Manager, Patient Financial Services

2019-05-29T17:30:09-06:00May 13th, 2019|
  • Full Time
  • Atlanta

CCRM Management, Inc.

CCRM Management Company (CCRM Fertility) seeks a Manager, Patient Financial Services, for its Enterprise Integration Division corporate office in Atlanta, Georgia.

CCRM is an Enterprise of practices and reproductive laboratories employing state of the art science and technology in the treatment of infertility and family building.  CCRM is currently comprised of eleven locations spanning the U.S. and Canada.  Aggressive growth is planned for continued network development on a domestic and international basis.

Position Summary

The Manager, Patient Financial Services, Enterprise Integration Division reports to the Director, Patient Financial Services.  The candidate is a highly seasoned expert in the various elements of the healthcare environment’s patient financial services arena.  The highly qualified candidate has specific experience in developing patient-centered financial counseling methods, approaches, and staff to ensure that patients fully understand their patient responsibility for their cost of care.

Exceptional candidates will also have meaningful experience in supervising transactional workflows in the full revenue cycle including but not limited to insurance verification, preauthorization, charge posting, payment posting, contractual adjustments, insurance follow-up and patient collections.

Experience in navigating both the clinical and billing areas of EHR systems, medical coding and billing, KPI/Dashboard/Scorecard development and reporting, operational analysis assessment, strategy development for maximizing revenue and cash collection realization, and tactical execution of related sensible policies and procedures are all important aspects of the role.

Although not required, experience in the patient financial and insurance arena in women’s healthcare, and specifically infertility, is an asset for the candidate.   A rich technology background is key where there is demonstration of the use of technology to increase efficiency and user (staff and patient) satisfaction.

Training and supporting Patient Financial Counselors is a primary responsibility of the position.

Background Information

 The Reproductive Endocrinology and Infertility specialty has transformed in recent years to family building for patients with different needs.  Although family building for those experiencing infertility continues to be a primary focus, CCRM also helps build all kinds of families, e.g. lesbian and gay couples, those single individuals who want to embark on family building, etc.

There are states with “mandated insurance coverage”, thereby yielding high rates of patients with insurance coverage.  There are other environments where there is little insurance coverage, thus yielding high rates of self-pay patients who are embarking on their family building.

Duties and Responsibilities

  • Liaison with New Product/Service Development – Because of the continual progressing change in the science, combined with continuing evolving changes in consumer needs and wants, CCRM is always focused on evolving the new products/service lines and financial offerings to reflect newly developed science and to meet consumer needs and desires. The Manager of Patient Financial Services participates in liaising with our Innovation and Product Development department to bring such new products to life, focusing on the financial aspect of such services.
  • Liaison with Network Contracting – Each market in which CCRM operates has unique payer requirements, payer mix, presence of insurance of infertility care/family building. The Manager of Patient Financial Services participates in liaising with the company’s Payer Contracting Department to ensure that such payer requirements are brought to the Patient Financial Coordinator/Counselor staff.  These staff then in turn use this information in counseling patients as to their coverages, their non-covered services and their related patient responsibility amounts.  This is critical in building and sustaining a successful revenue cycle management environment.
  • Best Practices and Process Development – For mandated states, due to the unique payer requirements in their covered services, and for non-mandated states, due to the high prevalence of excluded infertility and family building services, well defined policies and procedures must be in existence for the following.
    • Insurance Benefit Verification
    • Insurance Preauthorization

The Manager of Patient Financial Services ensures that “fool-proof” methods are in place such that insurance benefit verification for each new patient and each patient entering actual treatment has been performed on a timely basis, and that all required preauthorizations have been obtained to financially clear the patient for service delivery.

