Manager, Billing and Enrollment | Health Plan
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
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Facility: Cherapa Place Building
Location: Sioux Falls, SD
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
The Manager is responsible for the daily operations of the enrollment and billing teams to ensure timely and accurate enrollment processing, along with billing and reconciliation functions. The manager will also collaborate with analysts to track and report enrollment and billing reconciliation activities as well as ensuring membership and billing data integrity. This position is also responsible for responding to internal and external compliance audits related to enrollment and billing and reconciliation functions for all Health Plan lines of business. Provides direction and support to staff to ensure that they receive appropriate training, orientation, and support in issue resolution and guidance in solving problems. Empower staff to make decisions at local level where possible while achieving clarity as to which decisions are most appropriate for local versus central resolution. Ability to delegate tasks to cross-functional teams. Executes operational business plans for the department. Coordinates department operations and modifications with other areas of the organization. Oversees and assists with the creation and maintenance of policy and procedures. Partners with other leaders and teams as needed to ensure customer and regulatory needs are met. Sets critical work standards and expectations for a group or unit. Provides input on billing and enrollment department budget. Develop and maintain a training program for Billing & Enrollment positions for both new and existing employees. Oversees enrollment and billing reconciliation activities, workflows, and processes to meet regulatory and compliance requirements. Ensures billing timeliness and accuracy and handles related issues as needed. Accountable for timely and accurate processing of enrollment in accordance with contractual benefits and handles escalated enrollment and billing-specific issues as needed. Collaborates with appropriate stakeholders to coordinate resolution of enrollment and billing system issues with IT and software vendors. Responds timely to questions and concerns and produced solutions through team operations. Advises others on a variety of financial tools, techniques and approaches. Monitors, traces, and corrects process errors that may be negatively impacting members or other Health Plan departments. Develops, implements, and reviews performance monitoring reports to identify key trends, patterns, and resolve discrepancies as needed. Partners with Performance Excellence to identify opportunities for process improvement and implements changes to enhance the work of the team. Maintains optimum staffing levels through efficient monitoring of staff schedules. Provides verbal and written feedback and coaching to direct reports. Writes and administers formal performance appraisals and periodic reviews of goals/objectives. Creates performance development opportunities to grow individual and team capabilities. All other duties as assigned.
This position will manage a newly consolidated department which was previously divided into two separate teams. This role will be responsible for developing an experienced team to integrate new culture and identifying areas for efficiency to distribute workloads according to the strengths of the team members.
Bachelor's Degree in Business, Finance, Health Care Administration, Computer Systems or equivalent combination of relevant education required.
Three years of experience with insurance plan membership and billing operations; experience with Medicare and Federally-Facilitated Marketplace preferred.
Leadership experience preferred.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
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Job Function: Customer Support Services
Req Number: R-28961