Senior Manager of Revenue Cycle

The Senior Manager of RCM, reporting to the Vice President of RCM, supports revenue cycle operations in accordance with established business objectives and applicable regulatory requirements. Responsible for directing and coordinating the overall AR follow up and denials management. This includes ensuring maximization of cash flow while improving patient, physician and customer relations. Ensures all KPIs related to net collections, gross days in AR, rejections and edits are met. Proactively manages the AR through monitoring key performance indicators and understanding the revenue cycle needs and financial performance targets.  Recommends and implements process improvement strategies to further improve KPIs and financial targets.

TYPICAL DUTIES AND RESPONSIBILITIES:

·         Responsible for leading, coaching, and mentoring direct reports, as well as overseeing and upholding performance standards and the level of accountability within the department.

·         Promote growth of Team Members through established developmental goals, competencies, guidance, and counseling.

·         Act as coach, leader, catalyst, and facilitator with Team Members; serve as a resource person for others.

·         Provide direction to team members and organize the billing function to maximize departmental productivity.

·         Direct and evaluate the activities of the Billing Leads to see that all their duties are carried out at a high level of efficiency and professionalism.

·         Conduct regular productivity analysis and audits for assigned billing team.

·         Manage department, including problem solving, administering procedures to increase efficiencies, and implementing new systems to ensure accountability.

·         Audit, research, and reconcile setup and required maintenance of the billing system(s) including any payer contract changes.

·         Performs proactive revenue analysis by tracking practice management activity against financial goals and key performance indicators (KPIs).

·         Improves financial results by analyzing various factors, monitoring variances, identifying trends, and working with internal departments to resolve issues.

·         Active participant to assist in efforts of all new acquisition onboarding

·         Utilizes various software systems to generate reports, conduct data analysis, identify trends and variances, develop recommendations, implement solutions, and communicate all to VP of RCM

·         Monitor monthly cash collections by payor to eliminate potential payor issues.

·         Review, develop, implement, and maintain standard operating policies and procedures for the Billing Office that will facilitate the maintenance of internal and quality controls.

·         Establish baselines and manage accounts receivable to ensure that they are kept at an acceptable level; interface with physicians to strive for continuous quality improvement in processes.

·         Conduct and present appropriate statistical analyses and custom reports where needed.  Implement new policies as necessary to improve performance.

·         Provide leadership for the overall direction, coordination, implementation, execution, control and completion of specific projects ensuring consistency with organizational strategy, commitments and goals

·         Work with the analytics team to identify meaningful metrics for deep dive RCM review.

·         Maintains and ensures compliance with regulatory standards. Abide by HIPPA standards and requirements.

MINIMUM QUALIFICATIONS

Required Certifications, Registration or Licensure:

None

Minimum Knowledge and Education:

Bachelor’s degree preferred.

Minimum Work Experience:

10 years of central physician billing experience.

Specific Knowledge, Skills, Abilities:

• Minimum 10 years’ billing/revenue cycle management experience is required, with at least 5 years prior experience in a supervisory or management capacity.
• Advanced knowledge of the healthcare industry and a sound financial background is required.
• Clear understanding of billing and collection regulatory guidelines and requirements.
• CPT and ICD-9/ICD-10 exposure and experience.
• Proficient background in reimbursements.
• Knowledge of multiple specialties and ancillary services is required.
• Knowledge and experience in monitoring Clearinghouse activity, reports, processes.
• Knowledge and experience in setting up payors with EDI, ERA and EFT processes.
• Knowledge and experience in startup of a new or established revenue cycle engagements.
• High proficiency with computer software including but not limited to insurance websites, and Microsoft Office products to include Word, Excel, Outlook, and Teams. Competent with standard office equipment.
• Knowledge and experience in developing and manipulating excel reports/pivot tables.