Revenue Cycle Manager

Job Description

Job Description

Description :

The Revenue Cycle Manager (RCM Manager) oversees all functions in the Billing / Accounts Receivable department and is responsible and accountable for the revenue cycle process. This position works collaboratively with front-line staff, clinicians, department managers, and senior leadership to maximize revenue, provide reports demonstrating trends in patient accounts, and ensure accuracy and compliance in billing, collections, and denials. The RCM Manager also ensures proper oversight of related financial screening areas (e.g., sliding fee discount policy, patient refunds, patient collections, COVID-related claims, and write-offs).

Primary Responsibilities :

• Manage the day-to-day revenue cycle operational processes. Our complete billing cycle in handled in house
• Participate in the development and implementation of organizational strategies, policies, and practices to create overall department success
• Identify reimbursement issues and take timely steps to resolve
• Set productivity goals, monitor, and eliminate barriers to achieving those goals at the individual and / or team level
• Manage billing department staff (5) in daily activities, assign work, set completion dates, review work and manage performance in accordance with established policies and procedures
• Analyze and assign new errors and denials
• Exhibits exceptional customer service skills; answering client calls; prompt return and follow up to all interactions;
• Prompt response to requests for information, both internally and externally initiates and maintains direct contact with CHMB clients, engaged in proactive resolution of issues and timely response to questions and concerns.
• Clearly documents issues and resolution, as well as documents AR issues / status for client presentation.
• Participates in client workgroups, if needed, to address AR issues.
• Maintains a schedule of client meetings either monthly or quarterly depending on the size and scope of the client.
• Professionally interacts with clients and patients to resolve questions and concerns.
• Delivers timely required reports to the Director of Operations; initiates and communicates the resolution of issues, such as payer denial trends, collections accounts, inaccurate or incorrect charges, vendor input and implementation.
• Identifies and provides timely resolution of process issues.
• Track clients’ AR productivity (charge, payments, collections, adjustments) on a daily, weekly and / or monthly basis; as needed to ensure the client and company expectations are met.
• Provide training and mentoring to staff; ensure standard operating procedures (SOP) are followed and improvements occur.
• Stay current with company’s policies and procedures regarding AR activity such as, reviewing month end reports to guarantee the AR is below 20% over 90 days, identifying trends.
• Analyze reports to determine when, how and why decrease in clients’ AR; includes denials, unbilled, credit issues; holds; communicate with client and staff to resolve.
• Review work performed by outside vendors for accuracy and production.
• Hires, retains mentors and manages staff to achieve organizational goals.
• Meets regularly with staff; in-person and as a group to confirm the status of client accounts, effectively prioritizing AR activities for staff holding them accountable for work performed.
• Provides support, training and oversight to build and enhance a team to meet current and future business needs supporting our clients.
• Analyze and address staff performance, conduct and other problems in a timely and professional manner, offering counseling, correction and discipline as appropriate.
• Performs period reviews to mentor and give constructive feedback to improve performance.
• Handle and manage internal staffing issues regarding daily matters, including but not limited to such items as timekeeping, coverage, workflow, and training.
• Achieve goals set forth by supervisor, CHMB and compliance requirements.
• Other duties as assigned
• Assist in hiring and training new staff members
• Prepare reports for management and physician review
• Oversee and manage and direct the retrieval, approval and correction of claims as they come through the EHR to thePractice Management System.
• Reviews patient charges, payments and adjustments on automated systems.
• Reconcile charges, payments and adjustments posted to the system on a regular basis.
• Work closely with all stakeholders and billing personnel to assure the accuracy and integrity of the accounts receivable system, claims, registration processes.
• Report fiscal detail and trends to Executive leadership, regularly.
• Monthly review of patient statements, receivables.
• Ensure that all third-party denials are re-billed or appropriately adjusted.
• Help prepare yearly cost reports, UDS data, audit materials as requested.
• Work with Executive and Operations teams to ensure that any new programs and services are billable.
• Provide accurate detailed audit documentation for internal, external audits.
• Ensure processes are compliant with billing policies and procedures.
• Design and update business forms, as necessary.
• Train, supervise and evaluate revenue management, billing manager, billers, and coding staff.
• Facilitate patient and staff inquiries regarding financial accounts.
• Train and provide direction to other individuals whose functions directly impact patient financials, billing, denials, eg.Front Office and Medical Assistants.
• Provide over-site of outsourced accounts A / R management organizationsMaintain user access to external health plan, IPA portals used for membership reporting.

Essential Duties and Responsibilities :

Requirements : Job Qualifications :

Competencies & Skills :

Physical Requirement :

Work Environment :

Equal Employment Opportunity

Universal Community Health Center is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), age, disability, genetic information, national origin, or any other protected characteristic as defined under applicable state, federal, or local laws.