Manager, Revenue Cycle (Tucson)

Job Description

Job Description

Please note: This is not a remote position.

Catholic Community Services of Southern Arizona, Inc . (CCS) is thriving! For over 90 years, CCS has focused its mission to strengthen families, support communities, provide compassionate services, and deliver excellence. Providing Help. Creating Hope. Serving All.

We credit our continued success to our valuable employees! If you want to make a difference, help people, and serve your community, we want YOU to join our team! For more information visit our website at:

OVERVIEW

Under the direction of the Chief Financial Officer, the Revenue Cycle Manager oversees billing, claim submission, payment posting, denials, corrections, and resubmissions for designated behavioral health programs. Ensures timely and accurate billing in compliance with Arizona Medicaid requirements, health plan contracts, applicable laws, and company policies. Collaborates with Finance, Compliance, program leadership, health plans, and Electronic Heath Record (EHR) vendors to resolve documentation and workflow issues affecting reimbursement without directing clinical decisions or altering clinical records. Requires a high level of accuracy, organization, and performance within established deadlines. May perform other duties as assigned.

ESSENTIAL FUNCTIONS

• Manage the employee lifecycle for assigned staff, ensuring effective recruitment, development, performance management, and employee relations
• Oversee and support Billing Specialist activities, including billing, insurance verification, charge capture, collections, and development and implementation of billing procedures to ensure timely and complete collection of revenue
• Serve as company expert in EHR system and act as administrator, where appropriate
• Oversee and participate in data validation process to ensure submission of accurate claims for processing and payment
• Oversee and participate in the resubmission of claims, as necessary
• Direct and assist with processing and adjudicating claims, posting payments, monitoring claims, denials, and appeals for efficient processing, and resolving billing-related issues with both health insurance plans and EHR vendor
• Maintain medical billing spreadsheets
• Develop and implement short and long-range revenue cycle processes for the benefit of the organization and its members
• Communicate with management regarding front-end user errors and issues that are impacting the revenue cycle
• Coordinate with Compliance representative to ensure high level of ethics, accuracy, transparency, and accountability to agency programs
• Resolve and answer help desk tickets related to billing
• Complete month-end revenue reporting tasks within established deadlines
• Liaison with revenue cycle vendors, including EHR vendor, and health insurance plans, to coordinate billing activities and resolve issues
• Ensure compliance with and support of Executive directives, contracts, and established policies and procedures, as well as federal and state regulations
• May drive personal or agency vehicle on company business

MINIMUM REQUIREMENTS

Suitable work experience may be considered as transferable skills in order to meet minimum requirements of the position and will be considered by the Executive Director of Human Resources.

• Bachelor Degree in Business Administration, Finance or a related field
• 2 years of experience supervising and overseeing medical billing, data validation, and claims submission and resubmission, preferably in behavioral health
• 2 years of experience working in medical billing, data validation, and claims submission and resubmission, preferably in behavioral health
• Experience in producing and understanding dashboard reporting and Key Performance Indicators (KPIs) related to performance tracking
• Experience utilizing Microsoft Office Suite
• Proven strong communication skills, both oral and written, that are clear; concise; organized; and are appropriate in style, grammar, and tone

PHYSICAL AND MENTAL REQUIREMENTS

• Work is completed primarily indoors in an office environment
• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer
• Requires constant experience with competing priorities in an occasionally high-stress environment

REGULATORY

• Must be at least 18 years of age
• Valid driver license, proof of insurance, and 39-month motor vehicle report
• Ability to obtain and maintain Arizona Level One Fingerprint Clearance Card and FBI National Criminal Records History Report (employer paid)
• Pass pre-employment drug screen (incudes marijuana, regardless of recreational use laws) (employer paid)

DESIRED QUALIFICATIONS

• Master Degree in Business Administration, Finance, or a related field
• Billing and/or coding certification and/or credential
• Additional years of directly-related experience
• Experience in collections and management of Accounts Receivable
• Behavioral health work experience
• Experience working with Arizona Medicaid providers in relation to billing
• Bilingual in English and Spanish, verbal and written

The above statement reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered a detailed description of all work requirements that may be inherent in the job.

We are an Affirmative Action Equal Opportunity Employer for all individuals. All qualified applicants are encouraged to apply.