Revenue Cycle Manager

Mental Health Services For Clark & Madison Counties

Job Location:

Springfield - USA

Monthly Salary: Not Disclosed

Posted on: 30+ days ago

Vacancies: 1 Vacancy

Job Summary

Revenue Cycle Manager

FT 40 Hours per week

The Revenue Cycle Manager oversees end-to-end revenue operations for the behavioral health organization spanning outpatient inpatient psychiatry school-based services ACT/Community-Based programs and telehealth. This role ensures accurate patient access and financial clearance compliant charge capture and coding high first-pass claim yield timely cash posting proactive denial prevention and strong payer relationshipsdriving sustainable net revenue while upholding HIPAA and 42 CFR Part 2 requirements

Responsibilities

Own the full revenue cycle (pre-service mid-cycle back-end) and lead a high-performing team with clear goals SOPs and QA audits.
Partner with Clinical Utilization Review IT/EHR and Compliance to align workflows reduce friction and support organizational growth.
Lead month-end close tasks for revenue including accruals variance analysis and write-off oversight.
Oversee insurance verifications benefits coordination prior authorization management (including concurrent reviews for inpatient psych) and financial counseling and ensure timely complete documentation to support medical necessity and authorization requirements.
Ensure accurate timely charge entry for behavioral health CPT/HCPCS (e.g. therapy psychiatry IOP/PHP where applicable) revenue codes POS (including 02/10 for telehealth) and required modifiers.
Coordinate provider education and documentation audits to prevent under/over-coding; partner on clinical workflow fixes Manage clean claim production for 837P/837I rejection work queues secondary/tertiary billing and timely filing standards.
Oversee 835 auto-posting unapplied cash credit balance resolution refunds and reconciliation to the general ledger.
Establish root-cause tracking for denials (eligibility authorization coding medical necessity COB late filing) with closed-loop prevention.
Lead effective appeal strategies and regular payer meetings; maintain payer portal and clearinghouse operations and 835/remark-code mapping.
Maintain compliance with HIPAA 42 CFR Part 2 state Medicaid and Medicare rules managed care contract terms and No Surprises Act (as applicable).
Support internal/external audits and implement corrective action plans.
Build and maintain KPI dashboards (e.g. clean claim rate first-pass yield days in A/R % A/R > 90 denial rate auth turnaround DNFB charge entry lag cash-to-net).
Partner with IT/Analytics to optimize the EHR and clearinghouse edits; steward master data (payers fee schedules service locations NPI/Taxonomy).
Contribute to RCM requirements for EHR upgrades or migrations (e.g. charge router work queues 835 mapping
Follows all universal precautions for safety infection control and follows all state federal and joint commission health and safety standards.
Treats patients and family with dignity and respect and holds all patient information in the strictest confidence.
Adhere to professional standards policies and procedures federal state and local requirements and Joint Commission standards including National Patient Safety Goals. Presents a positive image of MHSCC to other community agencies caregivers and citizens
Completes all MHS required education and training including initial agency orientation mandatory training and education and upkeep of all required certifications and licensures as required by state federal and regulatory requirements.
Demonstrates organizational stewardship and exemplifies the mission vision and values of MHS.
Performs other job-related tasks as assigned

Education/Experience

Bachelors degree in accounting business health administration or related field preferred
2 years supervisory experience in a healthcare setting (preferred)
Experience with EHR commercial and private insurance billing and regulations
Experience with Joint Commission federal and state (Ohio) regulations and standards (preferred)

Licensure/Certifications

CPB CRCR CPC or CCS preferred

Required Experience:

Manager

Revenue Cycle ManagerFT 40 Hours per weekThe Revenue Cycle Manager oversees end-to-end revenue operations for the behavioral health organization spanning outpatient inpatient psychiatry school-based services ACT/Community-Based programs and telehealth. This role ensures accurate patient access and f...

Revenue Cycle Manager

FT 40 Hours per week

Responsibilities

Own the full revenue cycle (pre-service mid-cycle back-end) and lead a high-performing team with clear goals SOPs and QA audits.
Partner with Clinical Utilization Review IT/EHR and Compliance to align workflows reduce friction and support organizational growth.
Lead month-end close tasks for revenue including accruals variance analysis and write-off oversight.
Oversee insurance verifications benefits coordination prior authorization management (including concurrent reviews for inpatient psych) and financial counseling and ensure timely complete documentation to support medical necessity and authorization requirements.
Ensure accurate timely charge entry for behavioral health CPT/HCPCS (e.g. therapy psychiatry IOP/PHP where applicable) revenue codes POS (including 02/10 for telehealth) and required modifiers.
Coordinate provider education and documentation audits to prevent under/over-coding; partner on clinical workflow fixes Manage clean claim production for 837P/837I rejection work queues secondary/tertiary billing and timely filing standards.
Oversee 835 auto-posting unapplied cash credit balance resolution refunds and reconciliation to the general ledger.
Establish root-cause tracking for denials (eligibility authorization coding medical necessity COB late filing) with closed-loop prevention.
Lead effective appeal strategies and regular payer meetings; maintain payer portal and clearinghouse operations and 835/remark-code mapping.
Maintain compliance with HIPAA 42 CFR Part 2 state Medicaid and Medicare rules managed care contract terms and No Surprises Act (as applicable).
Support internal/external audits and implement corrective action plans.
Build and maintain KPI dashboards (e.g. clean claim rate first-pass yield days in A/R % A/R > 90 denial rate auth turnaround DNFB charge entry lag cash-to-net).
Partner with IT/Analytics to optimize the EHR and clearinghouse edits; steward master data (payers fee schedules service locations NPI/Taxonomy).
Contribute to RCM requirements for EHR upgrades or migrations (e.g. charge router work queues 835 mapping
Follows all universal precautions for safety infection control and follows all state federal and joint commission health and safety standards.
Treats patients and family with dignity and respect and holds all patient information in the strictest confidence.
Adhere to professional standards policies and procedures federal state and local requirements and Joint Commission standards including National Patient Safety Goals. Presents a positive image of MHSCC to other community agencies caregivers and citizens
Completes all MHS required education and training including initial agency orientation mandatory training and education and upkeep of all required certifications and licensures as required by state federal and regulatory requirements.
Demonstrates organizational stewardship and exemplifies the mission vision and values of MHS.
Performs other job-related tasks as assigned

Education/Experience

Bachelors degree in accounting business health administration or related field preferred
2 years supervisory experience in a healthcare setting (preferred)
Experience with EHR commercial and private insurance billing and regulations
Experience with Joint Commission federal and state (Ohio) regulations and standards (preferred)

Licensure/Certifications

CPB CRCR CPC or CCS preferred

Required Experience:

Manager

Key Skills

Business Development
Apprentice
Asset Management
ABAP
IT Strategy
Manufacturing

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About Company

Mental Health Services For Clark & Madison Counties

Mental Health Services delivers a comprehensive array of services to ensure the mental and behavioral health needs of Clark and Madison County residents are met across the generations. From youth and teens to adults and senior citizens, MHS touches lives at many different levels. Plea ... View more

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