JOB DESCRIPTION
Revenue Cycle Manager is responsible for overseeing each department with regard to revenue activities, organizing strategies to increase profitability, and meeting all financial objectives for the hospital, clinics, and DME office. Revenue Cycle Manager is in charge of exploring and reviewing billing activities and generating ideas for better practices regarding revenue programs, and monitor projections based on past financial results and analyze financial trends in order to modify company expectations as needed.
JOB DUTIES
· Assist in implementing the day-to-day functions of the billing department
Monitor and assist in completing day-to-day operations when an employee is out
· Assist in planning, developing, organizing and implementing written policies and procedures
· Organize, evaluate and monitor billing and admission office operations and employees in accordance with our established policies and procedures
· Ensure administrative functions are carried out promptly for efficient operation
· Interpret facility policy and procedures to personnel and patients as directed
· Accumulate, maintain and provide statistical data on the hospital and clinics
· Manage and maintain patient statement processes, and Cycle Bill processes
· Monitor Accounts Receivable
· Make sure efficiency is maintained with claim billing processes
· Monitor claim rejections and denials for trends and possible oversights
· Approve or deny claim administrative adjustments
· Monitor Contract Bill accounts to maintain patient privacy with regard to contract bill accuracy
· Run monthly Create Claims By Charge Period Reports for accurate cycle billing
· Credentialing of all provider and facilities with networks and insurance companies
· Submit Medicare and Medicaid credit balance reports quarterly to the appropriate agency
· Collect and Submit the required patient admit and d/c health care information quarterly to the MS Department of Health via the IODS Submission system.
· Gather and send appropriate accounts to Collection Service monthly
· Write Off appropriate accounts to Regular Bad Debt and to Medicare Bad Debt monthly
· Understand insurance billing and maintain correct billing processes throughout CPSI
· Understand and assist in federal and state mandated reporting processes (MU, PQRS, MIPS, etc)
· Stay informed and educated on the latest Medicare and Insurance billing rules.
· Assist patients with understanding their accounts, as well as taking payments from them over the phone
· Advocate on behalf of our hospital and our patients with insurance companies with regard to correct billing procedures and payments, as well as with refunds
· Keep updated on cost report rules, so that I can help with reporting processes
· Approve or deny sliding fee scale and charity applications, as well as verify appropriate documentation for such
· Understand and be proficient at CPSI tasks and procedures so that account errors from any department can be caught and corrected before claims get dropped to billers
· Oversee and educate employees on registration errors
· Add and update users to myaccessblue.com(BCBS website), MESA(MCaid website), unitedhealthcareonline(UHC site) and Novitasphere(MCare eligibility) and claims site
QUALIFICATIONS
High school diploma required and two (2) years college preferred. Five (5) years prior experience in a hospital or physicians billing office and management experience required. Knowledge of claims submission for insurance, Medicare and Medicaid. RHC and Critical Access knowledge preferred.
Requires multi-tasking, extensive customer service skills, and the ability to handle stress in a fast paced working environment. Also, integrity in maintaining confidential information and problem solving and troubleshooting of billing issues. Convey a positive, professional image.