Description

OVERALL SUMMARY:

Reporting to the Director of Finance, the Revenue Cycle Manager is responsible for all aspects of accounts receivable management including billing, insurance, coding, collections, pre-certification, referrals, A/R analysis, and the practice management computer system as it pertains to the department.

Additional responsibilities include direct supervision of 3 direct reports and 15-20 patient accounts clerks and team leads, working cooperatively with the scheduling, medical records, front desk, and switch board to educate on practice management, and liaising with various software vendors.

DUTIES AND RESPONSIBILITIES:

• Supervise patient account clerks and aid in their daily tasks.
• Interview and make recommendations to Director of Finance for hiring new personnel in patient accounts department.
• Conduct yearly evaluations and help establish goals and individual performance standards within department.
• Hold regular departmental staff meetings and serve as a a resource person within department to assist in cross-training and troubleshooting.
• Establish a system for obtaining patient demographic information and assure that initial patient registration in computer is complete and accurate.
• Maintain a current working knowledge of commercial, Medicare, and Medicaid insurance companies and the requirements for filing primary and secondary claims. Monitor all electronic billing functions and establish guidelines for rebilling and claim reviews.
• Make adjustments, credits, issue patient refunds, and balance daily journals.
• Set up batch control logs and maintain a close working relationship with the accounting department, i.e.: balancing daily computer transaction reports with daily deposits.
• Establish safeguards and policies regarding opening mail, making deposits, posting payments. Familiar with requirements and capable of establishing an orderly system for filing EOB’s, daily payment records, and all charges for both the office and surgery center.
• Maintain familiarity/proficiency in accounts receivable computer system and responsible for updating master files such as physician and insurance lists, ATB categories, yearly fee schedules, etc.
• Prepare and supervise a systematic collection system, working with the Director of Finance in monitoring accounts receivables. Send accounts to collection agency and establish and review collection procedures with leadership.
• Monitor/maintain necessary financial information for collection agencies and keeps Administrator informed of their productivity.
• Maintain current knowledge of all collection rules and regulations. Make effective collection calls to patients and provide instruction to insurance clerks as needed.
• Able to explain clinic and surgery center charges to patients and establish payment plans and agreements with patients.
• Review all correspondence and daily payments for the department as needed.
• Prepare necessary insurance applications for new managed care contracts, working closely with Director of Finance during negotiating and/or renewing contracts.
• Communicate with all departments within RGA, including doctors, APN, corporate officers, and management peers.
• Attend manager meetings and occasionally attend board/executive meetings held between 5:30 pm and 7:00 pm for expert advice and input.
• Other responsibilities as needed and agreed upon with leadership.

Requirements

QUALIFICATIONS:

1. 10 years experience in medical insurance field with minimum 5 years’ experience in claims filing, knowledge of accounts receivable, and supervisory experience.
2. Collection experience dealing with patients, insurance companies and collection agencies.
3. High school graduate, associate degree or higher strongly preferred. Proven abilities to initiate new projects, meet deadlines, and evaluate programs or policies.
4. Excellent communication skills, both verbal and written.
5. Experience/familiarity with PM systems (NextGen / A Plus), Contract Management systems (Rivet), Clearing house systems (E-Tactics / A Plus), and Pre-Authorization and/or Pre-Registration systems.