Accounts Receivable, Accounts Receivable Management, Administrative Skills, Behavioral Health, Billing, Coaching, Contract Review, Data Management, Develop and Maintain Customers, Establish Priorities, Healthcare, Insurance, International Classification of Diseases (ICD), Leadership, Medical Billing, Microsoft Excel, Multitasking, Organizational Skills, Patient Assessment, Performance Analysis, Presentation/Verbal Skills, Problem Solving Skills, Project/Program Management, Purchasing/Procurement, Reimbursement, Revenue Management, Set Goals, Team Player, Time Management, Writing Skills
Description
Job Summary:
Responsible for overseeing and coordinating revenue cycle activities with a goal of
maximizing reimbursement in cost effective manner that is in compliance with federal,
state, and payor-specific billing requirements. Revenue cycle activities include payor
contracting, negotiation, registration, credentialing, coding, charge capture, charge
entry, billing, collecting, payment entry, and reimbursement analysis. The Revenue
Cycle Manager is also responsible for supervising and developing the Accounts
Receivable Billing Manager. Finally, this position will be responsible for establishing
productivity standards/goals and monitoring performance against these.
Essential Functions:
● Develops, implements, and maintains CMG revenue cycle standard operating
procedures.
● Ensure patient eligibility is checked and benefits are verified in accordance with
payor contracts and as necessary to minimize accounts receivable exposure.
● Ensures authorizations are obtained for required services
● Ensures cash posting is timely and accurate
● Ensures timely and accurate billing of claims to payors.
● Ensures patient financial concerns are addressed, including but not limited to
insurance coverage and refunds.
● Monitors accounts receivable aging and ensure appropriate collection procedures
are being followed.
● Establishes internal collection goal(s) and regularly compares to identified external
benchmark(s).
● Resolves escalated reimbursement issues with payors.
● Participates in/project manage special projects as requested/required.
● Participates in the review of payor contracting including credentialing, and on-going
contract compliance.
Supervisory Responsibilities:
Provides leadership and guidance to the Accounts Receivable Billing Manager, Patient
Registration Supervisors, Patient Access Supervisor, Manger Cash Applications, and
Manager NPFC in the conduct of their job. Accurately assesses each strengths and
development needs and provides timely feedback and coaching.
Essential Qualifications:
Education/Certification: Bachelor’s degree or equivalent in business or
related field required
Required Knowledge: Proficiency in Microsoft Excel. Strong knowledge of medical billing, including ICD-10. Knowledge of behavior health billing.
Experience Required: Minimum 8 years of revenue cycle experience with at least 5 years being in a healthcare environment. At least four years medical revenue cycle management experience required. Experience with behavioral health billing preferred.
Skill and Ability: Ability to work collaboratively with colleagues. Strong organizational skills with a keen ability to prioritize and multi-task. Ability to adhere to and meet deadlines. Good communicator (oral and written). Strong administrative and data management skills. Ability to raise issues proactively and in a timely manner.
Job or State Requirements
Bachelor’s degree or equivalent in business or related field required. Minimum 8 years of revenue cycle experience with at least 5 years being in a healthcare environment. At least four years medical revenue cycle management experience required. Experience with behavioral health billing preferred.