Revenue Cycle Manager

: The Revenue Cycle Manager is a key leadership position, responsible for planning, organizing and managing all aspects of medical billing and coding to maximize revenue. The Revenue Cycle Manager is responsible for managing the revenue cycle team’s daily operations. The person in this role will develop training materials and train members of the billing team, providers, and operations team.

· Monitor revenue cycle processes and staff functions. This role will supervise Billers, Coder and Denials Specialist.

· Support revenue maximization and integrity through evaluation of coding and billing accuracy.

· Prepare, review, and transmit claims using billing software, including electronic and paper claim processing within 24 hours of receipt.

· Research and appeal denied claims.

· Answer all patient or insurance telephone inquiries pertaining to assigned accounts within 24 hours.

· Review billing workflows and work with the appropriate teams to adjust billing systems to better catch errors and/or omissions.

· Ensure all billing submissions are in alignment with insurance carrier requirements.

· Verify that all billing is coded properly and accurately.

· Approve all patient or insurance credits.

· Communicate with the credentialing company and SCRFHC staff to ensure timely credentialing.

· Lead and support the revenue cycle team by providing exceptional training, a supportive environment and workload balance.

· Support and assist the Chief Financial Officer (CFO) and the finance department.

· Develop and support all revenue cycle systems within the department.

· Participate on project teams as a technical build resource.

· Support any production systems to ensure the availability of the applications.

· Design and implement Operations and Finance workflow improvements.

· Function as subject matter expert and resource for all coding and billing processes.

· Lead the revenue cycle team including the ongoing development and unification of revenue cycle best practices, policies, monitoring activities, and other strategies for an effective revenue cycle program.

· Maintain contact with other departments to obtain and analyze additional patient information to document and process billings.

· Participate in risk assessment activities to ensure effective revenue cycle monitoring and follow up.

· Communicate risks, audit results and mitigation efforts to leadership.

· Utilize technology and data analytics to support revenue cycle risk mitigation efforts.

· Evaluate compliance-related activities and services.

· Conduct routine quality control audits of random sample cases and report practices requiring corrective action to departmental leadership.

· Prepare and analyze accounts receivable reports, weekly and monthly financial reports, and insurance contracts in concert with the CFO to maximize revenue.

· Review dashboards and metrics to maximize revenue.

· Review and interpret operational data to assess the need for procedural revisions and enhancements; participate in the design and implementation of specific systems to enhance revenue and operating efficiency.

· Analyze trends impacting charges, coding, collections, and accounts receivable and take appropriate action to realign St. Croix Regional Family Heath Center (SCRFHC) staff and revise policies and procedures.

· Keep up-to-date with billing changes and distribute new information within SCRFHC.

· Understand and remain current with coding and billing regulations and compliance requirements.

· Maintain a working knowledge of all health information management issues such as HIPAA and all health regulations.

· Provide, oversee, and/or coordinate the provision of training for new and existing billing staff on applicable operating policies, protocols, systems, standards, and techniques.

· Perform other duties as assigned

· Develops and sustains positive working relationships with SCRFHC team.

· Address issues in the moment in a respectful and, if necessary, confidential way and encourage the team to do the same.

· Provide mentoring and coaching.

· Model a team-oriented environment that supports one another.

· Facilitate team building – incorporate team into decision-making process.

· Encourage a trusting environment.

· Facilitate effective communication with team members.

· Lead and model a positive solution-oriented approach.

· Acknowledge mistakes; own mistakes and take responsibility for your team.

· Recognize team members’ abilities, accomplishments and opportunities for professional growth.

· Trust other managers to address issues in the moment even with individuals who are not on their team.

· Remind team members of expectations on a regular basis. Convey consistent messages across all locations.

· Provide appropriate supervision to your team.

· Bachelor’s degree in a related field or relevant experience.

· Minimum of 8 years of progressive financial experience in healthcare, including billing, coding, and denials management.

· Management experience overseeing a billing department preferred.

· Coding knowledge.

· Knowledge of regulations such as HIPAA and OSHA.

· Experience working in a community health center designated as a federally qualified health center (FQHC), and knowledge of FQHC requirements preferred.

· Computer skills, including command of Microsoft Office Suite (particularly Excel and Word) are required. Must be familiar with a practice management system. Experience working with EClinicalWorks electronic medical record system desired.

· Proficient language and mathematical skills with ability to read and interpret written documents and spreadsheets, and numerical data and equations.

· Demonstrated professional written, verbal, and interpersonal communication skills.

· Exceptional phone and in-person etiquette with active listening, clarity of speech, and customer service skills.

· Ability to remain patient, calm and understanding with customers with effective tolerance of discourteous customers and difficult situations.

· Ability to use proper judgment and problem-solving skills.

· Effective time management and organizational skills.

· Ability to perform quality work demonstrating accuracy, thoroughness, and attention to detail.

· Must maintain confidentiality and adaptability, and work in a teamwork environment.

· Must adhere to company safety guidelines.

· Must be dependable and adhere to company attendance guidelines.

· Requires well-developed organizational skills and basic office operations to assure appropriate documentation and follow-through to meet the department needs.

· Demonstrate a patient-focused attitude. Commit to providing excellent service to all patients, staff and visitors.

· Must demonstrate ability to work in fast-paced, deadline-oriented environment where the ability to meet deadlines is a must with constant communication required.

· Demonstrates proficient computer skills including accurate data entry into Microsoft Excel, as well as documentation and communication through Microsoft Outlook.

Job Type: Full-time

Pay: $58,000.00 - $80,000.00 per year

Benefits:

• Dental insurance
• Employee discount
• Health insurance
• Life insurance
• Paid time off
• Retirement plan

Schedule:

• Monday to Friday

Work Location: In person

Salary : $58,000 - $80,000