Revenue Cycle Manager

Overview

Gastro Center of Maryland is a 21 provider GI group practice which is seeking to add a Revenue Cycle Manager based in our Columbia, Maryland office. The Revenue Cycle Manager is responsible for overseeing and optimizing the revenue cycle operations for both a gastroenterology group practice and set of Ambulatory Surgery Centers (ASCs). This role includes managing the performance of an outsourced Revenue Cycle Management (RCM) group, ensuring efficient billing, collections, coding compliance, and adherence to financial goals. The Revenue Cycle Manager serves as the primary liaison between the organization and the outsourced RCM team, while also collaborating with internal teams to maintain seamless revenue operations across the practice and ASC.

Salary and Benefits

• Highly competitive salary
• Comprehensive benefits

Job Description

Key Responsibilities:

1. Oversight of Outsourced RCM Operations:

• Oversee the performance of the outsourced RCM group for both the gastroenterology practice and the ASCs, ensuring they meet contractual obligations and key performance indicators (KPIs).
• Conduct regular performance reviews, audits, and meetings with the RCM team to ensure alignment with organizational goals.
• Collaborate with the RCM group to resolve issues related to claims denials, coding discrepancies, and delayed reimbursements for both entities.
• Ensure the RCM group adheres to payer contracts and optimizes reimbursement rates for ASC and practice services.

2. Revenue Cycle Management:

• Oversee the full revenue cycle for the gastroenterology practice and ASC, including patient registration, charge capture, claim submission, and collections.
• Develop and implement strategies with the RCM team to reduce denials, improve collection efficiency, and optimize cash flow.
• Ensure that the unique billing and reimbursement requirements for ASC services (e.g., facility fees) are properly managed.

3. Compliance and Coding Oversight:

• Ensure compliance with all federal, state, and payer-specific regulations, including HIPAA, Medicare, Medicaid, and commercial payer guidelines.
• Oversee coding accuracy for both professional (practice) and facility (ASC) billing, ensuring compliance with ICD-10, CPT, HCPCS, and other coding standards.
• Collaborate with clinicians and coders to optimize documentation for accurate and timely reimbursement.

4. Financial Analysis and Reporting:

• Analyze revenue cycle data and performance metrics for both the gastroenterology practice and ASC to identify trends, inefficiencies, and opportunities for improvement.
• Prepare and present comprehensive financial reports to leadership, summarizing the performance of the outsourced RCM group and internal processes.
• Recommend and implement action plans to address any financial or operational gaps.

5. Payer and Patient Relations:

• Manage payer relationships, ensuring contract adherence and timely resolution of reimbursement issues across both the ASC and practice.
• Oversee the patient billing process, ensuring clarity and professionalism in addressing patient inquiries and concerns related to practice and ASC services.
• Implement and monitor patient payment plans as necessary.

6. Staff and Vendor Collaboration:

• Act as the primary point of contact between the gastroenterology group, ASC, and the outsourced RCM group.
• Collaborate with clinical and administrative teams to address documentation, coding, and revenue cycle needs.
• Facilitate training and communication with internal staff to support accurate patient intake and charge capture processes.

Qualifications:

Education:

• Bachelor’s degree in healthcare administration, business, or a related field preferred.

Experience:

• Minimum of 5 years of experience in healthcare revenue cycle management, with a focus on managing outsourced RCM services preferred.
• Experience with gastroenterology and/or ASC operations is highly desirable.

Skills:

• Strong knowledge of medical billing, coding, and reimbursement processes for both professional and facility services.
• Expertise in revenue cycle metrics, including ASC-specific KPIs such as case mix index and cost-per-case analysis.
• Proficiency in electronic health records (EHR) and practice management systems (e.g., EPIC, NextGen, Athena) and ASC billing platforms.
• Excellent leadership, organizational, and communication skills.
• Ability to analyze complex data sets and develop actionable strategies.

Certifications:

• Certified Revenue Cycle Professional (CRCP), Certified ASC Coder (CASCC), or Certified Professional Coder (CPC) preferred.

Key Competencies:

• Vendor and contract management
• Financial and operational acumen specific to ASC and specialty practices
• Analytical thinking and problem-solving
• Strong collaboration and leadership skills
• Attention to detail and compliance