RCM Billing Manager

Job Description

Job Description

Overview

The Revenue Cycle Manger (RCM) of Acquisition and Training is responsible day-to-day operations of the RCM teams related to acquisitions, revenue cycle department training and quality assurance.

Responsibilities

DUTIES AND RESPONSIBILITIES:

• Manages the day to day operations of newly acquired revenue cycle teams to maximize cash flow by managing all aspects of the insurance billing and third-party collections while ensuring
  adherence to department policies and procedures.
• May serve as the departmental liaison with all vendors, including but not limited to, clearinghouses, contracted business partners, third party payers, and information systems.
• Provides project management, coordination, implementation, education, training, and oversight to approved RCM projects including but not limited to practice management system upgrades and
  RCM functions related to acquisitions, system integrations.
• Identify any potential opportunities to increase EDI transactions with clearinghouses or business partners. Actively research and inquire any technology or product offering that improves RCM
  process efficiency and/or reduces cost with existing vendor partners
• Onsite process mapping using workflow mapping software including Microsoft Visio.
• Provide hands on training to new acquired RCM staff, mapping of roles and oversight of development.
• Oversees the hiring, training, and supervision of department staff. Ensures that department policies are fairly administered by overseeing corrective action process, employee training, mentoring and
  coaching employees and supervisors as well as completing performance reviews.
• Develop and maintain an annual assurance plan to proactively ensure accurate and optimal revenue capture, and seek to continually improve revenue cycle operational processes while
  assuring compliance with regulatory guidelines.
• Monitor quality assurance results to identify risks, quality assurance opportunities and training needs.
• Assist with development of the revenue cycle training programs and new hire orientation.
• Remain knowledgeable on all HIPAA electronic transactions including claims (837), remits (835), eligibility (270/271), and claim status (276/277) Identify opportunities for implementation of HIPAA
  transactions
• Meets or exceeds quality, productivity and deadlines standards as set by senior management.
• Monitor and drive continuous improvement in key performance metrics around financial, activity and quality indicators; address performance gaps with team and processes.
• Other duties as assigned.

GENERAL DUTIES:

• Conducts self in accordance with the company’s standard values and policies.
• Participates in a variety of educational programs, corporate and professional, to maintain current skill and competency levels.
• Position may require occasional travel to newly acquired practices

Qualifications

Education and Experience:

• Minimum five years in a leadership role within a healthcare revenue cycle department.
• Previous supervisory experience with strong leadership skills and an ability to motivate others
  with a positive attitude.
• Leadership capability and proven successful experience in managing medium to large A/R
  teams.
• Experience working in Excel (advanced formulas, pivot table), PowerPoint, Word and Outlook.
• High school diploma or GED required. BA/BS in Business Administration, Account, Finance or
  equivalent is preferred.
• Must be able to travel to newly acquired practice to perform training and process mapping in
  addition to system integrations.

Essential Skills and Core competencies:

• Strong background and experience in full Revenue Cycle Management.
• Active knowledge of CMS guidelines contracted insurance guidelines and coding policies.
• Demonstrated ability working in Excel (advanced formulas, pivot table).
• Well-organized with attention to detail.
• Ability to read and understand oral and written instructions.
• Excellent math skills. Professional customer service skills.
• Have a desire and dedication to work with self-discipline.
• Maintains the strictest confidentiality: adheres to all HIPAA guidelines and regulations.
• Ability to manage time in order to meet deadlines and deliverables
• Experience with work flow and process mapping software.

Physical Abilities:

• Ability to sit for long periods. Work requires walking, bending, standing, sitting, and reaching