Description:
The Revenue Cycle Manager will lead, direct, and support the billing team in the routine day-to-day functions within the Patient Financial Services (PFS) Department. This will include but is not limited to monitoring medical and dental accounts receivables, batch and sending electronic claims, and the generation of patient statements. The Revenue Cycle Manager will be responsible for working closely with other leaders to build and maintain effective partnerships and alliances across departments.
Responsibilities
- Manage billing staff to ensure accuracy and high-quality work products that are following regulatory agency guidelines.
- Manage the submission, tracking, and follow-up of insurance claims, minimizing denials and maximizing reimbursement.
- Identify, analyze, and address reasons for claim denials, collaborating to prevent future denials.
- Develop training programs and job aids for new hires and existing team members. Conduct ongoing training to improve knowledge of pre-claims processes, regulatory changes and customer service skills.
- Monitor key performance indicators (KPIs) such as accounts receivable days, denial rates, and collection targets.
- Ensure that all billing practices comply with federal, state, and local regulations, as well as insurance company guidelines.
- Collaborate with Coding Supervisor and Medical CCR Managers to create cross functional guidelines and duties between departments to streamline and improve pre-claims operations.
- Proactively provides leadership to staff to promote a respectful, safe and positive work environment.
- Actively contributes to the leadership forum to promote exchange of information amongst leaders and departments.
- Ensures that current policies and procedures are updated for accuracy and relevance.
- Manages department human resources functions.
- Demonstrates adherence and support of the MLCHC mission, vision, goals, policies and procedures of MLCHC.
- Provides excellent service and support to all members of the MLCHC team.
- Understands and retains focus on strategic goals and communicates them effectively to staff.
- Efficiently manages expenses of the department adhering to Finance guidelines.
- Actively participates in Quality Improvement efforts.
Requirements
- Possesses general work-related skills at a higher level than completion of high school, including written and verbal communications skills, computational and computer skills, and mathematical knowledge frequently acquired through completion of a "business school (non BA/BS)" or "associates degree" type program.
- Certified Professional Biller (CPB), Certified Revenue Cycle Professional (CRCP), similar credential (preferred) or bachelor's degree (preferred).
- Five to seven years of billing experience in a healthcare setting, preferably in a FQHC.
- Two to five years leadership experience required.
- Ability to read and speak Spanish and/or Russian preferred but not required.