Job Type
Full-time
Description
Description:The Revenue Cycle Manager will be directly responsible for the revenue cycle for assigned accounts. Revenue Cycle Manager will also be responsible for direct reports within the Revenue Cycle Management Team. Responsible for leading, coaching, and mentoring their direct reports, as well as oversee and uphold performance standards and the level of accountability within the department.
Responsibilities:- Manage a team of Billing Specialists and collaborate with the Management team and supported departments to accurately capture reimbursement opportunities, while providing extraordinary customer service.
- Promote growth of Team Members through established developmental goals, competencies, guidance, and counseling.
- Act as coach, leader, catalyst, and facilitator with Team Members; serve as a resource person for others.
- Provide analytical, practical, and operational experience with private practice revenue cycle.
- Provide direction to team members and organize the billing function to maximize departmental productivity.
- Conduct regular productivity analysis and audits for assigned billing team.
- Manage department, including problem solving, administering procedures to increase efficiencies, and implementing new systems to ensure accountability.
- Review payor denials, making required corrections in billing system(s) by obtaining the necessary contract documentation.
- Ensure all bills/claims received by billing team are expediently logged, prioritized and verified according to established policies and procedures.
- Ensure billing team follows MMG Billing Policies as well as Client Policies.
- Train team on the specifics of each contract, changes in policies and procedures, industry or regulatory changes to ensure compliance.
- Identify and facilitate problem solving and conflict resolution.
- Ensure continual payor maintenance.
- Participate in payor reimbursement meetings and/or conferences relating to Medical Billing and Accounts Receivable as requested.
- Audit, research, and reconcile setup and required maintenance of the billing system(s) including any payer contract changes.
- Generate standard reports, and reviews each for accuracy and consistency with the billing system(s).
- Communicate and meet with practices to review account activity/issues.
- Conduct professional meetings, prepare agendas and provide minutes to meetings.
- Analyze accounts MTD/YTD activity and address concerns regularly.
- Maintains and ensures compliance to regulatory standards. Abide by HIPAA standards and requirements.
- Monitor monthly cash collections by payor to eliminate potential payor issues.
- Participates in professional development efforts to ensure currency in health care practices and trends.
- Participate in LinkedIn posts and articles.
- Travel as required or needed to the Corporate Office or Client sites.
- Other duties as assigned.
Requirements
Qualifications:- High school diploma or equivalent required. Associate or Bachelor Degree a plus.
- Minimum 10 years billing/revenue cycle management experience is required with progressive experience in a supervisory or management capacity.
- Strong knowledge and experience in FQHC (Federally Qualified Healthcare Centers) required.
- Advanced knowledge of the healthcare industry and a sound financial background is required.
- Clear understanding of billing and collection regulatory guidelines and requirements.
- CPT and ICD-9/ICD-10exposure and experience.
- Proficient background in reimbursements.
- Knowledge of multiple specialties and ancillary services is required.
- Knowledge and experience in monitoring Clearinghouse activity, reports, processes.
- Knowledge and experience in setting up payors with EDI, ERA and EFT processes.
- Knowledge and experience in startup of a new or established revenue cycle engagements.
- High proficiency with computer software including but not limited to insurance websites, and Microsoft Office products to include Word, Excel, Outlook, and Teams. Competent with standard office equipment
- Knowledge and experience in developing and manipulating excel reports/pivot tables.
- Demonstrated ability to work independently or in a team environment.
- Ability to uphold production standards and accountability among direct reports.
- Proven ability to train, lead, guide, and direct subordinates is essential.
- Organize and prioritize responsibilities while remaining flexible to changing demands.
- Ability to react calmly and effectively in high stress or delicate situations.
- Excellent written and oral communication skills, interpersonal skills, and an ethical mindset.
- Able to analyze complex data and draw conclusions.
- Must have high level of discretion and judgment.
- Able to make decisions with limited information in a timely fashion.
- Utilize a proactive approach to solving problems and willingness to confront and raise issues before they become problems.
Physical Demands:- Work may require sitting for long periods of time.
- Occasionally lifting files or paper.
- Operating a computer, keyboard, telephone, copier, fax, scanner or other such office equipment through a normal business day.
Reasonable accommodations may be made be made to enable individuals with disabilities to perform the essential functions.
This job description is intended to provide a basic guideline for meeting job requirements.
Responsibilities, knowledge, skills, abilities and working conditions may change as necessary.
