The Manager is responsible for leading and managing the revenue cycle team, including managing the relationships payers and a third party billing vendor, to drive results for our OBGYN Client base.
This position requires a thorough understanding of the medical revenue cycle billing process.
The Revenue Cycle Manager is responsible for the entire accounts receivable process, performance, personnel management, and the profitability of our supplementary / add-on services.
The Manager is responsible for driving continuous performance improvements through data analysis, system optimization, other automation techniques, provider education and/or RCM process changes.
Essential Job Functions: Prepare revenue cycle financial analysis including aged accounts.
Monitor and assesses KPI’s in order improve efficiencies.
Analyze insurance denial trends and create front end edits/rules to help increase clean claim rate, reduce denial rates and increase cash collections.
Maintains strong understanding of payor related changes across all states/markets Document processes and collaborate with external vendors to track and develop enhancements to the billing software and/or billing process Ensure external vendors are meeting standards for the practice.
Able to identify issues and provide solutions to bottlenecks with action plans with the vendors.
Provide weekly status reports on projects Coordinate with coding team on priorities and improvements and effectively lead weekly RCM meeting Prepare data and communicate with care center on payor denials, documentation or registration issues to help drive self pay and insurance cashflow.
Audit of employees and accounts required to help understand how to provide additional training or process enhancements Able to independently manage multiple tasks and deadlines, with minimal oversight Review Athena process enhancements to ensure the RCM team is utilizing all functions to streamline workflows Educate provider offices on improvements to workflows including self pay Ongoing quality assessment: perform audits to ensure the accuracy of coding performed, oversee the capture and analysis of data regarding operational performance and quality control, ensure all coding is completed with quality and regulatory compliance Meet / exceed budget and profitability goals Vendor management Position Requirements: Minimum of 5 years experience in healthcare medical Revenue Cycle environment College degree desired Certified coder desired, but not required Intermediate to advanced proficiency in MS Excel and PowerPoint preferred Prior presentation skills to Executive leadership teams on KPI and leadership priorities Excellent relationship building skills and aptitude for working collaboratively with cross-functional groups Strong working knowledge of payor denials and payors Able to clearly document processes and effectively communicate process to external users Knowledge of Athena Collector is preferred Extreme attention to detail is required Critical thinker with ability to problem solve and perform root cause analyst and implement action plans Strong knowledge of payor and clearinghouse claim edits and rules Strong analytic skills are required Ability to handle multiple projects concurrently Excellent verbal and written communication skills