  • Patient Financial Counseling – A quality patient experience is a core value for CCRM. Ensuring that each patient fully understands the relationship between the care plan that has been developed for them by their physician, the coverage provided and not provided by their plan, and ultimately what is calculated to be patient responsibility to be paid up front is the core dependency for the quality patient experience on the financial domain.  The Manager of Patient Financial Services therefore is responsible for the following.
    • Staff Hiring – Assist local sites in recruiting, interviewing and hiring the right people for the Patient Financial Coordinator/Counselor role.
    • Staff Professional Development – Assist in developing and continually refining a quality staff development and training program that positions Financial Coordinators to succeed in delivering the highest of a quality patient experience.   This includes both successful training approaches and meaningful training materials.  Such approaches, materials and mentoring emphasizes both didactic knowledge and high “E.Q.” importance of empathy for and sensitivity to the patient’s experience and needs.
  • Patient Financial Education– Continually develop and refine patient financial educational materials, using current and relevant delivery approaches to enhance the patient’s understanding of the financial aspects of their family building journey. In addition, continually develop and refine patient financial agreements that clearly specify the patient financial responsibility amounts for the clinical care plan developed for the patient.
  • Patient Accounts and Insurance – It is required that revenue cycle activities be performed with a high degree of accuracy and timeliness. These include but are not limited to charge posting, payment posting, special adjustment posting, insurance follow-up and patient collections.  In the infertility environment, there is a significant volume of recordation of prepayment of services as well.

The Manager, Patient Financial Services, is responsible for assisting in the development of policies and procedures that cause such transactions to be accurately recorded in the practice management system, and to be done so on a timely basis.  In addition the Manager, Patient Financial Services trains and mentors Patient Account Representatives who serve at check-out and who serve in patient accounts and insurance areas, so that they are well equipped to perform their functions with quality and certainty.

  • Metrics, KPI’s and Dashboards – The Manager, Patient Financial Services reports on those metrics that serve as key performance indicators, that represent that the Patient Financial Coordinators/Counselors and Patient Account Representatives are meeting the objectives set forth for their performance. In addition, the Manager will, using technology, develop efficient and reliable methods, to gather the underlying performance data on which KPI Dashboards are prepared.
  • Patient Experience – Including, but not limited to the all of the above, The Manager, Patient Financial Services creates a patient financial experience such that patients walk away with the sense that their Financial Coordinator/Counselor will hand-hold them and support them financially through the process.
  • Resource to Clinical Members – The Manager, Patient Financial Services serves as a resource to Physicians and Nurses in addition to Patient Financial Coordinators/Counselors regarding any possible impact insurance coverage limitations may have on a patient’s care plan.

Other Knowledge, Skills and Abilities:

  • Enjoys creating “best of class” strategies in patient financial service delivery.
  • Excellent interpersonal and communication skills, an outgoing personality, with a professional demeanor and positive attitude
  • Excellent organizational skills with an ability to multitask and effectively prioritize
  • Team player
  • Knowledge of or ability to conceptualize and learn infertility financial and insurance concepts inherent in infertility patient financial services
  • Strong analytical skills and the ability to effectively read, generate and analyze data and generate reports
  • Seasoned training strategy development.
  • Ability to robustly use electronic spreadsheets

Requirements:

  • Travel of approximately 25% may occur from time-to-time.
  • Position Location
    • Atlanta Office of CCRM Management Company
    • 400 Northridge Road, Suite 500
    • Atlanta, GA 30350
  • Educational Requirement
    • The minimum educational requirement is either a Bachelor’s Degree in Healthcare Administration, Management, or other related business discipline.
    • The ideal candidate will have an MHA or MBA in the areas noted above.
  • Experience Requirement – The candidate must have a minimum of 4 years management/leadership experience following the earning of the Bachelor’s degree.
  • Interested and qualified candidates — Send resume to – sgerson@ccrmivf.com. 

EQUAL OPPORTUNITY EMPLOYER

CCRM is an equal employment opportunity employer and complies with all applicable laws relating to discrimination against qualified applicants or employees in hiring or in any decision affecting job status, pay, or any other terms and conditions of employment based on race, color, creed, religion, national origin, sex, marital status, familial status, disability, genetic information, sexual orientation, age, or other applicable protected classes.

To apply for this job email your details to SGerson@ccrmivf.com