Manager of Revenue Cycle Management

Manager of Revenue Cycle Management

Job Summary:

Responsibilities:

• Manage high performing billing office, where client and payer issues are addressed timely and effectively, and teammates are valued.
• Review performance statistics weekly, monthly and quarterly leveraging PM system reporting tools, including overall performance metrics, key driver metrics and staff productivity metrics.
• Complete payroll tasks (PTO requests, schedules, processing). Manage schedules to the needs of the business.
• Perform disciplinary and performance management tasks assigned by Director.
• Communicate accordingly through prescribed avenues based on organizational policy and processes.
• Oversight and management of revenue cycle system tables (i.e. insurance, interface, fee schedule).
• Perform root cause analysis and drive claims resolution.
• Pursue avenues to create networking relationships/continuing education to be in the know of industry changes and trends specific to the billing office functions.
• Conduct meetings with key department leaders to help troubleshoot any issues and support them to resolution.
• Support clinical teams by providing education and to support practice managers.
• Directly supervises and coordinates the work of the medical coding staff (ensures work assignments are appropriate by effectively monitoring both quality and quantity of workflows and workloads.
• Assists in developing policies and procedures and suggests appropriate training to improve the performance of the team.
• Collaborate with other departments and professionals within the organization to effectively resolve any medical coding issue that may arise.
• Assist team members by helping them to develop competence knowledge and skills by training, managing and mentoring them.
• Analyzes denials and payer trends to proactively provide direction to the team regarding appropriate actions to be taken.
• Work closely with Compliance on changes in payer and medical coding regulations and determine appropriate needs for the department regarding education and training for staff and potentially providers based upon potential impact of changes.
• Continuously assessing established processes to improve efficiency and effectiveness of the team.
• Special projects as assigned

Required Attributes & Knowledge:

• Multispecialty professional billing practices for all payers including LCD, NCDs, ABNs, preferred modifiers, and HCC coding, etc.
• Interpretation of EOBs.
• Revenue cycle workflows.
• Ability to de-escalate patient customer service issues by driving a culture of being a support department.
• Credentialing and payer enrollment.
• Be effective at anticipating issues and identifying solutions.
• Must be engaged and able to foster team environment including coaching/building talent.
• Ability to work and manage in a fast-paced environment.

Preferred Knowledge:

• Excel Spreadsheets, Microsoft Word, and other general office processes and tools such as scanning, faxing, email, and interfaces systems.
• Registration, scheduling, check in and check out, pre-visit workflow (including eligibility), Day End Review, and other procedures, processes, and tools both in organizational policy and PM system.
• Athena EMR knowledge is a plus.

Requirements:

Education and Certifications:

• High school diploma. Associate or Bachelor’s degree from an accredited college in healthcare, administration, business, accounting, or finance.

Experience:

• 6+ years of experience in medical billing, EMR and project management, with knowledge of current trends in government and commercial insurance.
• 3+ years of experience in leadership/management roles.

Physical Requirements:

• Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
• Must be able to lift and support weight of 35 pounds.
• Ability to concentrate on details.
• Use of computer for long periods of time.