Revenue Cycle Manager

Overview
We are seeking a detail-oriented Revenue Cycle Manager to join our team. The ideal candidate will be responsible for managing the financial health of our organization by ensuring accurate billing, timely collections, and efficient revenue cycle processes.

Responsibilities
- Review and analyze patient accounts for accuracy and completeness
- Process insurance claims and follow up on outstanding claims
- Verify insurance coverage and benefits for patients
- Communicate with patients regarding billing inquiries and payment options
- Collaborate with internal teams to resolve billing discrepancies
- Maintain up-to-date knowledge of insurance regulations and billing procedures

- Oversee and manage the revenue cycle departments, including patient billing, utilization management, and financial counseling, and all components of the revenue cycle including pre-authorization and re-authorization, eligibility and benefits verification, claims submission, payments and payment posting, claims denial management, authorization and billing appeals, reporting and any other functions which involve revenue management.

Requirements

• Bachelor's degree preferred.
• Certified Professional Coding Certificate from AAPC.
• Knowledge of credentialing and payer enrollment.
• At least 5 years of experience in healthcare Revenue Cycle required.
• Knowledge related to accounts receivables, billing systems performance, coding, A/R reporting, and revenue management analysis.
• 2-3 years Management experience in Practice Management or Revenue Cycle Management Preferred.
• Experience with physician billing in Cardiology setting preferred.
• Advanced knowledge of third-party insurance, and familiarity with insurance plan types; HMO, PPO, POS, and Indemnity.
• Excellent knowledge and understanding of EHRs and Physician Billing Systems. Athena experience preferred.
• Excellent knowledge of the Commercial, Medicare, HMO, and PPO Programs particularly as it relates to CPT procedures and ICD-10 diagnostic coding and billing. Thorough knowledge of Medicare Fraud and Abuse regulations.
• Ability to counsel patients financially regarding outstanding charges and effectively resolve problems exhibiting the highest customer service skills and etiquette.
• Ability to work independently and as part of a team.

SUMMARY OF JOB DUTIES:

The Revenue Cycle Manager manages, coordinates, and oversees overall daily billing operations of the practices to ensure maximization of cashflow while improving patient, physician, stakeholder and other customer relations. Responsibilities include; Patient Billing and Collection, A/R Management, Application Systems Support, Claims Management, Coding, Charge Capture, Data Entry, Account Follow-Up, Customer Service, Denial Management, Edit Management, Payment Variance Analysis, Contract Analysis, Credit Analysis, Refund Management, Payment Posting, Auditing, Training, and Productivity and Performance Reports.

The Manager provides oversight and support for Revenue Cycle integrity and workflow processes. Assures all established billing systems, and workflow process requirements have been met in order to ensure timely and optimal reimbursement. Manages the development of regular business operations reports and works to improve Revenue Cycle production and efficiency through the analysis of key performance indicator data. The Manager recommends changes that will positively impact the Revenue Cycle and helps the Business Office operate according to industry benchmarks and meet A/R performance goals and productivity. Oversee and manage the revenue cycle departments, including patient billing, utilization management, and financial counseling, and all components of the revenue cycle including pre-authorization and re-authorization, eligibility and benefits verification, claims submission, payments and payment posting, claims denial management, authorization and billing appeals, reporting and any other functions which involve revenue management. Develop and implement strategies to improve revenue cycle processes, maximize covered days, reduce denials, and enhance cash flow.

Job Type: Full-time

Pay: $70,000.00 - $80,000.00 per year

Experience:

• Medical billing: 4 years (Required)

Ability to Commute:

• Macon, GA 31201 (Required)

Ability to Relocate:

• Macon, GA 31201: Relocate before starting work (Required)

Work Location: In person

Salary : $70,000 - $80,000