Revenue Cycle Manager

Job Description
Revenue Cycle Manager
Southern Jersey Family Medical Centers, Inc. is looking for a talented Revenue Cycle Manager to step into our fast-paced facility!
Summary: Responsible for directing and coordinating the overall functions of the patient billing cycle, including patient accounting, billing/claims, and collections for federally qualified health centers ("FQHC"). Promotes the organization's effectiveness and efficiency by maximizing cash flow while improving patient, physician, and other internal and external customer relations.
Hours: This is a full-time position with Monday through Friday business hours.
Position Responsibilities/Duties:

• Oversee and supervise the daily operations of the billing department

• Directs the timely and accurate completion of the patient billing cycle. Plans and develops processes for insurance, billing, collections, and data processing to ensure accurate billing and efficient account collection.
• In collaboration with the CFO, negotiates with managed care contracting agencies on reimbursement rates and services covered. Monitors enrollment, payments, and utilization of the managed care plan and ensures compliance with managed care organizations' policies and procedures.
• Develops and oversees insurance, billing, accounting systems, and EMR systems, and works with Information Technology to ensure timely and accurate enhancements and implementations.
• Serves as a financial liaison with all State, federal, and local agencies governing or pertaining to health centers.
• Maintains confidentiality of patient medical information and status of patient accounts.
• Oversees the credentialing process to ensure physicians are timely enrolled in insurance plans.
• Hires, supervises, trains, and manages the performance of assigned personnel. Monitors the operating activity of the department and makes necessary adjustments in work assignments.
• Assists with developing annual budget and periodic projections/forecasts.
• Responsible for protecting against fraud, waste, and abuse claims and billing activity.
• Serves as subject matter expert on ICD-10 codes and prevents use of outdated or incorrect codes for procedures.
• Identify reimbursement deficiencies and opportunities for appropriate reimbursement.
• Prevent use of outdated or incorrect codes for procedures.
• Verify ICD-10 and electronic health record (EHR) meaningful use readiness.
• Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation.
• Ensures strict confidentiality of financial records.
• Maintains knowledge and complies with applicable laws and established policies and procedures.
• Other duties as specified by the Director of Finance or designee.

• Oversee in review claims for errors in coding or other mistakes that would prohibit payment from insurance companies
• Coordinating audits of insurance claims to ensure they meet regulations and industry standards

Experience and Skills

• Bachelor's Degree.
• Minimum 3 years of related experience (5+ years preferred).
• Certificate or diploma from an accredited medical training program preferred.

• Comprehensive knowledge of patient accounting and billing systems
• Advanced knowledge of medical coding and billing systems and regulatory requirements.
• Strong Knowledge of medical terminology, health coding terms, and healthcare coding structure.
• Applied knowledge of governmental and third-party health insurance programs, operating procedures, regulations, and billing requirements.
• Concreate knowledge of patient billing methodologies and patient insurance systems
• Ability to analyze and solve problems.
• Strong communication and interpersonal skills.
• Ability to communicate medical information to professional practitioners and/or the general public.
• Knowledge of Medicare, Medicaid, Medicaid Managed Care, HMOs, Commercial Insurance Plans, Workers Compensation, MVA and Dental Insurance Plans.
• Valid driver's license
• Excellent verbal and written communication skills
• Strong computer skills, EPIC EMR experience preferred
• Ability to work a full time schedule with flexible hours
• Proficient in Microsoft Office - Preferably Microsoft Excel and Word.

Southern Jersey Family Medical Centers is an Equal Opportunity Employer.
Job Benefits
Southern Jersey Family Medical Centers, Inc. provides a rewarding and challenging work environment, state-of-the-art facilities, and a very competitive benefits package which includes: a healthy work/life balance, generous paid time off, floating /paid holidays, competitive wages, Tuition Assistance Program, 403(b) Retirement Plan with company contribution, Medical, Prescription, Dental, and Life Insurance.