Revenue Cycle Manager

Revenue Cycle Manager

Overall Responsibility:

Leading the oversight, directing, management and review, planning, organizing, and evaluation of activities for the revenue management of the facilities; assisting with development, implementation and evaluation of all business office processes, policies and procedures; monitoring, advising and training the Solara and facility staff members to achieve optimum financial performance of the facility. 

Key tasks and responsibilities (essential functions):

1. Assist in direction and training of the Solara and Facility Business Office activities and oversight of the following areas:  Intake, Medical Records, Billing, Coding, Collections, Insurance Verification, Scheduling, Cash Posting
2. Possess the ability to provide back up for the job descriptions related to the listed functions.
3. Lead coordination and participation of events involved in the review and analysis of Business Office activities for facility patient accounts, identification of issues and areas of improvement proactively.
4. Perform consistent reviews to maintain knowledge of industry changes (LCDs) as related to case/service performance within our facilities.  Transfer related information to Solara Directors for proper address and implementation.
5. Lead the determination and enforcement of corrections required for identified problem resolution.
6. Support Revenue Team members in answering a variety of correspondence from respective Solara and facility staff members, insurance companies and other concerned parties regarding Business Office related inquiries, processes and issues.
7. Oversee and ensure timeliness and accuracy of daily/monthly routines of the entire accounts receivable process.
8. Lead preparation and review of financial reports and business office performance analysis, setting forth progress, adverse trends and appropriate recommendations or conclusions. Monitor, analyze and report metrics in place for each facility.
9. Perform review and analyzation of weekly/monthly reporting procedures, as well as the month end close process.
10. Analyze and evaluate the viability of procedures/services performed within our facilities.
11. Perform annual review; development and recommendations, implementation of policies and procedures for all Business Office functions and monitor compliance.  Ensure compliance with policy and procedures related to internal controls.
12. Is thoroughly familiar with each facility’s third party payer contracts and ensures the business office staff is provided the information and training to also understand the contract terms as is appropriate to their position.
13. Ensure proper performance of system maintenance for areas relating to the Business Office and Revenue Cycle Management.
14. Maintain expert knowledge of A/R system and A/R system reporting.
15. Ensure each facility’s fee schedule is accurately loaded into the billing software.
16. Ensure proper maintenance and completion of all forms for documentation in the patient’s medical records.
17. Assist with compilation of statistics for running required state reports each quarter. 
18. Help maintain the confidentiality of the patient’s medical and financial information.
19. Keep job related skills current through training programs.
20. Participate in all compliance programs.
21. Participate in loss prevention by protecting company assets and maintaining a safe environment.  Participate in and initiate the training of the Facility Business Office Staff as is appropriate to their duties.
22. Perform other related duties incidental to the work required in this job description.
23. Support the use of new technology; attend technology training sessions; demonstrate skill in using technology.
24. Maintain compliance requirements without reminder or follow-up, including annual compliance training; license/certification renewal; specialized training requirements; annual TB testing; etc.
25. Demonstrate the safe operation of equipment and machinery and follow procedures for reporting and correcting an unsafe situation
26. Adhere to established safety requirements and procedures to ensure a safe working environment.
27. Integrate knowledge, attitudes, skills and behaviors to maintain consistent standards of care and competency based practice following standards of care and center policy.
28. Interact with all persons in a mature, responsible manner to ensure a positive and professional environment.
29. Explain procedures in terms others understand; shares resources with other (ex: computers, knowledge); provides information in a timely manner; informs patients or coworkers of any delays; tries to find a solution to patient or coworker issues.
30. Look for ways to continually improve work methods that will benefit patients, physicians, and coworkers; respects coworkers and works cooperatively as a team to improve patient care/services excellence; avoids all contact with patient information that does not involve role at the center; practices good personal hygiene, including keeping nails trimmed; identifies the center, department and self when answering outside calls.
    
    Environmental and physical requirements  - The employee works in a temperature controlled environment.  Candidate must be able to read and speak English fluently, have cognitive skills for math, reading, computer skills, communication skills to deal well with the public (customers) as well as peers.  Vision for near, mid-range, far and accommodation.  Hearing for low, medium and high pitch.  Job requires sitting for 70% of activities with minimal up and down activity.  Job risk include exposure to computer for 6-7 hours per day with typing activities, lifting of 20-30 pounds maximum, potential for exposure to blood and body fluids (minimal), and exposure to infectious disease.  

Qualifications

Experience required: High school diploma or equivalent required. Bachelor’s degree preferred. Ten or more years’ experience in medical billing and patient account management with a minimum of five years in a supervisory role.   Experience in an Ambulatory Surgery Center setting is preferred.   Experience in process improvement to include; process mapping, identification of process gaps, opportunities for improvement to reduce errors, presentation and implementation of identified improvements. Experienced in word processing and spreadsheet software. Ability to simultaneously manage multiple projects and timelines at various stages.  Good knowledge of correct bookkeeping, billing and collection practices. Good communication, organizational and interpersonal skills. Good personal credit report required.