Revenue Cycle Manager Per Diem

MAJOR FUNCTION This position works in conjunction with the Chief Financial Officer and Director of Finance and Revenue Cycle to oversee essential functions critical to the organization's financial health.

They provide visionary leadership, ensuring high team performance through clear goal setting, regular evaluations, and ongoing coaching.

Responsible for strategic planning and policy development with the Director of Finance & Revenue Cycle, they optimize medical coding compliance, revenue integrity, and billing practices.

Additionally, the manager analyzes revenue cycle metrics, identifies process improvement opportunities, and effectively communicates findings to stakeholders while staying abreast of healthcare regulations and reimbursement trends.

ESSENTIAL FUNCTIONS :

• Supervisory Provide leadership and guidance to the revenue cycle team, ensuring high performance and professional development.
• Assign duties to the billing team and review their work product to ensure accuracy and efficiency.
• Set clear goals, expectations, and performance metrics for team members.
• Conduct regular performance evaluations and address issues promptly.
• Provide ongoing coaching, feedback, and support to enhance team capabilities and efficiency.
• Foster a collaborative and positive work environment.
• Communicate effectively with team members, stakeholders, and senior management.
• Participate in strategic planning and decision-making processes.
• Identify training needs and coordinate professional development opportunities for the team.
• Assist Director of Finance & Revenue Cycle in development and implementation of departmental policies and procedures and internal control systems.
• Medical Coding Lead and support the CFO, Director of Finance and Revenue Cycle, and finance team in analyzing opportunities for business performance improvement related to coding practices.
• Ensure coding compliance with federal and state regulations, payer policies, and industry standards.
• Assist Revenue Cycle Specialist as needed with internal coding audits to ensure accuracy and compliance in billing practices.
• Revenue Integrity Provide analytical support to other departments on revenue cycle issues.
• Monitor billing metrics, generate reports to track revenue performance, and identify areas for improvement.
• Maintain compliance with coding and billing regulations, including HIPAA, CPT coding guidelines, and local coverage determinations.
• Present best practices based on audits to prevent findings and recommend documentation improvements for maximum reimbursement.
• Compliance and Documentation Maintain compliance with coding and billing regulations, including HIPAA, CPT coding guidelines, and local coverage determinations.
• Oversee and monitor preparation for audits related to billing.
• Ensure timely and accurate submissions for Medicare and Medicaid WRAP billing, NJ Letter of Agreement (LOA) billing, and quarterly City of Trenton grant billings.
• Oversee preparation and submission of annual Sliding Fee Scales (SFS) to comply with grant and HRSA requirements with the Revenue Cycle Supervisor.
• Oversee preparation and submission of Medicare credit balance reports.
• Review proposed patient account adjustments and Bad Debt write-offs with Revenue Cycle Supervisor in accordance with policy.
• Coordinate case policy adjustments with Revenue Cycle Supervisor to ensure compliance with grant requirements.
• Evaluate new federal, state, and commercial coding and billing requirements and develop processes, procedures, and codes to ensure accurate billing capture.
• Revenue Analysis and Reporting Generate reports and analyze revenue cycle metrics such as coding accuracy, claim submission timeliness, and denial rates.
• Identify trends, patterns, and opportunities for revenue enhancement or process improvement.
• Present findings and recommendations to management or stakeholders. updates to management on billing and collection activities.

ADDITIONAL RESPONSIBILITIES :

LICENSURE AND / OR CERTIFICATIONS :

Organization reserves the right to request certifications and / or licensures as needed EDUCATION & EXPERIENCE :

KNOWLEDGE, SKILLS, ABILITIES AND OTHER (KSAO’s) :

Skills :

Supervisory Skills :

Abilities :

Other :