Revenue Cycle Manager

99 Healthcare Management is seeking a Revenue Cycle Manager to manage the client billing process, oversee the credentialing process, and provide leadership to the billing and credentialing departments. The position requires having solid knowledge of service fees, reimbursements from insurance companies, and write-off percentages of the insurance companies. This role directs the posting of invoices and collection of fees owed, a process which involves specific communications with physician providers, insurance companies, state agencies and patients. It involves familiarity with the medical industry, policies, codes and specific medical records databases.

Skills and Responsibilities

•Serves as liaison between billing department staff, physician providers, and our internal management team.

• Acts as a resource to all departments regarding billing questions and concerns.

• Meets billing operational standards by contributing billing information to strategic plans and reviews; implementing production, productivity, quality, and customer service standards; resolving problems; identifying billing system improvements.

•Researches, negotiates with, and creates contracts with new and existing insurance companies. Monitors successful contractual compliance.

•Meets billing department financial standards by providing annual department budget information, monitoring expenditures, identifying variances and implementing corrective actions.

•Conducts regular meetings with physician providers to review status of physician claims and billing; addresses concerns; and resolves problems. Serves as subject matter expert to physician providers and an educational resource.

•Guides employee actions by researching, developing, writing, and updating billing policies, procedures, methods, and guidelines.

•Approves and monitors billing department expenses.

•Understands current regulations and keeps up to date on all changes as they relate to all 3rd party payers and other compliance criteria.

•Provides direct oversight of the day-to-day operations of the Credentialing Department, including overseeing all aspects of the credentialing and re credentialing process.

•Understands and adhere to HIPAA policies, procedures and regulations to assure patient confidentiality.

• Works with the entire billing team to submit timely and accurate claims for reimbursement.

•Ensures that payments are posted as they are received.

•Ensures that follow-up and collections on accounts with outstanding receivables are completed timely.

•Attends required meetings and participates in training programs as required.

•Understands and adheres to HIPAA policies, procedures and regulations to ensure and maintain patient confidentiality.

•Contributes to team effort by accomplishing related results as needed.

•Accomplishes departmental human resource objectives by selecting, orienting, training, assigning, scheduling, coaching, counseling, and disciplining employees; communicating job expectations; planning, monitoring, appraising job contributions; recommending compensation actions; adhering to and ensuring compliance with policies and procedures.

• Assists with special projects including the onboarding of new clients and performs other duties as assigned.

Requirements:

·         5 years medical revenue cycle experience.

·         2 years’ management experience.

Education: Bachelor’s degree in Business Administration or related field.

We offer full benefits: medical, dental, vision, life, disability, 401(k) retirement plan with company match, paid time, and paid holidays.