Clinic Revenue Manager Reports to: Director of Clinic Revenue Operations & Informatics
Rate: $90-$100K annually doe, 40hpw, 5 days on-site
Supervises 4 support = 2 patient service + 2 eligibility associates
Position Description: The clinic revenue manager is a highly-visible role taking control and forward the financial effectiveness of patient services at SFCHC, a federally qualified health center [FQHC]. The CRM is responsible for ensuring that all processes are efficient, adhering with regulatory standards yet removing barriers to person access to whole person care. Importantly, the CRM works to improve and enhance patient services and satisfaction, reduce denials contributes to healthy cashflows. The CRM works collaboratively with the Clinical Manager in promoting timely billing, proper coding and increased productivity.
Responsibilities are but not limited to:- Managing the end-to-end revenue cycle: Leads patient registration, appointments, insurance verification, prior authorization, coding, billing collections, denials, appeals , and more.
- Clean claims are processed: Working with Ochin Billing Services [OBS], a 3rd party billing and collections services and the clinicians that charges are completed, coded correctly, signed off and submitted within 72 hours.
- Resolving billing issues: Working to resolve any billing-related issues flagged by OBS with the clinicians within 5 days
- Managing accounts receivables: Working to effectively manage accounts receivables and reduce over 60 days past dues
- Annual master fee schedule: Updates SFCHC master fee schedule and sliding fee discount table for April 1 implementation
- Staying apprised of trends: Staying current with coding and revenue trends
- Implementing coding changes: Implementing coding changes and providing coding education to staff
- Managing the team: Managing and supervising new patient enrollment, appointments, cancellations, insurance verification, eligibility, sliding fee, and works collaboratively with the ESA, ECM and program clients' support staff
- Reporting compliance and analyses: Creates provider productivity and utilization reports, weekly, monthly and year-to-date charges, payments, adjustments and write-offs
- Related fiscal and compliance functions: PIP, risk pool inventive, capitation, wrap-around and credentialing and enrollment of new providers to DHCS-PAVE, CMS-PECOS, and managed care and private health plans
- Staff training and collaboration : Creates workflows, on-boarding and training of new staff, cross-functional training with allied services like ECM, programs and Clinical Msnager
Qualifications, training and experience:- A bachelor's in accounting, business administration, or healthcare disciplines
- Valid certification in medical/dental billing or coding or related certification is a must
- 3-5 years of experience in medical billing, coding, eligibility and health insurance plans
- Community healthcare or federally qualified health clinic experience is highly desirable
- Medi-CAL, ECM, Medicare, managed care plans, or private health insurance
- Sliding fee discount program, 340b drug discount for uninsured and public health assistance
- Supervisory experience of 3-5 years
- Full knowledge and understanding of HIPAA, PHI, patient rights and responsibilities
- Proficiency in electronic health records, medical records, preferably in EPIC
- Active participation in medical clinic huddles, regular check-ins with dental, behavioral clinical teams and integrated services
Benefits:- Competitive compensation
- Comprehensive health, vision, and dental insurance
- Company sponsored life, and long-term disability insurance
- Generous paid time off including paid holidays
- Company-sponsored retirement plan
- Opportunities for professional growth and development
Location:San Francisco, CA
