupational exposure