Manager, Revenue Cycle Optimization

Description

Job Description : The Health Care Revenue Cycle Operations Manager serves as the point of communication, coordination, and collaboration between the PBP organization / practices and RCM operations.

This includes reviewing, assessing, and optimizing the process and operations concerning registration, pre-authorization, coding, billing, collections, reimbursement, and financial analysis to optimize revenue generation and cash collections and ensure compliance with regulatory requirements.

The role requires strong leadership, analytical skills, and a deep understanding of end-to-end HB billing processes. Responsibilities : Revenue Cycle Management : Assess and evaluation the entire revenue cycle process from patient scheduling / registration to final payment or resolution of outstanding balances.

Monitor key performance indicators (KPIs) related to revenue cycle operations, identify areas and develop / implement plans for improvement.

Develop and implement strategies to improve revenue cycle efficiency, reduce denials, and maximize collections. Collaborate with operational leaders within PGP, RCM, and other divisions of Emory Healthcare to drive PBP RCM performance.

Develop strong relationships and collaboration with the providers of PGP and staff. Financial Analysis : Analyze revenue cycle data to identify trends, issues, and opportunities for optimization.

Prepare financial reports and presentations for senior management, highlighting key performance metrics and areas for improvement.

Technology and Systems Management : Collaborate with IT department to optimize revenue cycle software and ensure seamless integration with other systems.

Staff Management : Supervise and mentor staff. Provide training and professional development opportunities to enhance staff skills and knowledge.

Compliance and Risk Management : Ensure compliance with all relevant healthcare regulations, including billing and coding guidelines, fraud and abuse laws, and payer requirements.

Develop and implement policies and procedures to mitigate revenue cycle risks and ensure adherence to compliance standards.

Assist in the monitoring of operations to ensure accurate and compliant billing and coding practices in accordance with regulatory guidelines, such as HIPAA and CMS regulations.

Stay updated on changes to billing and coding regulations and advise the organization on necessary changes to maintain compliance.

Minimum Qualifications : Bachelor's degree in Healthcare Administration, Business Administration, Finance, or related field (Master's degree preferred).

Minimum of 5 years of experience in healthcare revenue cycle management, with a demonstrated track record of success in optimizing revenue and reducing denials.

In-depth knowledge of healthcare billing, coding, reimbursement, and compliance regulations. Strong analytical and problem-solving skills, with the ability to interpret complex financial data and identify opportunities for improvement.

Excellent leadership and interpersonal skills, with the ability to effectively manage a team and collaborate with cross-functional stakeholders.

• Proficiency in revenue cycle management software and Microsoft Office suite. PHYSICAL REQUIREMENTS (MediumMax 25lbs) : up to 25 lbs, 0-33% of the work day (occasionally);
• 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs;

Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS : Factors affecting environment conditions may vary depending on the assigned work area and tasks.

Environmental exposures include, but are not limited to : Blood-borne pathogen exposure Bio-hazardous waste Chemicals / gases / fumes / vapors Communicable diseases Electrical shock , Floor Surfaces, Hot / Cold Temperatures, Indoor / Outdoor conditions, Latex, Lighting, Patient care / handling injuries, Radiation , Shift work, Travel may be required.

Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

Financial Benefits

• Competitive Pay
• Retirement planning and counseling
• 403(b) fixed employer-based contribution*
• 403(b) retirement plans with 4% or 5% match based on years of service
• 457(b) plan for eligible employees
• Student loan repayment benefit
• Long-term disability insurance
• Short-term disability insurance
• Life insurance and supplemental life option
• Long-term care insurance option
• Hospital indemnity option
• Auto and home insurance discounts
• Identity protection insurance
• Employee hardship donation program
• Credit Union memberships
• Financial tools, resources and webinars to help with budgeting

Health and Wellness BenefitsMedical and Dental Plans

• Three medical plan options including behavioral and preventive care coverage
• Health Savings Accounts / Flexible Spending Accounts
• Tier Zero Prescription benefits
• Two dental plan options
• Vision plan
• Infertility benefits
• Emory Eye Center and Emory Vision Center discounts
• Emory Aesthetic Center discounts

Wellness Programs

• Employee Assistance Program assistance with relationships, life events, challenges, daily living needs
• Healthy Emory wellness program with incentives
• Discounts at Emory wellness / fitness centers
• Other fitness center discounts
• Diabetes prevention program
• Wellness challenges
• Know Your Numbers kiosks

Childcare Resources

• Discounts
• Placement assistance
• Back-up and emergency care options
• Emory Healthcare childcare co-op / app
• Access to Emory student job network
4 days ago