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Revenue Cycle Manager

Revenue Cycle Manager

The Center for Orthopedic and Research EWellington, FL, US
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Job Description

Job Description

ESSENTIAL FUNCTIONS

  • Manages the day-to-day operations of the billing department to maximize net revenues and cash flow by managing all aspects of the revenue cycle while ensuring adherence to policies and procedures.
  • Monitor accounts receivable activity and initiates appropriate corrective measures as needed.
  • Communicates performance data and associated action plans to Senior Leadership.
  • Identifies and implements processes to achieve key revenue cycle metrics including but not limited to a / r days, unbilled a / r, denial percentage, and cash collections.
  • Analyze large volumes of data and provide financial analysis and regularly presents trends, movements, and status to Senior Leadership.
  • Review billing work queues regularly to ensure that workloads are distributed evenly, and that the department metrics are being met.
  • Resolve complex patient, physician, and other issues when necessary.
  • Manages self-pay receivables including vendor relationships to help resolve AR. Inclusive of self-pay receivables is the process of charity review and bad debt management.
  • Develop and implement policies and procedures for designated areas; evaluate new systems and methods and recommend changes as necessary.
  • Communicate with payers and know when and how to escalate payer issues.
  • Oversee the hiring, training, and supervision of department personnel.
  • Maintains comprehensive knowledge of 3rd party billing requirements and reimbursement principles. Also maintains comprehensive working knowledge of payor contracts and ensures that payors are billed according to contract provisions.
  • Conducts regular meetings with staff to discuss third-party reimbursement methodologies. Provides direction to staff on changes in managed care reimbursement and expectation of changes in insurance guidelines.
  • Keeps abreast of compliance regulations, standards, and directives regarding governmental / regulatory agencies and / or third-party payers. Ensure communication and education of such to the Billing department as well as other Revenue Cycle Leaders.
  • Must be able to meet deadlines given by Manager or Senior Leadership.
  • Research and resolve discrepancies in a timely manner.
  • Works with sensitive and confidential materials and must be able to exercise discretion.
  • Verifies and updates patient registration information in the practice management system.
  • The job holder must demonstrate current competencies for this position.

EDUCATION

  • High School diploma or equivalent working knowledge preferred.
  • BA / BS in Business Administration, Accounting, Finance or equivalent is preferred.

    • EXPERIENCE

  • A minimum of five years of experience in a leadership role within a billing department in healthcare revenue cycle operations.
  • Prefer experience working with multiple physician specialties.
  • Previous supervisory experience and strong leadership skills with an ability to motivate with a positive attitude that positively impacts others.

    • REQUIREMENTS

  • Demonstrated successful healthcare revenue cycle leadership experience.
  • Experience analyzing and trending financial data.
  • Excellent written and verbal communication and presentation skills.
  • Excellent critical thinking, troubleshooting, and analytical skills.
  • Excellent interpersonal skills including conflict management.
  • Experience working in Excel (advanced formulas, pivot table)
  • Well organized and able to meet deadlines.
  • Excellent attention to detail.

    • KNOWLEDGE

  • Knowledge of claims processing and editing systems.
  • Strong knowledge of Medicare and Medicaid payer guidelines across multiple states.
  • Knowledge of CPT, HCPCS, and diagnosis coding.

    • SKILLS

  • Skill in effective data collection and analysis.
  • Interpersonal skills essential to communicate effectively, written and oral, with internal and external personnel at various levels.
  • Skill in effectively managing multiple projects simultaneously.

    • ABILITIES

  • Ability to multi-task and work well under pressure.
  • Ability to analyze problems and interpret information and to prioritize and reprioritize, as necessary.
  • Ability to work independently, and as part of a team.
  • Ability to read and interpret payer contracts.

    • ENVIRONMENTAL WORKING CONDITIONS

  • Normal office environment.
  • Extended work hours at or near month end to meet department objectives may be necessary.

    • PHYSICAL / MENTAL DEMANDS

  • Requires sitting and standing associated with a normal office environment.
  • Some bending and stretching are required.
  • Manual dexterity using a calculator and computer keyboard.

    • This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.

    At Center for Bone & Joint Surgery , we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following :

  • Competitive Health & Welfare Benefits
  • HSA with qualifying HDHP plans with company match
  • 401k plan after 6 months of service with company match
  • Employee Assistance Program that is available 24 / 7 to provide support
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    Revenue Cycle Manager • Wellington, FL, US