Revenue Cycle Manager
Revenue Cycle Manager
This position manages all aspects of the patient billing process, including billing, coding, compliance, reimbursement, and receivables. Responsibilities include accurate and timely completion of the revenue cycle process and supervising a team of billing specialists, monitoring and supporting their efficiency and effectiveness. This role will take the lead in the development of effective policies and procedures, maintaining current knowledge of changes in compliance standards and payer policies, analyzing data for reimbursement trends, managing denial processes, and interfacing with internal and external leaders to resolve identified issues within the revenue cycle. The person in this position must be able to multi-task and function in a fast-paced environment.
Manages and performs revenue cycle-related processes and procedures
- Manages the electronic and paper claim submission process.
- Ensures all data elements are properly loaded in the billing system and updated as needed.
- Ensures claims are submitted timely for processing by payers.
- Ensures and reviews all payer-related items are accurate and up to date.
- Manages billing error reports to ensure claims are being submitted to payers accurately.
- Manages projects for all insurance plans for payment of services.
- Manages patient collections, reimbursement, and provider enrollment issues regarding payment of claims.
- Addresses escalated patient calls and ensures situations are resolved in a tactful and professional manner.
- Serves as backup for billing specialists as needed.
Supervision and staff management for Billing team
- Manages daily tasks and assignments for Billing team
- Continually reviews tasks and processes for efficiencies and process improvement.
- Manages employee performance through coaching, appraising, and motivating.
- Works with staff to set performance and productivity goals that help ensure fair evaluation of work outcomes and timely collection of payments.
- Reviews productivity performance with staff and addresses issues with individual staff in a timely manner.
- Develops quality assurance criteria for activities in area of assignment and performs regular audits and review and findings with staff.
- Interviews and hires billing staff for replacement or expansion.
- Promotes an environment of open communication and collaboration.
Support of other organizational departments
- Works closely with Directors, Managers, and other supervisors to:
- Ensure positive collaboration between the billing department and the rest of the agency
- Ensure completeness and accuracy of patient information collected by front desk personnel and encounter information recorded by providers.
- Ensure accurate and timely billing and collection.
- Establish revenue cycle benchmarks
- Improve effectiveness and efficiency of revenue cycle operations.
- Researches EMR/billing issues as needed in order to resolve timely.
- Ensures new programs are provided with training and leadership for successful registration, billing, and collection.
- Provides information as requested according to the department policy on information dissemination.
Support of EFO and the organization as a whole
- Works closely with the credentialing contractor to ensure compliance with Third Party Payer requirements.
- Establishes, updates and maintains policies and procedures governing billing and collections, ensuring this documentation is always current, complete, and user-friendly.
- Works with EFO to identify areas of potential audit concern, and to maintain and implement internal controls as needed.
- Prepares reports and conducts analysis for the EFO as needed and on a timely basis, in order to support decisions by leadership and maintain/grow revenue collection.
- Recommends actions and ensures issues are addressed timely.
- Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.
- Uses experience, education or training, and judgment to plan and accomplish key performance indicators for A/R metrics and other measures of organizational health.
- Maintains a high degree of confidentiality pertaining to Mazzoni Center and patient care that adheres to HIPAA compliance policies regarding all information obtained during the course of work.
- Performs additional special assignments, duties, and related functions as required.
- Excellent oral and written communication skills are required for this position. Information must be exchanged using tact and persuasion appropriately.
- The person in this position must be able to communicate with the clients, staff, and others, and contribute to a positive environment.
Education, Training, License and Certification, Skills
- Bachelors Degree and 3-5 years experience in revenue cycle management in a physician provider setting, or equivalent combination of education and experience, required.
- 1-2 years of supervisory experience required.
- Experience in a family practice setting preferred.
- Excellent written and verbal communication skills.
- Proficiency with Microsoft Office, especially Excel.
- Proficiency with electronic medical/health record software required; experience with Athena or EPIC preferred.
- Certification in medical coding and billing preferred.
- The ability to stand, sit and walk for extended periods of time
- The ability to lift objects greater than 35 pounds
- The ability to communicate using written and spoken words
- Must have all necessary vaccinations
- Annual PPD