Job Description
Job Summary:
The Revenue Cycle Manager is responsible for leading the organization's revenue cycle process. This includes, but is not limited to, monitoring and enforcing the billing teams workflow, providing education and training to manager and staff related to revenue cycle. The Revenue Cycle Manager manages all functions of the ODHC billing and revenue cycle to maximize cash flow while maintaining and improving internal and external customer relations.. The Revenue Cycle Manager works with and under the direct supervision of the CFO to develop and implement plans, processes, procedures, and objectives specific to the efficiency of the Finance Department.
Job Responsibilities:
- Manage daily operating functions of revenue cycle process and billing staff.
- Assists with developing and enforcing revenue cycle policies and procedures.
- Communicates effective strategies for improving revenue cycle process to Clinic Managers, staff and billing company on a regular basis.
- Takes action towards continuous improvement and innovative use of billing software, including more automation.
- Overall management of the PM system for efficient and functional use including but not limited to enforcing protocols and procedures, updates, reporting management, software upgrades.
- Proactively develop automation for billing and reporting functions.
- Meets deadlines for month end close and reporting; produces accurate monthly revenue cycle reporting.
- Proactively studies, recommends and leads implementation of revenue cycle improvements.
- Manages compliance with Federal, State and payer rules and regulations and reporting, including, but not limited to UDS reporting.
- Ensures that start up offices are properly licensed and complaint for operation. Ensures that current office sites are current concerning state and federal licensure.
- Manages provider and staff organization and payer credentialing process.
- Identifies denial/billing error trends through management of Days in AR and other billing metrics and communicates these to the CFO.
- Manages compliance with Federal, State and payer rules and regulations and reporting, including, but not limited to UDS reporting.
- Stays knowledgeable about FQHC billing and operations
- Proactively ensure superior customer service to internal and external customers according to standards set by Open Door Health Center.
- Develops and leads ongoing revenue cycle training for all staff
- Provides projections and reports as required, for development and management of budget.
- Update/keep up to date current CPT, ICD-10, and HCPCS guidelines.
- Monitors timeliness and effectiveness of department activities, ensuring that outstanding patient accounts and accounts receivables is not more than the agreed upon limit and that bad debt is within budgeted target.
- Complies and prepares various status reports for management in order to analyze trends and make recommendations.
- Work collaboratively with leadership to implement new programs and services to meet identified populations needs.
- Assist Human Resources Department with Credentialing and Re-Credentialing of all licensed staff
- Maintain internal provider grid to ensure all information is accurate and login are available.
- Maintain accurate and up to date provider profiles on CAQH and all applicable databases.
- Complete revalidation requests issued by government payers.
- Perform other tasks as assigned.
Knowledge, Skills, Abilities, Qualifications:
- BA/BS degree or equivalent in business, accounting, or related field.
- A minimum of 3 years' experience in healthcare management such as but not limited to clinic management, patient management, accounts receivables and payables.
- Strong background in financial management and knowledgeable of federal and state laws and requirements relating to healthcare management.
- Strong managerial competencies in the areas of leadership and team development, managerial coaching and mentoring, and situational assessment skills and with proven track records in building and developing high performing teams.
- Bilingual skills are a plus.
Other Requirements:
Travel is required to meetings, events and to support other clinic locations within the community and across the region. Means of travel and travel expenses will be reimbursed according to ODHC's travel policy. Physical ability to sit for extended periods of time. Position requires repetitive use of fingers,
hands, wrist in job related duties, i.e. telephone, computer. Complete range of motion, including fine motor skills and tactile sense of both hands. Able to lift 25 pounds. This document is intended to describe the general nature and level of work performed and is not intended to serve as an exhaustive list of all duties, skills, and responsibilities.
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