Job Description

About the Company

Our client is dedicated to enhancing the efficiency and effectiveness of healthcare revenue cycles. Their mission is to provide innovative solutions that improve financial performance while maintaining the highest standards of compliance and patient care. They foster a culture of collaboration, integrity, and continuous improvement.

About the Role

The Revenue Cycle Manager will oversee the revenue cycle functions, ensuring accurate billing and reimbursement processes while collaborating with various departments to enhance operational efficiency.

Responsibilities

• Facilitates the collection of earned reimbursement, reviewing payor contracts to ensure contract fees are modeled accurately in the billing system and working with billing staff to identify variances in actual payment.
• Identifies and implements solutions to problems and issues affecting revenue cycle functions, working collaboratively with other departments within our healthcare system, including the MSGs and University Hospital (UH).
• Develops and organizes groups/committees to address issues to improve oversight and efficiency of the revenue cycle.
• Reviews and tracks payment trends, presents data, makes recommendations for problem and issue resolution based upon staff findings, and reports findings to leadership.
• Resolves complex physician professional billing issues in a timely manner.
• Leads and mentors revenue cycle subject matter experts and their supporting teams, ensuring a high level of engagement and productivity.
• Prepares service level metrics and explanatory summaries for leadership.
• Develops MSG standards and procedures for all points of the revenue cycle including, but not limited to, charge capture, data entry, payment posting, insurance follow up, collections and denials management.
• Adheres to all department and organization policies, procedures, and best practices.
• Maintains working knowledge of applicable Federal, State, and local laws and regulations. Monitors billing compliance with all third-party payer regulations.
• Maintains confidentiality in compliance with HIPAA regulations and ensures that department remains compliant with all relevant regulations.
• Completes other duties as needed and assigned.

Qualifications

• Bachelor’s degree in health administration or related field required.
• Candidates must have at least six years of experience within healthcare industry, including medical reimbursement and insurance for physician practice, hospital or health system. Position requires at least two years of supervisory experience.
• EPIC experience required, knowledge of other EHR billing systems is advantageous.
• Current, in-depth knowledge of governmental and commercial insurance rules and regulations is required, including regulatory compliance requirements. Extensive knowledge of Medicare, Medicaid, Managed Care is required.

Required Skills

• Strong analytical and computer skills are required along with the ability to interpret data to identify trends or areas for improvement, and present information in a succinct, actionable manner.
• Requires strong written and verbal communication skills as well as ability to interact and collaborate effectively with personnel at all levels to expedite revenue cycle processes while supporting customer service.
• Capacity to manage multiple priorities in a fast-paced environment.

Preferred Skills

• Experience with additional EHR systems.
• Advanced knowledge of healthcare financial management.

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