Revenue Cycle Manager

Cedar Point Health is looking for an experienced Revenue Cycle Manager to join our team. This position is responsible for the oversight of the Revenue Cycle Department to include staff management, payer relations, payer contracting, coding / billing / claims management, 3rd party software, coding, and audits, and is located in Montrose, Colorado.

Responsibilities :

Liaise with 3rd party billing vendor. Oversee performance expectations and successful process improvements while facilitating / collaborating with 3rd party vendor for CPH billing, coding, A / R, collections, and any other contractual expectations.

Train, develop, support and manage staff while supporting a team environment.

Maintain / manage bonus program, adhere to HR / Company policies and procedures, evaluate and approve timecards and time off requests.

Work in collaboration with department supervisors for oversight with check in and out process : education, training, dashboards, scripting, CPH software, mapping, etc.

Working in collaboration with CFO and bookkeepers as it relates to revenue cycle management.

Maintain monthly dashboard including KPIs, production numbers, etc., on a monthly basis.

Comply with all CMS, Federal and State regulations, payor guidelines and ensure consistent and complaint coding application.

Research and collaborate on regulation updates to ensure all necessary changes are incorporated into daily workflows.

Develop double check process for EMR postings to bookkeeping software on a quarterly / monthly basis.

Collaborate with EMR vendor for improved data mining and financial reporting tools as it relates to revenue cycle.

Assist CFO on payment analysis for the various commercial payers as it relates to fee schedules, contracts, and the various plan offerings under each insurance plan.

Collaborate with CFO and DO as it relates to key insurers on value-based revenue achievements as it relates to performance outcomes.

Assist CFO in preparing and developing operational strategies to increase cash, reduce bad debt, and decrease patient refunds.

Collaborate with credentialing department to ensure clear integration and alignment for incoming and outgoing providers occurs.

This position is required in person.

Audit, compliance, A / R Management, billing, insurance follow-up, and coding experience is mandatory.

Understanding of healthcare reimbursement environment including coverage, and payment necessary.

Ability to interact with others effectively, both verbal and written.

Strong influencing and leadership skills and the ability to collaborate in a team environment.

Ability to set and meet deadlines.

Proven understanding of the commercial and government payer landscape

Must be proficient in the use of technology and adaptable to proprietary systems and methods.

Strong organizational skillset with strong cycle time management capabilities

Proficient skills in all office programs

Exceptional problem solving and research capabilities with a strong analytic mindset.

Forward-thinking and self-directed

Adherent familiarity with HR policies and procedures

Development and support of CPH culture and overall team building, promote mission and vision as a department leader.

Experience : Minimum 5 years of experience working in Healthcare Revenue Cycle / Medical Billing / A / R Management.

Education : Bachelor’s Degree or higher in a related field (preferred)

Mental and Physical Requirements : Must possess the physical and mental abilities to perform the tasks normally associated with an office position that involves standing, sitting, reaching, manual dexterity to operate office machines, stooping, bending to handle files and supplies, and mobility to complete errands or deliveries. May work at computer monitors for prolonged periods with danger of eye strain and muscle pain.

Other Requirements : Commuting to other locations within a 75-mile radius may be requested.

Conditions : The position requires the ability to work under pressure and with a diverse population, including staff, physicians, clients, patients, applicants, insurance companies, and other members of the public on a regular basis. Due to the nature of the business, the position may come across communicable diseases and other conditions common in a clinical environment.