Revenue Cycle Manager

Brief Description

JOB SUMMARY:

Under the general direction of the Sr. Director of Revenue Cycle, the Revenue Cycle Manager coordinates the activities, training, internal audits, productivity and reporting of the revenue cycle functions. The Revenue Cycle Manager will work create and maintain workflow to increase the revenue cycle staff knowledge and skills in coordination with the functional areas revenue cycle leaders.

ESSENTIAL DUTIES AND RESPONSABILITIES: Revenue Cycle Manager Duties may include but are not limited to Core Functions: Supervision of, Payer Contracts and credentialing, Pre-verification, Prior-Authorization, billing and collections productivity, accuracy and workflows.

Other duties:

• Analyze, identify and track trends impacting the revenue cycle activities and continuously improve patient accounts process and correct gaps during the RCM
• Conduct quality assurance and accuracy audits of RCM functions
• Identifies opportunities for system enhancements to support he revenue cycle system and assists with the implementation and monitoring of the process once completed
• Enhance professional growth and development, coordinate, support and conduct training as needed
• Write, implement and ensure adherence to policy and procedures impacting the revenue cycle activities
• Ensure and maintain constant communication with patient, staff, leadership, and third party agencies, handling any questions or problems that may arise regarding the RCM activities
• Collaborate with all revenue cycle supervisors to ensure continuous quality, and to develop best practice workflow plans, patient access and collection improvement
• Observe, identify, recommend and evaluate methods to ensure effective use of staff, while maintaining exceptional standards
• Supervise, train and support staff with all Revenue Cycle Functions
• Perform and coordinate audits and reconciliation activities to ensure proper resolution and compliance with projects and activities
• Periodically review and update policies, such as sliding fee scale, to ensure each continues to meet the objectives of the organization
• Assist, maintain and support the configuration of the practice management system in aspects related to the revenue cycle
• Run relevant financial reports to extract key financial data and report key metrics within the RCM
• Assist on the coordination with insurance companies to resolve payment problems and reimbursement issues in a timely manner.
• Effectively navigate insurance portals and EMR system
• Brings any unusual occurrence to the attention of the RCM Leaders
• Perform revenue cycle management duties as needed
  
  

Other Elements:

Knowledge Reimbursement and third party payer procedures, schedule and collection techniques Ability to accurately enter and review data. Ability to multitask. Knowledge of Microsoft and Outlook.

Experience Billing and collections in a health system or Medical billing certificate is preferred. Must have good computer skills.

Judgment Demonstrates good judgment in reasoning when investigating and solving problems. Respect the confidentiality of patient information in compliance with the HIPAA and other applicable regulations.

Action The ability to prioritize the assignments.

Accountability Ability to meet deadline and work product. Ability to perform assigned duties with minimal direction and supervision in a timely manner. Ability and flexibility to work in-office or remotely.

Interrelationships Effective interaction with external and internal representative impacting the medical billing and patient revenue activity. Must communicate clearly in consistent manner and work towards resolution of problems with immediate staff and other managers.

Environment The work environment are general business office working conditions.

Physical Effort The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Requires minimal physical efforts and constant use of computer, telephone and fine printed information. While performing the duties of this job, the employee is frequently required to stand, walk, sit, and use hands to finger, handle or feel. The employee is occasionally required to reach with hands and arms, climb or balance, and talk or hear. The employee must frequently lift and/or move up to 25 pounds.

Occupational Risks Regular volume of work and deadlines impose stress on routine basis. Frequent interruptions. The noise level in work environment is usually low to moderate.

Character of

Supervision This position requires supervision