Revenue Cycle Manager-Medical Practice

Job Title: Revenue Cycle Manager - Medical Practice Department: Patient Accounts

Reports to: Director of Patient Financial Services Revision Date: 2/6/25

Status: Exempt

Job Summary:

Oversight of patient registration, coding and billing processes and systems for Oswego Health Medical Practice to ensure maximization of cash collections, cost effectiveness, efficiency and to ensure work stream success. Recommends, implements and monitors department policy and procedure. Subject matter expert for billing system and clearinghouse.

Knowledge of all positions in the billing department and the ability to provide coverage for those positions when necessary.

Partner with the Finance department during the annual Financial Audit process. Partner with insurance companies to ensure payment on claims.

Oversee the hiring process, as well as timely employee evaluation processing, ongoing performance management and policy application with departmental staff.

Duties/Responsibilities:

• Billing Department
  • Oversee departmental workflow to ensure departmental efficiencies.
  • Oversight of employee schedule to ensure adequate departmental coverage.
    • Dissemination of any pertinent updates to the billing staff.
    • Update month end spreadsheets to review with staff
    • Review and approve employee time cards.
    • Coordinate monthly staff meetings.
    • Develop competencies and ensure departmental trainings are completed by staff.
  • Monitor key performance indicators including A/R Aging, A/R days, Aging by insurance, clean claim rate, and denial rates
  • Develop process to ensure all denials are reviewed and responded to including disseminating to other departments and working to develop processes to improve denial rate.
  • Facilitate regular meetings with Insurance Companies, ensuring all claims are being processed accurately, and addressing issues/concerns in a timely manner.
  • Collaborate with outside vendors- including credentialing service and collection agency.
  • Coordination of the flow of information between the billing department and operational leadership
  • Maintain knowledge of state, federal, and contracted third party regulations for billing and reimbursement for all payers.
• Patient Registration
  • Develop policies and procedures for patient registration to ensure consistency across all practices
  • Train Site Managers in registration policy and procedures and serve as a point of contract for site managers to assist in problem resolution
  • Educate practices on changes to insurance plans and use of technology to verify insurance coverage
  • Develop and monitor No Surprises Act requirements
• Coding
  • Serves as supervisor of coding staff
  • Educates practices on CPT code changes
  • Assists practices in development of accurate documentation templates for physicians
  • Coordinates annual compliance and auditing of coding
• Perform other duties as assigned.

Required Skills/Abilities (Unit Specific):

• Excellent verbal and written communication skills as well as interpersonal skills.
• Proficient in standard computer programs, including Microsoft Office Suite (Excel, PowerPoint, and Word).
• Excellent time management skills with a proven ability to meet deadlines.
• Professionalism and business acumen appropriate for working with guests, clients, physicians, employees and volunteers.
• Proactive and independent, with the ability to take initiative.
• Familiarity with laws, regulations, and best practices applicable to billing practices.

Education and Experience:

Must be a high school graduate, have healthcare and insurance knowledge in relation to the billing and collection process and prior billing office supervisory experience. Must have knowledge of billing office operations, experience in billing, credit and collections and follow-up. Must have good communication skills to convey billing and financial policies. 5 Years of billing and follow-up experience required in addition to 5 years supervisory experience preferred.

Working Conditions:

• Extended periods of sitting, using standard office equipment including, but not limited to: computers, phones, scanners, fax machines, printers, etc.
• Occasionally requires assembling, using and maintaining all departmental equipment.
• Occasionally requires prolonged periods of standing and walking with the ability to lift, push or pull up to 15 lbs. using proper body mechanics.
• Attendance ensures that job requirements are met.
• Actively participates in Quality Assurance programs and CQI, in-service programs, cross-training; completes department specific requirements/competencies; attends all mandatory classes as required; participates in meetings and committees as assigned.
• Complies with DOH requirements for annual health assessments and required immunizations.

Pay Range: $90,000-$95,000/annual

Employee salary is based on commensurate experience and other qualifications.

About Oswego Health:
The mission of Oswego Health is to provide accessible, quality care and improve the health of residents throughout Oswego County. As a nonprofit healthcare system established in 1881, Oswego Health is proud to be Oswego County's largest private employer. More than 1,300 employees spread throughout its 18 locations, work for the Oswego Health system, which includes the 132-bed community Oswego Hospital, a 32-bed psychiatric acute-care facility with multiple outpatient behavioral health service locations, The Manor at Seneca Hill, a 120-bed skilled nursing facility, and Springside at Seneca Hill, an independent retirement community. The health system also operates Oswego Health Home Care, the only hospital-based certified home healthcare agency in the County, as well as two outpatient centers, including the Fulton Medical Center, offering urgent care, lab, medical imaging, physical therapy, and occupational health services, and the Central Square Medical Center, offering urgent care, lab, medical imaging, and physical therapy services. In addition, the healthcare system includes Oswego Health Medical Practice, a multi-specialty medical group offering the community accessible, high-quality healthcare. 100 physicians and advanced practice providers offer an extensive array of services across CNY, including primary care and specialty care in the areas of orthopedics, cardiology, ENT, gastroenterology, breast care, general surgery, urology, and bariatrics.

EQUAL EMPLOYMENT OPPORTUNITY

Oswego Health is committed to providing equal opportunity in all employment-related matters, without regard to race (including traits historically associated with race), creed, color, religion, sex/gender, national origin, age, marital or familial status, disability, pregnancy-related condition, sexual orientation, gender identity, gender expression, transgender status, citizenship status, ancestry, arrest/conviction record, military or veteran status, domestic violence victim status, genetic predisposition or carrier status, reproductive health decision making, relationship or association with a member of a protected category, or any other legally protected characteristic. Decisions affecting your position including, but not limited to, recruitment, hiring, placement, promotion, transfer, compensation, benefits, training, tuition assistance, leaves of absence, disciplinary action, layoff/recall, and terminations will be made in accordance with this policy.

Salary : $90,000 - $95,000