Revenue Cycle Manager

• Provides leadership and oversight of daytoday billing operations with a strategic focus on revenue cycle functions to ensure accurate complete and timely data capture across all divisions and locations. Proactively identifies escalates and resolves process and system issues that impact billing accuracy reimbursement integrity and overall revenue performance.
• Responsible for entire pipeline of charge capture activities from encounter form development and review to correct coding and oversight for ensuring accurate reimbursement for services billed. Responsible for driving process improvement initiatives related to front end revenue cycle functions in collaboration with the operations leadership and divisional managers.
• Manages the monthly reconciliation process to ensure that all procedures/cases are billed in a timely manner. Analyzes month end reports presented by billing vendor identifying opportunities for work process improvements with respect to claims denials. Works with divisional managers on strategies to improve front end related issues.
• Oversees and provides input to ensure all systems are functional in categories such as data dictionary file data elements interface and mapping payer specificity file transmission billing area set adding/deleting ICD10 and CPT codes etc.).
• Responsible for denial code file management by coders ensuring timely submission of charges to the billing vendors. Develop forms for each Division to ensure all services provided are captured. Reviews encounter forms/systems at least twice a year to ensure appropriateness of ICD10 and CPT codes.
• Coordinates and facilitates compliance audits for the department. Provides feedback and education to clinician/physicians on coding errors for both procedure(s) and E&M services. Verifies that fee schedules are appropriate against insurance payers allowable fees.
• Serves as a key resource for changes in payment and coding guidelines from all payers. Educates and reeducates the team on these continual updates. Responsible for constant and continual education of the clinician/physicians on coding changes.
• Facilitates and influences the credentialing process to assure prompt ability to bill for services rendered by newly hired clinician/physicians.
• Analyzes monthly Appeals reports tracking work effort by the billing team members and payors to ensure collections activity on a regular basis. Analyzes weekly charges and payments data to ensure billing/staff vendor is on track to meet established targets for productivity. Reviews Explanation of benefits (EOBs) as needed to determine/address payer problems. Coordinates efforts regarding authorization issues.
• Authority to lead and support team members in daily work activities with direct accountability for hiring decisions corrective actions and performance management including performance reviews.

• Bachelors degree in health care administration business or another related field

• Minimum of 5-8 years of experience in health care management such as but not limited to clinic management patient management and accounts receivables.
• Strong background in financial management and knowledgeable of federal and state laws and requirements relating to healthcare management.
• Knowledge of CPT and ICD-10 coding.
• Certified Professional Coder preferred.

Required Experience:

Manager