Revenue Cycle Manager-Billing

Description

Revenue Cycle Manager – Billing

Classification: Exempt

Reports to: Director of Revenue Cycle

Date: April 2024

Summary/Overview

Working closely with the Director of Revenue Cycle, the Revenue Cycle Manager – Billing is responsible for managing the Billing of accurate and timely claims. Develops and maintains the policies and procedures to effectively manage the billing and coding teams.

Primary Duties and Responsibilities

• Prepares, reviews and analyzes the effectiveness of the department using KPI’s and reporting.
• Provides a goal-oriented work environment by establishing protocols and standards to ensure accurate and timely processes. Develops and plans goals and objectives for the department with the Director and Management Team.
• Coordinates and prioritizes assigned activities to achieve maximum productivity and assumes responsibility for professional growth and development.
• Reviews and evaluates trends. Collaborate and resolve issues with other departments; make recommendations to the Director to implement appropriate measures to decrease lost revenue.
• Work with Clinical Leadership on updating coding requirements and assisting in clinical education when needed.
• Supervises directly or indirectly, exempt, and nonexempt personnel engaged in the department. This includes interviewing, hiring, performance evaluation, training, time keeping, and disciplining all department personnel. Delegates authority as determined appropriate.
• Responsible for organizing and designing more efficient procedures for timely resolution of claim edits and procedure reviews.
• Identifying trending errors by providers and reporting to Director of Revenue Cycle and Clinical Leadership for training purposes.
• Participate in departmental and organization-wide meetings/workgroups. Conducts meetings with managerial staff and interacts closely with other departments to provide a smooth business flow to reflect the effectiveness and scope of all policies and procedures administered by the department.
• Resolve customer service issues promptly and with satisfaction to the patients involved. Show a positive and professional image when interacting with patients, management, staff, and others.

Education & Experience

• Bachelor's degree in business, Finance, or similar OR Three (3) years of Relevant Experience in the healthcare industry with knowledge of collections, billing, and/or cash posting.
• One (1) year of supervisor/management experience, preferably in a healthcare setting.
• Knowledge of the use of medical records, billing claim forms, and federal and state regulations concerning the use of medical records and medical billing.
• Experience in directing the daily activities of a cash posting team in a high volume, complex setting.

Qualifications

• Strong analytical skills are necessary to analyze various accounting problems.
• Strong knowledge of CPT, ICD10 codes and modifiers.
• Proficient in MS Office suite of applications, billing systems, and business intelligence tools
• Ability to manage, evaluate, understand, and act on analysis of large datasets
• Excellent written and verbal communication skills are necessary to successfully perform all managerial responsibilities.
• Self-motivated and comfortable managing multiple tasks at the same time
• Demonstrates the ability to perform responsibilities in a fast-paced environment, requiring excellent organizational skills, sound judgment and critical decision making.
• Team player with positive attitude and effective communication skills
• Ability to work flexible hours when needed to deliver results

Physical Requirements

While performing the essential functions of this job, the following are required:

• Talk, hear, and communicate with people over the telephone;
• Use hands and fingers to operate a computer and telephone;
• View computer screens for extended periods of time;
• Sit at a desk for extended periods of time; and
• Regular, predictable attendance.

Work Location Requirements

• The job duties and functions for this position are performed hybrid, based on work projects and management discretion. This position may require onsite work.