Senior Revenue Cycle Support Manager

Job Description

Job Description

Overview

The Sr. Revenue Cycle Support Manager assists and tracks EDI enrollments, is a subject matter expert, and will provide training as needed. Provides oversight of complete billing processes for HCHB Home Health and Hospice. This includes submission of claims and accurate claim processing.

Responsibilities

• Accurate payer setup in multiple billing system(s) :
• Confirm correct rate and claim presentation
• Confirm success of transmissions upon initial setup
• Accurate contractual allowance setup.
• Assign appropriate status to billed claims to ensure appropriate handling by branch and revenue cycle team.
• Accurate calculation of expected reimbursement.
• Researching proper billing policies and procedures for all payer types, ensuring claims are processed correctly against industry and government standards and regulations, adhere to company compliance, integrity, patient privacy and ethical billing practices.
• Stay updated with Payor bulletins regarding any billing and updates / changes and coordinate with collections as needed to ensure awareness.
• Accurately document billing activities in EMR, ensuring transparency, training, and accountability.
• Oversight of billing team.
• Responsible for team’s success.
• Resolve claim rejection issues and discrepancies swiftly and effectively.
• Monitor for variances and facilitate research.
• Communicate any identified anomalies and action plans.
• Provide support and expertise in implementation or automation or AI technologies to streamline billing processes.
• Ensure that all electronic and paper claims are filed and billed properly in a timely manner.
• Research any issues, prioritize, and advise staff on claims that require attention. Efficiently uses company billing software platform, including maintaining accurate and detailed patient and billing records.
• Responsible for system software training to Billing team and offer frontline support to address system functionality questions and issues.
• Setup of new sites within Revenue Cycle Platforms.
• Proactively work acquisitions to avoid as many disruptions as possible.
• Work with EDI staff to ensure all eligible electronic options are enabled / utilized.
• Perform Month-End Close Procedures / Processes :
• Report variances
• Review systems for non-admits or duplicate admissions.
• Problem solving system issues, identifying root cause and next steps.
• Partner with Operations, as needed, to identify work through issues.
• Analyze data for anomalies.
• Supervise work of direct reports.
• Maintain excellent partnerships with multiple lines of business and departments.
• Coordinate to identify changes for governmental payors.

Qualifications