The Revenue Cycle Manager is responsible for managing the overall functions of the Revenue Cycle for Duncan Regional Hospital Inc. (DRH Health). This position will ensure maximization of revenue and cash flow while maintaining the highest levels of patient, physician/provider, and team member satisfaction and 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 coding, billing and collections, patient insurance data processing, denials management, integrity of patient accounts, and accounts receivable management. The Manager is responsible for the direction of these efforts to ensure the accuracy and timeliness of charge capture, coding, claims submission, follow-up, denial, and underpayment management.

RESPONSIBILITIES (ESSENTIAL FUNCTIONS):

• Plans and directs, patient insurance, billing, and collections, and data processing to ensure accurate patient billing and efficient account collection.
• Reviews 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.
• Establishes and recommends credit and collection policies.
• Monitors daily operating activity of department and makes necessary adjustments in work assignments.
• Supervises team members, including hiring, scheduling and assigning work, training, orientation, mentoring/coaching, evaluating and reviewing performance, and recommending salary increases, promotions, transfers, demotions, or terminations.
• Maintains knowledge of and complies with established policies and procedures including government, insurance, and third-party payer regulations.
• Serves as internal and external resource for questions regarding patient accounts.
• Develops and maintains set-up in the billing and accounts receivable system or software.
• Assists Revenue Cycle Director with various projects and responsibilities, when needed.
• Maintains professional and technical knowledge through continuing education opportunities including internal and external educational offerings.
• Must adhere to, and promote, safety protocols at all times.
• Per DRH policy, all required conditions of employment must be met and maintained including required vaccinations.
• Implement DRH Standards of Behavior and exhibit behaviors consistent with DRH core values.
• Performs other related duties as assigned.

Minimum Qualifications: Communication skills including fluency in oral and written English. Basic computer skills including the ability to send/receive/email, navigate information technology associated with the position, and use Electronic Health Record information tools. Ability to remain flexible to quickly adapt to urgent situations. Ability to adapt procedures, processes, tools, equipment, and techniques to accomplish the requirements of the position.

Education and/or Experience: Bachelor's degree in related field required;Significant years of direct revenue cycle management work experience may be considered in lieu of degree.A minimum of 7 years of hospital revenue cycle including experience in the home care/hospice and/or physician billing/collections experience required. At least 5 years of supervisory experience required. Exceptional interpersonal skills for written, verbal, presentation, and computer communication required. Demonstrated ability to calmly lead others and establish goals in a fast-paced sometimes high-pressure environment.

Demonstrated knowledge of: business management and basic accounting principles; computer accounting programs, spreadsheets, and applications; medical terminology and coding; third-party/insurance company operating procedures, regulations, and billing requirements and government reimbursement programs; provider and facility credentialing and working with CAQH profiles as well as revalidation process; negotiated agreements and managed care contracting. Demonstrated skill in: leadership; problem-solving; customer service; establishing and maintaining, effective working relationships with others at all levels of the organization; development/mentoring/coaching of staff; departmental budget management and cost containment.

Certifications, Licenses, Registrations: For those positions requiring travel, a current valid driver’s license and automobile liability insurance must be maintained.

Non Safety-Sensitive Position

As a condition of employment, vaccinations are required per DRH Policy. Medical and Religious Exemptions are available upon request.