Revenue Cycle Manager
The Revenue Cycle manager is responsible for coordinating billing and collection, Health Information Management (HIM) activities, maximizing payments and providing direction and oversight of processes impacting cash collections.
- High School Diploma or G.E.D. required. Bachelor’s Degree preferred
- Five+ years of full cycle medical billing and collection experience required.
- Minimum of three years in a manager/supervisory role required.
- Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement in a variety of areas, including but not limited to: claim submission, insurance and self-pay collections, refunds and write-off approvals. Key metrics to review include: Accounts Receivable (AR) Days, AR over 120 Days, cash collections, denials, avoidable write-offs, refunds, charge lag, front end work queue volumes, Bad Debt, Chart Completion turnover days, and Delinquency Rate.
- Leads monthly meetings with staff to review key metrics, trends and performance improvement opportunities (staff training, physician coordination, policy/process revisions, etc.)
- Develops goals to link department and revenue cycle initiatives with the organization’s strategy. Supports and maintains a work environment that embodies professional excellence, teamwork, integrity, and organizational alignment.
- Serves as a resource to staff by answering questions and assisting with problems related to the billing, collecting and HIM processes.
- Continuously updates, in conjunction with related clinical data collection, appropriate procedures for billing, collecting and HIM activities.
- Is responsive to payer billing and claims appeal requirements, and maintains strong relationships with payer provider representatives.
- Assists with and supervises the submission of claims and provides follows-up with third party payers and patients for services received in accordance to Facility Policy and Procedures.
- Maintains current information on claims adjudication and payment policies on all encountered third party payers and government intermediaries.
- Files insurance claims both primary and secondary according to Facility Billing Standards.
- Generates patient statements according to facility policy and procedures.
- Monitors accounts receivable to identify billing errors, coding errors, and timely rebilling.
- Follows-up on past due accounts with patients and payers.
- Reports status of accounts receivable as requested.
- Completes chart audits as per protocol, providing summary to Business Office Director monthly.
- Ensures accurate and timely posting of payments and write offs as well as generation of required cash reports.
- Assists with month end balancing and closing to meet required close date.
- Works closely with the finance team to ensure accuracy of accounts and reconciliations.
- Oversee training of new employees &/or implementation training of new processes for existing employees.
- Demonstrate a strong knowledge of insurance carrier administrative policies including Medicare, Medicaid and Commercial insurances.
- Other duties as assigned by the Business Office Director
- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus.
- The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regular basis.
- The employee must be able to stand and/or walk at least five hours per day.