Revenue Manager

Role Description

Reporting to the PRMO Senior Revenue Manager, the revenue manager coordinates activities performed by the staff responsible for charge capture, coding, charge entry, insurance follow up, reimbursement analysis, or other PRMO function within the assigned clinical area.

• Monitor performance for staff responsible for appointment scheduling, registration, clinic check-in, and clinic collections.
• Develop and prepare/utilize reports to track financial and operational performance across the entire spectrum of the revenue cycle for assigned clinical area.
• Review and recommend changes/updates to the departments charge master(s) to maintain fees at levels that maximize reimbursement.
• Review and recommend changes to department's charge capture documents to facilitate accurate and comprehensive billing in compliance with annual CPT/HCPCS and ICD-10 updates.
• Identify revenue cycle problems, research/analyze data to resolve issues, identify and select alternatives to address outstanding issues, and implement solutions for improvement.
• Work with financial analyst, physicians, and administrative leadership to educate and train providers and staff about coding and other outstanding revenue cycle issues.
• Act as a liaison to management and staff in the designated clinical area, Patient Revenue Management Organization (PRMO), Duke University Health System (DUHS), Duke Health Integrated Practice, and third-party payers on revenue cycle activities for assigned areas.
• Continuously research, monitor, provide education and implement payer regulations and guidelines related to revenue management activities of the assigned clinical area.
• Coordinate revenue management orientation and educational activities of clinical personnel including providers and staff about coding and other outstanding revenue cycle issues.
• Develop and utilize management models to monitor productivity and quality of staff performance.
• Train, direct, and coordinate activities of assigned financial analyst /or other employees.
• Perform other related duties incidental to the work described herein.

The PRMO Revenue Manager serves as a liaison among PRMO, Operational Owners and Maestro Care Clinical/Billing analysts to assist in the design, development, maintenance, training and evaluation for assigned Maestro Care clinical and business systems to support the revenue cycle.

This position will be primarily responsible for design/re-design of workflow, working with Maestro Care Build teams, testing, and validating of application functionality specifically related to charge capture/billing.

This position will coordinate all revenue cycle issues that arise for their application area and must be very knowledgeable of DUHS/PRMO policies, procedures, and business operations.

Qualifications

• Bachelor’s degree required. Master’s degree preferred.
• At least 6+ years of relevant Healthcare Care experience preferably in Charge Integrity/Revenue Management is required.
• Coding certification (e.g. CCS, CPC, RHIA, RHIT), HFMA CHFP (Certified Healthcare Professional), CRCR (Certified Revenue Cycle Representative), or BSN RN preferred.
• Strong leadership capabilities with demonstrated ability to lead, motivate, and collaborate effectively with Hospital leadership.
• Strong oral and written communication skills.
• Excellent problem solving, analytical, and technical troubleshooting skills.
• Prioritization skills and ability to manage multiple projects concurrently.
• Ability to work on a flexible schedule.
• Strong research and documentation skills.
• Ability to work independently.
• Intermediate to expert in Microsoft Excel, PowerPoint, Teams, Word, Visio and Outlook.

Requirements

• Manage revenue cycle-related inquiries.
• Monitor & manage from key performance indicators.
• Monitor & manage reimbursement changes.
• Facilitate revenue cycle collaboration and strategic planning activities.
• Coordinate and chair revenue-oriented workgroup activities and meeting.
• Manage communications among PRMO, hospitals, and physician practices.
• Arrange revenue cycle training activities.
• Manage revenue and/or compliance requests.
• Develop and manage action plans & timelines.
• Identify and recruit appropriate resources.
• Develop creative solutions.
• Specialize & manage revenue cycle functions and Epic Systems applications.

Benefits

• Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.
• Duke aspires to create a community built on collaboration, innovation, creativity, and belonging.
• Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes.
• To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard.
• All members of our community have a responsibility to uphold these values.