Revenue Cycle Manager

Job Description

Job Description

Manages the day-to-day operations of the billing department to maximize net revenues and cash flow by managing all aspects of the revenue cycle while ensuring adherence to policies and procedures.
· Monitor accounts receivable activity and initiates appropriate corrective measures as needed.
· Communicates performance data and associated action plans to Senior Leadership.
· Identifies and implements processes to achieve key revenue cycle metrics including but not limited to A/R days, unbilled a/r, denial percentage, and cash collections.
· Analyze large volumes of data and provide financial analysis and regularly presents trends, movements, and status to Senior Leadership.
· Review billing work queues regularly to ensure that workloads are distributed evenly and that the department metrics are being met.
· Resolve complex patient, physician, and other issues when necessary.
· Manages self-pay receivables including vendor relationships to help resolve AR. Inclusive of self-pay receivables is the process of charity review and bad debt management.
· Develop and implement policies and procedures for designated areas; evaluate new systems and methods and recommend changes as necessary.
· Communicate with payers and know when and how to escalate payer issues.
· Oversee the hiring, training, and supervision of department personnel.
· Maintains comprehensive knowledge of 3rd party billing requirements and reimbursement principles. Also maintains
comprehensive working knowledge of payor contracts and ensures that payors are billed according to contract provisions.
· Conducts regular meetings with staff to discuss third-party reimbursement methodologies. Provides direction to staff on changes in managed care reimbursement and expectation of changes in insurance guidelines.
· Keeps abreast of compliance regulations, standards, and directives regarding governmental/regulatory agencies and/or third party payers. Ensure communication and education of such to the Billing department as well as other Revenue Cycle Leaders.
· Must be able to meet deadlines given by Manager or Senior Leadership.
· Research and resolve discrepancies in a timely manner.
· Works with sensitive and confidential materials and must be able to exercise discretion.
· Verifies and updates patient registration information in the practice management system.

EDUCATION
· High School diploma or equivalent working knowledge preferred.
· BA/BS in Business Administration, Accounting, Finance, or equivalent is preferred.

EXPERIENCE
· A minimum of office 5 year of experience in a leadership role within a billing department in healthcare revenue cycle operations.
· Prefer experience working with multiple physician specialties.
· Previous supervisory experience and strong leadership skills with an ability to motivate with a positive attitude that positively impacts others.

REQUIREMENTS
· Demonstrated successful healthcare revenue cycle leadership experience.
· Experience analyzing and trending financial data.
· Excellent written and verbal communication and presentation skills.
· Excellent critical thinking, troubleshooting, and analytical skills.
· Excellent interpersonal skills including conflict management.
· Experience working in Excel (advanced formulas, pivot table)
· Well organized and able to meet deadlines.
· Excellent attention to detail.

KNOWLEDGE
· Knowledge of claims processing and editing systems.
· Strong knowledge of Medicare and Medicaid payer guidelines across multiple states.
· Knowledge of CPT, HCPCS, and diagnosis coding.

SKILLS
· Skill in effective data collection and analysis.
· Interpersonal skills are essential to communicate effectively, written and oral, with internal and external personnel at various levels.
· Skill in effectively managing multiple projects simultaneously.

ABILITIES
· Ability to multi-task and work well under pressure.
· Ability to analyze problems and interpret information and prioritize and reprioritize, as necessary.
· Ability to work independently, and as part of a team.
· Ability to read and interpret payer contracts.

ENVIRONMENTAL WORKING CONDITIONS
· Normal office environment.
· Extended work hours at or near month end to meet department objectives may be necessary.

PHYSICAL/MENTAL DEMANDS
· Requires sitting and standing associated with a normal office environment.
· Some bending and stretching are required