The BPN Revenue Cycle Manager is responsible for managing the overall functions of the Bryan Physician Network (BPN) Central Business Office to ensure maximization of revenue and cash flow while maintaining the highest levels of patient, physician, employee and other customer relations. This includes management oversight of all business related functions of the patient visit from point of entry to accurate adjudication of the patient’s account. Specific areas of responsibility include registration, billing and collections insurance carrier maintenance, data processing, integrity of patient accounts and accounts receivable management.
PRINCIPAL JOB FUNCTIONS:
*Commits to the mission, vision, beliefs and consistently demonstrates our core values.
*Plans and directs pre-authorization of patient insurance, registration, billing and collections, data processing to ensure accurate patient billing and efficient, timely account collection.
*Acts as liaison with physicians on behalf of billing, coding and accounts receivable staff to ensure optimal management of patients’ accounts.
*Manages BPN’s Central Business Office within the established budgetary guidelines.
*Evaluates the current status of patient accounts to identify and resolve billing and processing problems in a timely manner.
*Establishes and implements a system for the collection of delinquent accounts ensuring third-party payers are contacted.
*Develops and recommends credit and collection policies for front and back-end personnel to administer; monitors and makes recommendations for improvement.
*Solves difficult payment and associated business office problems; audits problem accounts.
*Coordinates the exchange of information including medical record documentation to obtain and analyze additional patient information to document and process billing, respond to insurance inquiries, and manage liability accounts.
*Ensures proper coding processes and procedures; ensures training and competence of clinic staff processing charges; conducts regular coding audits.
*Promotes effective communications between BPN’s Central Business Office personnel and clinic front-end staff to ensure ongoing education/training and expedite problem resolution.
*Manages the work processes within patient registration and central billing office services; makes adjustments in work assignments to maintain optimal accounts receivable and customer relations; develops work standards, monitors quality and quantity of work processed, and ensures that policies are communicated and administered consistently.
*Works closely with clinic personnel and managers to monitor compliance to policies and procedures as they relate to the revenue cycle.
*Develops and oversees the functionality and integrity of the practice management information system; works with information technology personnel to ensure timely and accurate administration of work processes within the system including the submission of electronic claims to third party carriers, claims logic development and maintenance, custom reporting and electronic remittance of third party payments.
*Coordinates with the BPN Financial Manager, in creating an annual capital and operations budget for BPN’s Central Business Office operations.
*Evaluates the BPN’s fee schedule at least annually, cross-referencing the Network’s fees with the top 5 payers, and makes recommendations for adjustment as indicated.
*Oversees the management of all personnel within assigned business office duties; trains, orients and evaluates the performance of assigned personnel, recommends disciplinary actions as appropriate; works closely with the clinic office managers and has input into the evaluations of front-end revenue cycle personnel within office sites.
*Maintains current knowledge of, and complies with established policies and procedures including patient confidentiality, patient rights, government, insurance and third party payer regulations.
EDUCATION AND EXPERIENCE:
Bachelor’s degree in Business Administration, Finance or Accounting required. Minimum of five (5) years experience working with physician billing services preferred. Fifteen years of direct experience may be used in lieu of Bachelor’s degree. Prior supervisory experience preferred.