Revenue Cycle Manager - Billing
The Revenue Cycle Manager will be responsible for the management and day to day operation of the admissions staff and billing department. This position will assume responsibility for ensuring and supporting the delivery of quality patient care to the satisfaction of patients, physicians and staff. They will manage and oversee the patient scheduling, admission process, pre-authorization, coding, billing, claims and collections to maximize the productivity and minimize the errors of the revenue cycle process. This position will be responsible and accountable for providing vision and leadership in the development, design, and implementation of effective and sustainable processes within the billing, clinic office and hospital admission staff.
MINIMUM QUALIFICATION STANDARDS:
Education: Bachelor Degree in Accounting, Finance, Healthcare Administration, Business Management or related fields required.
Licensure: not applicable
Work Experience: 2-3 years’ experience in revenue and collection processes in a healthcare setting, preferably a critical access hospital. Management experience in a clinic or hospital setting preferred.
SKILLS AND KNOWLEDGE REQUIREMENTS:
• Strong verbal and written communication skills
• Creating a safe, welcoming, and efficient environment
• Experience with electronic medical records
• Leadership skills with focus on empowering and motivating
• Basic Computer knowledge
• Revenue cycle processes
• Excellent Customer Services skills
• Phone etiquette
• Medical teamwork
• Attention to detail
• Organization and Scheduling
• Friendly Bedside manner
• Supply management
• Knowledge of infection control standards of practice
• Predict and Anticipate patient and provider needs
• Critical thinking and extensive problem-solving skills
• Extensive knowledge of private insurance and CMS payor requirements
ESSENTIAL JOB FUNCTIONS:
Assess methods and processes from the revenue cycle to recommend ways to improve efficiency, effectiveness, and maximize payment recovery.
Develop department objectives, establish staffing patterns, and organize work of the department.
Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, collections, and reimbursement management.
Analyze billing and claims for accuracy and completeness. Submit claims to proper insurance entities and follow up on any issues.
Prepares and analyzes accounts receivable reports, weekly and monthly financial reports, and insurance contracts. Collects and compiles accurate statistical reports.
Track metrics related to the patient engagement cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.
Work in conjunction with the Clinic Manager to promote patient satisfaction, clinic efficiency, accurate documentation for reimbursement purposes and employee engagement.
Recruits, interviews, and selects high quality candidates and trains new staff members. Responsible for evaluating, counseling, creating performance improvement plans and disciplining clinic office staff according to facility policies and procedures.
Manages reception areas to include, but not limited to, clinic department, diagnostic departments, hospital/ER department.
Ensuring adequate coverage of managed areas through scheduling of shifts, compliance with policies and procedures, promote excellent customer service to staff and ensuring all duties within the area are completed timely.
Coordination of day-to-day operations of the front office area, in collaboration with Clinic Manager.
Ensures patient satisfaction, including troubleshooting when there is a billing complaint and developing process improvements to prevent recurrences.
Ensure billing and coding for all current and new medical service lines are accurate, consistent, and maximize revenue opportunities.
Manage relationships with payers and providers to generate high reimbursement rates and a low level of denials. Oversee denial management, including reporting, accountability, and resolution.
Able to integrate the financial, clinical, and billing processes to ensure compliance and maximize reimbursements.
Participates in budget preparation with input from team and ensure established limits are not exceeded.
Protects confidentiality within the parameters of federal guidelines and established policy and process as well as compliance with payer and provider contracts.
Able to carry out the essential functions of this job (with or without reasonable accommodation) without posing specific, current risk of substantial harm to health and safety of self and others.
NOTE: The essential functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities may be assigned as needed by immediate manager.
Position Type : Full Time
Shift : Day
South Big Horn County Hospital District
388 South US Highway 20
Basin, WY 82410