Revenue Cycle Specialist

**Job Description:**

We are seeking an experienced Billing and Receivables Manager to join our team. As a key member of our organization, you will be responsible for coordinating and streamlining the end-to-end processes of revenue raising and maximization across health services.

About the Opportunity:

The Billing and Receivables Manager coordinates and streamlines the end-to-end processes of revenue raising and maximization across health services, with the aim of optimizing systems and processes both within service areas and across all billing, collection and other revenue-related systems. This involves identifying and implementing best practice for revenue cycle improvements and ensuring that an efficient cost-effective control framework is in place for the whole revenue cycle.

Key Responsibilities:

• Ensure the values of our organization are incorporated into daily work practices of Health Services Revenue staff.
• Proactive management of the billing and receivable processes, procedures and systems for the business unit.
• Implement and manage changes and enhancements to the business unit's billing and collection processes, procedures and systems as necessary.
• Develop and maintain a high caliber Health Services Revenue team with people who are motivated and focused on service and with low levels of staff turnover.
• Develop and maintain efficient, cost-effective transactional processes that are focused on business outcomes.
• Develop and maintain the quality and accuracy of work emanating from Health Services Revenue.
• Manage the follow-up and action required for all Health Services bank and general ledger related unreconciled items.
• Proactively contribute to projects for all potential billings and receivables systems (including all relevant data source systems).
• Register Health services departments with government portals for billing and receivables purposes.
• Manage the month end process for billing and receivables sub-systems' revenue.
• Provide ongoing assessment of reports used at month end ensuring they are fit for purpose and deliver the required information and outcomes.
• Manage the billing and collection process for relevant inpatient and outpatient services.
• Ensure health services billing processes and procedures meet all relevant compliance and statutory reporting obligations.
• Management of relationships with private health insurance providers to ensure maximum revenue derivation from private patients.
• Management of non-patient related revenue streams, including education, car-parking, aids and appliances, rental and provision of services to external parties.
• Identification of under-realised and unrealised revenue streams available to Health Services, with annual reporting on streams identified and revenue realised.
• Liaison with peers in the Revenue Management space across Victorian public health services to stay abreast of developments, challenges and opportunities for new and existing revenue streams.

Requirements:

• Excellent communication and stakeholder engagement skills, with the ability to liaise effectively with clients, government agencies, internal teams, and executive leadership.
• Proven experience in managing billing and receivables operations within the hospital services.
• Demonstrated understanding of medical billing processes and health fund claiming requirements.
• Familiarity with billing across private patients, health funds, workers compensation, third party, and self-funded patients.
• Experience managing government funding streams, including Aged Care Subsidies, Home Care Packages, Medicare, and DVA billing, as well as private billing and client contributions.
• High level of negotiation skills and the ability to derive the best possible result for Mercy.
• Strong computer skills working with central systems and PC based applications.
• Proven ability to drive process improvement, optimise billing systems, and implement controls that improve accuracy, efficiency, and compliance.
• Provides ongoing feedback and identify and address areas of performance development.
• Strong knowledge of current aged care legislation and funding frameworks, including the Aged Care Act 1997, Home Care Packages Program Guidelines, Medicare Benefits Schedule (MBS), ANACC, NDIS and the Private Health Insurance Act 2007.
• Demonstrated understanding of the upcoming new Aged Care Act (effective 1 July) and the transition to the Support at Home program, with the ability to adapt internal processes accordingly.

Evidence Required:

• You will also be required to provide evidence of, or in the process of obtaining: a current Police Record Check.

Benefits:

We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.

Join Our Team:

If you are a motivated and experienced individual looking for a challenging role, please apply now.