REVENUE CYCLE MANAGER - HYBRID

Description

Job Summary / Overall Objectives

The Manager of Revenue Cycle is responsible for supporting and monitoring the acute and physician revenue cycle operations. The Manager will work closely with the Director of Revenue Cycle, Lead Revenue Cycle Analyst and RCM vendor(s) to identify opportunities, challenges, and deficiencies and escalate issues timely for optimal revenue realization. In addition, the Manager will provide direct oversite of the Acute credentialing and Ambulatory manual charge entry as well provide leadership to the Contract Management team. The manager must work effectively within a multi-layered organization, working with service line, finance, and revenue cycle leaders to achieve performance objectives.

Essential Job Functions

Continuously monitors and assesses Revenue Cycle Management (RCM) performance to ensure financial goals are met, including metrics such as accounts receivable (AR) days, AR aging, administrative write-offs, charge lag and reconciliation, denials, and underpayments.

Provides leadership to the Contract Management team to facilitate new contract initiatives and monitor contract milestones. Additionally, partners with the Contract Management vendor to ensure contracts are uploaded promptly and with precision. Works with team to regularly evaluate contracted reimbursement rates against actual payments and addresses any inconsistencies that arise.

Manages Single Case Agreement process in collaboration with Contract Management, RCM vendor and Service Line Leaders.

Manages ambulatory manual charge processing for external IHS providers.

Manages all aspects of the Acute credentialing process. Reviews and troubleshoots monthly health plan nonparticipation denials.

Supports change management initiatives connected with process modifications or regulatory changes that affect workflows and billing practices. Collaborates with relevant departments and external partners to facilitate a smooth transition and minimize any disruptions to operations.

Delivers specialized support and guidance to both internal teams and external clients, addressing complex revenue cycle issues and ensuring high-quality customer service and compliance. Exercises sound judgment when making decisions that influence patients, payers and the broader health system, weighing potential outcomes to promote financial health and operational efficiency.

Maintains collaborative and productive working relationships with all revenue cycle, service line, and finance leaders to support alignment on business objectives and the achievement of key performance benchmarks. Proactively communicates and partners with cross-functional teams to identify needs, address challenges, and implement effective strategies that drive operational excellence and financial success across the organization.

Maintains and cultivates relationships with health plan leaders and participates in health system JOC meetings.

Reviews and updates revenue cycle policies and procedures.

Other duties as assigned.

Competency and Experience [Knowledge, Skills and Abilities]

Required Qualifications / Experience

Bachelors Degree or Equivalent Experience and (5) years of Acute / Physician revenue cycle management experience.

Five (5+) years supervisory / management experience in functional area.

Strong leadership ability, good organizational skills, independent and critical thinking skills, sound judgment, and knowledge of legal aspects and liability of functional area.

Strong ability to communicate complex and / or controversial topics and concepts to a wide and diverse audience.

Advanced Microsoft Office with emphasis on Excel.

Preferred Qualifications / Experience

Advanced Degree

3-5 years of relevant experience in medical collections, physician / hospital operations, AR follow-up, cash posting, denials and credentialing,

License, Certification & Clearances

• Act 34-PA Criminal Record Check from the PA State Police system

Position Type / Expected Hours of Work

Incumbent will be scheduled based on operational need (rotate shifts, standby, on-call, etc.).

Travel may be expected locally between System locations.

Equal Employment Opportunity

Independence Health and its affiliated companies are Equal Opportunity Employers. It is their policy to prohibit discrimination of any type and to afford equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, marital status, disability, veteran status, or genetic information, or any other classification protected by law. Independence Health and its affiliated companies will comply with all applicable laws and regulations.

Disclaimer

This job description is not designed to contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee. Moreover, duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

Work Environment

Effective March 2020 or during pandemic : goggles, face shield and mask are required according to CDC guidelines

When lift requirement is in excess of 50#, lift assistance (2 person) and / or transfer device is required.

Essential – Absolute Necessity.

Marginal – Minimal Necessity.

Constantly – 5.5 to 8 hours or more or 200 reps / shift.

Frequently – 2.5 to 5.5 hours or more or 32-200 reps / shift.

Occasionally – 0.25 to 2.5 hours or 2-32 reps / shift.

Rarely – Less than 0.25 hours or less than 2 reps / shift.

Physical Condition

Essential

Marginal

Constantly

Frequently

Occasionally

Rarely

Never

Extreme Heat

Extreme Cold

Heights

Confined Spaces

Extreme Noise(>

85dB)

Mechanical Hazards

Use of Vibrating Tools

Operates Vehicle (company)

Operates Heavy Equipment

Use of Lifting / Transfer Devices

Rotates All Shifts

8 Hours Shifts

10-12 Hours Shifts

On-Call

Overtime(+8 / hrs / shift; 40 / hr / wk)

Travel Between Sites

Direct Patient Care

Respirator Protective Equipment

Eye Protection

Head Protection (hard hat)

Hearing Protection

Hand Protection

Feet, Toe Protection

Body Protection

Latex Exposure

Solvent Exposure

Paint (direct use) Exposure

Dust (sanding) Exposure

Ethylene Oxide Exposure

Cytotoxic (Chemo) Exposure

Blood / Body Fluid Exposure

Chemicals (direct use) Exposure

Mist Exposure

Wax Stripper (direct use)

Non-Ionizing Radiation Exposure

Ionizing Radiation Exposure

Laser Exposure

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights () notice from the Department of Labor.