POSITION SUMMARY : Under generalsupervision of the Controller, the Revenue Cycle Manager is a leadershipposition in the Fiscal Department responsible for directing and coordinatingthe overall functions of the billing, coding and provider credentialingactivities of the organization. Thebilling office includes both internal staff and an external billing and codingvendor relationship.

ESSENTIAL JOB FUNCTIONS : The list that follows is notintended as a comprehensive list, but rather to provide a representativesummary of the major duties and responsibilities. Incumbent(s) will be required to perform avariety of duties listed, including but not limited to:

1. Supervise billing office functions such as billing, coding, charge entry, claims submissions, payment posting, accounts receivable follow-up and reimbursement management.
2. Collaborate with billing office and clinical front office staff to ensure timely and accurate billing.
3. Plans and directs patient insurance documentation, workload coding, billing and collections to ensure accurate billing and efficient account collections.
4. Manage the company's outside Billing and Coding vendor.
5. Analyzes billing and claims for accuracy and completeness; submitting claims to proper insurance entities (Government and Commercial) and follow up on any payment issues.
6. Develops and maintains a system for adjustment analysis, reviews and monitors all denials and works with Billing Supervisor on follow up claim activity.
7. Develops and maintains billing office policies and procedures regarding coding, patient billing, collections efforts to ensure compliance with applicable billing and collection laws.
8. Audits billing processes to monitor and improve efficiency of billing and collection operations.
9. Maintains fee schedule within the electronic health record.
10. Develops and provides in-house training for clinic front office and support staff, records staff and providers regarding administrative processes and procedures related to billing and coding.
11. Prepares and analyze accounts receivable as well as other financial reports and billing related Key Performance Indicators (KPI).
12. Analyzes trends impacting charges, coding, collection, and accounts receivable and takes appropriate actions to realign staff and revise policies and procedures, as necessary.
13. Completes applications, as necessary, for payer enrollment and re-validation.
14. Collaborate with third party credentialing vendor to ensure providers are timely and correctly credentialed.
15. Coordinates the completion of annual OSHPD reports and Medi-Cal clinic reconciliations.
16. Understands and remains updated with current coding and billing regulations and compliance requirements.
17. Other duties as assigned.

AllNVIH employees are expected to:

-Provide the highest possible level of service to patients;

-Promote teamwork and cooperative effort among employees;

-Maintain safe practices; and

-Abide by current NVIH's policies and procedures.

REQUIRED QUALIFICATIONS

• eClinical Works (eCW) preferred, but not required.

8. Skill in analyzing complex and sensitive financialforecasting, budgetary, and economic issues, evaluating alternatives andreaching sound conclusions.

9. Working knowledge of Microsoft Office products such asWord, Excel and Power Point.

Medical, Dental, Vision, Life Insurance, 401K, 4 weeks PTO, 13 Holidays, Flexible Scheduling