What are the responsibilities and job description for the Revenue Cycle Manager position at Little River Medical Center, Inc.?
Revenue Cycle Manager
POSITION SUMMARY
The Revenue Cycle Manager (RCM) is responsible for managing the day-to-day activities of the billing department, which includes oversight of collections, cash posting and reconciliations. Also, the RCM is responsible for training and monitoring provider and staff adherence to coding and billing requirements. Another major responsibility is to identify revenue cycle deficiencies to the Revenue Cycle Director (RCD), suggest solutions and implement best practice processes.
WHY LRMC:
Little River Medical Center is a non-profit community health center within Horry County. At Little River Medical Center, we strive to offer exceptional health services and deliver quality, compassionate care to everyone. We provide a wide range of affordable health and support services for every family.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following but not limited to:
- Provide and monitor communication to patients and staff to assure it is timely and professional.
- Maintain effective, productive relationships with staff, patients and other agencies.
- Maintains a well-organized work area. Responsible for maintaining an adequate amount of supplies.
- Develops a thorough understanding of billing staff responsibilities and procedures.
- Provide training and guidance to billing staff and providers.
- Track employee review dates and provide timely review for staff.
- Assures that claims are filed timely.
- Assures that billing staff corrects and re-files claims from appropriate reports and prioritizes high risk claims by utilizing best software tools available.
- Assures that mail edits are worked on a timely basis, generally daily.
- Assures that all insurance and patient receipts are posted by the end of the month. Exceptions must be approved by the RCD.
- Assures that front office billing corrections are made timely, by completing action requests.
- Assures that secondary claims are processed on a timely basis.
- Monitors to see that electronic patient statements are being processed daily.
- Assures that hospital claims are processed timely, which includes verifying the pay source and filing the claim.
- Process patient and insurance refunds on a timely manner.
- Assures that all grant program claims are processed timely.
- Assures that small balances and credits are processed timely according to policy.
- Assures that close of day processing is performed on a daily basis.
- Develops understanding of sliding fee program to be able to reconcile accounts for patients with multiple pay types.
- Performs month-end processing and oversees closing tasks.
- Assures that patient collections are processed according to the Financial Policy.
- Coordinates all billing projects assigned to make corrections or to seek higher reimbursement.
- Works with the accounting department regularly to ensure proper balancing and ledger entries.
- Attend monthly payer meetings as needed.
- Submit payer concerns to the Quality Department for payer meetings as needed.
- Strive to meet Billing Metrics and End of Month goals within the A/R process.
- Ability and desire to work towards department goals, as assigned by the Revenue Cycle Director, to obtain the highest level of performance for the department.
- Attends all in-service training as required.
- Maintains patient and Center confidentiality at all times.
- Performs other duties as assigned.
SUPERVISORY RESPONSIBILITIES
Revenue Support Supervisor, Patient Services Specialist, Billing Administration Support, Billing Specialist, Payments Specialist, Patient Financial Specialist, Certified Coding Specialist.
QUALIFICATIONS
To perform this job successfully, the individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE:
- High School diploma required.
- At least four years of healthcare billing experience required. FQHC billing a preference.
- Medical billing supervisory experience required.
- Experience with remote supervision required.
- Extensive knowledge of medical terminology and CPT coding required.
- Professional billing certification from AAPC or AHIMA required.
LRMC offers benefits such as:
- Medical, Vision & Dental insurance.
- Employer matched 403B Retirement Plan.
- Paid Vacation time, Sick time, & Holiday's. As well as paid qualifying Administrative Leave.
- Employer Paid Health Benefits: Life / AD&D Policies, Short/Long Term Disability, and a Employee Assistant Plan.
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