Operations Manager, Transactions Management
Please Note: To protect our patients, our workforce and our community, Valley Health is requiring that all newly hired employees and internal transfers (current employees requesting internal transfers) must have received at least one COVID-19 vaccination dose. Newly hired Applicants (those not currently employed by Valley Health) who have been offered a position will have to provide documentation of their vaccination status at the time of their Employee Health appointment. For internal transfers, Employee Health will contact you if they have questions around your vaccination status. Valley Health has a process for applicants who have been offered a position to request an exemption or deferral for medical or religious reasons. To search for vaccine locations, visit vaccines.gov.
- Entity: Valley Health Corporate
- Shift: Day
Who We Are
Valley Health System is a not-for-profit network of hospitals, urgent cares, physician practices, and services. Expanding across Virginia, West Virginia, and Maryland, we are devoted to the health of all who call our 18-county area home.
A vital resource for healthcare, we are the region’s largest employer, a dependable community partner, and are at the leading edge of clinical innovations.
We are looking for passionate, innovative, and caring people who will each bring their unique skills and perspectives to our workplace.
What You Will Do:
Operations Manager, Revenue Transactions Management reports to the Vice President of Patient Financial Services with dotted-line reporting to Director, Accounting, Finance & Treasury Affairs.
Scope of responsibility includes:
The day-to-day operations of the Cash Management Department, including one supervisor, and approximately 16 frontline staff, and closely supported by Revenue Cycle Analysts. Daily cash balancing to ensure reconciliation with general ledger (G/L) activity in compliance with transaction processing policies and internal control procedures of the Valley Health System Finance & Treasury Department (F&T). Timely, accurate, and efficient posting of cash and non-cash payer Revenue Cycle transactions (including, but not limited to, adjustments, zero payments, remittance codes (CARC codes), and other informational transactions received through 835 ERA's, payer Explanation of Benefits (EOB's), or any other remittance or remittance advice formats received from payers) in a manner that effectively communications payer responses into revenue cycle systems to report downstream accounts receivable follow-up and reporting in order to assure the integrity and stability of revenue and billing data. Working knowledge of payer contracts and contractual obligations, denials management, payer times and associated business rules. Must stay current with emerging trends in the healthcare and insurance industry and possess the critical thinking skills to recognize and adapt to emerging threats and opportunities in the marketplace. Comprehensive knowledge of patient accounting practices, procedures, and requirements, including common governmental and managed care payer behaviors, requirements, and billing rules. Working knowledge of accounting and healthcare accounts receivable systems and regulatory requirements. Close coordination and cooperation with the Hospital Billing (HB) CBO and Physician Billing (PB) CBO patient accounting teams. Close coordination and cooperation with HB & PB CBO Scanning/Document Imaging teams to ensure timely, accurate, and efficient scanning of Patient Financial Services (PFS) related correspondence and remittance documentation to ensure efficient and rapid retrieval of such correspondence and documentation. Managing transactional relationships with revenue cycle vendors, ensuring rapid and timely balancing and distribution of payer remittances and patient accounts transaction data. Maximizing technology, robotic processing automation, and industry best practices in cash management, transaction processing, and revenue cycle to move the Valley Health Cash Management Department and revenue cycle teams to the forefront of healthcare revenue cycle efficiency and best practices. Enforcement of revenue cycle operational policies and procedures as well as contribution to the ongoing optimization of such policies and procedures. Delivering successful results with employee engagement, industry KPI, benchmark metrics, and productivity goals. Coordination with HB & PB CBO’s to ensure the timely, efficient, and accurate resolution of patient account credit balances and refund processing in compliance with all governmental and commercial credit balance reporting and refund requirements. Maintaining professional and productive working relationships with all Valley Health entities and corporate customers at all levels of responsibility. Manager is expected to closely support and be supported by F&T teams, PFS, EPIC/IT counterparts, including, but not limited, hospital CBO, physician CBO, Managed Care, Patient Access, and Epic Revenue Cycle Teams.
What You Will Bring:
Bachelors' Degree required, preferably in Accounting, Finance, or Math
Master’s Degree preferred
10 years cumulative experience in the areas of hospital or large group patient accounting, healthcare accounting, and healthcare cash management, including a minimum 5 years in patient accounts management
Working knowledge of HIPAA 835 & 837 transactions
Working knowledge of WEDI Remittance Advice & Payment (ERA/EFT) standards
Minimum 3 or more years cash and healthcare transaction processing experience required (can be counted concurrently with other experience)
Experience in Epic preferred
What You Will Get:
- Competitive salary
- Flexible scheduling
- Health Insurance
- Paid Time Off
- Wellness Program
- Tuition Assistance
- Retirement Plan
- Life Insurance
*some benefits are subject to change due to job status
We celebrate, support, and thrive on our differences for the benefit of our employees, our patients, and the communities we serve.
We are neighbors caring for neighbors, and our goal is always to help those we serve get well, feel well, and stay well.
3 A Administration