Revenue Cycle Manager

COVID-19 vaccination *NOT* for this position.
*SECTION 1: Job Summary*
Develops a cohesive work unit, consisting of the Business Office, Insurance, and Billing functions, by managing their daily operations, employees and other functions. Manages all activities of these functions, focusing on coordinating their employees, processes and procedures to provide consistency in initial and ongoing training, timely and accurate reporting and auditing, and quality patient relations services.
*SECTION 2: Duties and Responsibilities*
* Train and develop staff on all job related functions, to be assisted by the supervisors as needed and requested.
* Have knowledge of all processes and procedures of departments, with responsibility for reviewing and revising these as needed for ongoing efficiency.
* Prepare and present detailed reports to senior leadership and other partners as requested, which efficiently reflect the status of all areas of responsibility in each department. .
* Maintain high quality customer service in all departments of responsibility, ensuring that employees have training, coaching and guidance as needed in order to promote professional behavior at all times.
* Handle or oversee handling to resolution of all operational problems and errors incurred daily in each department of responsibility, including the evaluation of efficiency and quality, and formulating responses to address and improve operational deficiencies.
* Oversee and recommend updates as appropriate to fee schedules for commercial insurance and Medicare.
* Oversee and evaluate insurance appeals process and results, revising as needed for ongoing efficiency and ensuring training on appeals for all Business Office staff.
* Develop relationships with managed care companies and providers and with government payers.
* Implement and maintain timely internal audit functions for accuracy, consistency and efficiency. These will include, but are not limited to the following:
* Implement and ensure checks and balances from front office through billing, including identifying potential problems and developing resolutions as needed.
* Analysis of A/R and reporting on past due daily and weekly network adjustments by posters
* Suitability of accounts appeal
* Ensuring that billing denials are corrected and re-billed on a timely basis
* Standard and random audits of cash drawers, charge tickets and other Front Desk functions
* Zero or overwritten charges
* Insurance company payments per fee schedules
* Payment trends by insurance carriers
* Review and update managed care contracts
* Accurate lists of insurance companies' relationships to actual payers, and their fee schedules
* Routine errors in billing, posting, referrals and coding
* Patient and insurance refunds
* Any special projects assigned by the Director of Revenue Cycle Operations or Vice President Revenue Cycle Management
* Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.
* Performs other duties that may be necessary or in the best interest of the organization.
*SECTION 5: Experience Requirements*
* Minimum three (3) years insurance billing/posting experience in a customer service related industry, preferably in a medical office
* Minimum three (3) years supervisory experience, required.
*SECTION 6: Knowledge, Skills and Abilities Requirements*
* Thorough knowledge of medical billing coding, including CPT and ICD-10 coding, required.
* Thorough knowledge of medical billing procedures and medical insurance, including credit and collection procedures, required.
* Thorough knowledge of medical accounts receivable collection procedures, including knowledge of insurance correspondence, required.
* Basic knowledge of medical terminology, required.
* Detail oriented, professional attitude, reliable
* Management and organizational skills to support the leadership of this function
* Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations
* Interpersonal skills to support customer service, functional, and team mate support needs
* Able to communicate effectively in English, both verbally and in writing
* Mathematical and/or analytical ability for basic to intermediate problem solving
* Basic to intermediate computer operation
* Proficiency with Microsoft Excel, Word, and Outlook
* Specialty knowledge of systems relating to job function
* Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines
*Qualifications*
*SECTION 7: Supervisory Responsibilities:*
* Directly supervises employees in the Business Office.
* Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
* Responsibilities include interviewing, hiring, and training employees, planning, assigning, and directing work; appraising performance, rewarding and disciplining employees, addressing complaints and resolving problems.
#INDHP
Job Type: Full-time
Pay: $50,000.00 - $60,000.00 per year
Benefits:
* 401(k)
* Dental insurance
* Employee assistance program
* Employee discount
* Flexible spending account
* Health insurance
* Health savings account
* Life insurance
* Paid time off
* Vision insurance
Schedule:
* 8 hour shift
* Monday to Friday
Ability to Relocate:
* Tyler, TX 75701: Relocate before starting work (Required)
Work Location: In person%14156205% %%finance%%