Revenue Cycle Manager

Revenue Cycle Manager

Job Overview: The Revenue Cycle Manager (RCM) is accountable for ensuring the consistency and quality of the procedures and best practices for all revenue cycle operations including charge capture, billing, payment posting, collections & follow-up, denials management, billing audits, and revenue cycle data reporting. In conjunction with other departments, the revenue cycle manager will contribute to the day-to-day operations on all issues related to the revenue cycle function, provide analysis, create written processes and train others in implementing a cross functional revenue cycle team. This position requires current knowledge of governmental and commercial insurance rules and regulations, including regulatory compliance requirements related to the billing of services

Reports To: Chief Finance Officer

Supervising Duties: Billing Specialists

Work Schedule: Initially onsite, with the possibility of flex time after training

Employee Classification: Salary, full-time, exempt

Qualifications:

• Minimum associates degree in business related field. A combination of appropriate education and at least 5 year’s supervisory experience in a medical billing setting may be substituted for the minimum education requirement.
• Strong, in-depth knowledge of revenue cycle management principles and practices including medical or behavioral health billing, coding, collections, contr, regulatory compliance, payor enrollment/credentialing, and financial reporting.
• Ability to lead, influence, and work collaboratively with others, develop and maintain strong relationships throughout the organization.
• Ability to multitask and prioritize tasks, projects, and demands with a sense of urgency and positivity.

Essential Duties & Responsibilities:

• Responsible for ensuring all revenue cycle functions (billing, collections, reporting, credentialing) are operating efficiently and effectively.
• Responsible for managing billing dept staff, understanding their job functions, and maintaining awareness of process flow and equitable work distribution.
• Attend regularly-scheduled meetings with other department supervisors and keeps them abreast of important issues related to revenue cycle operations.
• Maintain knowledge of health insurance requirements for credentialing. Performs site and provider credentialing and recredentialing functions including but not limited to verifying education and licensure, completing and monitoring applications, obtaining NPI numbers, etc.
• Maintain passwords to online insurance related accounts and communicate changes to concerned parties
• Develops policies and procedures for all points of the revenue cycle including, but not limited to, charge capture, data entry, payment posting, insurance follow up, collections and denials management.
• Troubleshoots problems associated with missed or unbilled charges, payment delays, denials, and other revenue cycle issues.
• Provides direction on the follow-up process for all payers, including claim correction and appeals process.
• Working closely with CFO, reviews and reconciles the month-end close process.
• Working closely with CFO, reviews payor contracts and requests fee schedule adjustments regulary
• Ensures compliance, monitors and adheres to applicable Federal, State, and local laws and regulations. Conducts audits for coding and documentation accuracy and reporting information as requested.
• Conducts and leads the internal audit process for billing
• Maintain a training manual for revenue cycle management processes.
• Provides ongoing support and training on all aspects of billing and EHR software.
• Continually seeks ways and means for improving the delivery and support of revenue cycle activities and programs.
• Assists with special projects and assumes additional duties as assigned by the CFO
• Stay informed of payor changes and communicate such changes to the Chief Clinical Officer and the agency.