Revenue Cycle Manager

Employer Paid Benefits: $0 for employee only coverage
Medical / Dental / Vision / STD / LTD / Life / AD & D
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BASIC FUNCTION

Responsible for overseeing the day-to-day operations of the Revenue Cycle department for the organization. Manages and develops team members and/or coordinates all workflow procedures of team members or contracted vendors. This leader will work with a diverse group of stakeholders in the organization. Is responsible in assuring that team reaches or exceeds collections objectives and goals and provide quality customer service.

PRIMARY RESPONSIBILITIES AND DUTIES

1. Revenue Cycle Management
   1. Monitor the Revenue Cycle, from charge capture to payment posting, ensuring timely claims submission and revenue optimization with minimal reimbursement delays.
   2. Collaborate with other departments, such as finance and operations, to maintain a seamless Revenue Cycle workflow.
      1. Provide education and training on payor regulations and guidelines to appropriate health center staff.
         1. Collaborate with, and monitor, outsourced billing company
      2. Stay up to date with federally qualified health center regulations, insurance policies, and billing guidelines to ensure adherence to legal and industry standards.
      3. Develop and enforce compliance policies within the billing department, conducting regular audits to maintain accuracy and prevent fraudulent activities.
      4. Generate regular reports and key performance indicators (KPIs) related to billing activities, such as collection rates, accounts receivable aging, and claim submission timelines.
      5. Analyze data to identify trends and areas of improvement, making informed decisions to enhance billing department performance.
   3. Leverage billing software and tools to streamline processes, reduce manual tasks, and increase accuracy in claim submissions and payment tracking.
   4. Stay informed about emerging billing technologies and recommend appropriate upgrades or system changes when necessary.
2. Performs other duties as assigned
   1. Effectively carries out tasks and responsibilities beyond core job duties and primary role. The additional duties may vary from time to time and encompass a wide range of activities that contribute to the overall success of the organization (floating, assisting co-workers, patients, visitors, customers, leaders, and other stakeholders in support of the organization).

LEADERSHIP RESPONSIBILITIES

1. Monitors Revenue Cycle performance and addresses issues as needed.
2. Functions as a liaison to operations for the purpose of training updates in order to establish best practices.
3. Provides excellent customer service and resolves concerns/complaints/issues in a timely professional manner.
4. Effectively prioritize task and projects based on business needs and resources
5. Ensure alignment of initiatives with organization priorities and objectives.
6. Manage competing demands and adapt to changing priorities.

QUALIFICATIONS:

PROFESSIONAL/TECHNICAL KNOWLEDGE, SKILLS & ABILITIES

1. Possesses advanced general skills, including written and verbal communications skills, computational and computer skills, and mathematical knowledge frequently acquired through completion of a general bachelor’s degree program or associate’s degree with acquired business experience.
2. Possesses 3 years’ experience in healthcare or 3 years related experience in training in insurance billing and denial, with a preference given to experience within a Federally Qualified Health Center (FQHC).
3. Must know all aspects of Revenue Cycle management in the field of healthcare as it is performed in the organization, sufficient to effectively train or instruct others, and to serve as a resource to employees.

LICENSES & CERTIFICATION

1. Valid State Driver’s License – Must have and sustain good driving record and criminal/background record. Must have and sustain valid state driver’s license.
2. Possession of certification from one or more of the following institutions is desired but not required:
   1. American Academy of Professional Coders (AAPC), American Health Information Management (AHIMA), American Academy of Professional Coders (AAPC), Board of Medical Specialty Coding and Compliance (BMSC).

Mission: To provide evidence-based healthcare utilizing a patient empowered team approach resulting in individual wellness.

Vision: Best place for patients to receive care. Best place for providers to practice medicine. Best place for employees to work.

Values: Integrity, Respect, Empathy, Ethics, Excellence, Diversity, Safety, Professional.