Revenue Cycle Manager
Salary undisclosed
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Essential Functions
At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:
- Manages the day-to-day operations of the billing department to maximize net revenues and cash flow by managing all aspects of the revenue cycle while ensuring adherence to policies and procedures.
- Monitor accounts receivable activity and initiates appropriate corrective measures as needed.
- Communicates performance data and associated action plans to Senior Leadership.
- Identifies and implements processes to achieve key revenue cycle metrics including but not limited to a/r days, unbilled a/r, denial percentage, and cash collections.
- Analyze large volumes of data and provide financial analysis and regularly presents trends, movements, and status to Senior Leadership.
- Review billing work queues regularly to ensure that workloads are distributed evenly, and that the department metrics are being met.
- Resolve complex patient, physician, and other issues when necessary.
- Manages self-pay receivables including vendor relationships to help resolve AR. Inclusive of self-pay receivables is the process of charity review and bad debt management.
- Develop and implement policies and procedures for designated areas; evaluate new systems and methods and recommend changes as necessary.
- Communicate with payers and know when and how to escalate payer issues.
- Oversee the hiring, training, and supervision of department personnel.
- Maintains comprehensive knowledge of 3rd party billing requirements and reimbursement principles. Also maintains comprehensive working knowledge of payor contracts and ensures that payors are billed according to contract provisions.
- Conducts regular meetings with staff to discuss third-party reimbursement methodologies. Provides direction to staff on changes in managed care reimbursement and expectation of changes in insurance guidelines.
- Keeps abreast of compliance regulations, standards, and directives regarding governmental/regulatory agencies and/or third-party payers. Ensure communication and education of such to the Billing department as well as other Revenue Cycle Leaders.
- Must be able to meet deadlines given by Manager or Senior Leadership.
- Research and resolve discrepancies in a timely manner.
- Works with sensitive and confidential materials and must be able to exercise discretion.
- Verifies and updates patient registration information in the practice management system.
- The job holder must demonstrate current competencies for this position.
- High School diploma or equivalent working knowledge preferred.
- BA/BS in Business Administration, Accounting, Finance or equivalent is preferred.
- A minimum of five years of experience in a leadership role within a billing department in healthcare revenue cycle operations.
- Prefer experience working with multiple physician specialties.
- Previous supervisory experience and strong leadership skills with an ability to motivate with a positive attitude that positively impacts others.
- Demonstrated successful healthcare revenue cycle leadership experience.
- Experience analyzing and trending financial data.
- Excellent written and verbal communication and presentation skills.
- Excellent critical thinking, troubleshooting, and analytical skills.
- Excellent interpersonal skills including conflict management.
- Experience working in Excel (advanced formulas, pivot table)
- Well organized and able to meet deadlines.
- Excellent attention to detail.
- Knowledge of claims processing and editing systems.
- Strong knowledge of Medicare and Medicaid payer guidelines across multiple states.
- Knowledge of CPT, HCPCS, and diagnosis coding.
- Skill in effective data collection and analysis.
- Interpersonal skills essential to communicate effectively, written and oral, with internal and external personnel at various levels.
- Skill in effectively managing multiple projects simultaneously.
- Ability to multi-task and work well under pressure.
- Ability to analyze problems and interpret information and to prioritize and reprioritize, as necessary.
- Ability to work independently, and as part of a team.
- Ability to read and interpret payer contracts.
- Normal office environment.
- Extended work hours at or near month end to meet department objectives may be necessary.
- Requires sitting and standing associated with a normal office environment.
- Some bending and stretching are required.
- Manual dexterity using a calculator and computer keyboard.
At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:
- Competitive Health & Welfare Benefits
- HSA with qualifying HDHP plans with company match
- 401k plan after 6 months of service with company match
- Employee Assistance Program that is available 24/7 to provide support
Essential Functions
At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:
- Manages the day-to-day operations of the billing department to maximize net revenues and cash flow by managing all aspects of the revenue cycle while ensuring adherence to policies and procedures.
- Monitor accounts receivable activity and initiates appropriate corrective measures as needed.
- Communicates performance data and associated action plans to Senior Leadership.
- Identifies and implements processes to achieve key revenue cycle metrics including but not limited to a/r days, unbilled a/r, denial percentage, and cash collections.
- Analyze large volumes of data and provide financial analysis and regularly presents trends, movements, and status to Senior Leadership.
- Review billing work queues regularly to ensure that workloads are distributed evenly, and that the department metrics are being met.
- Resolve complex patient, physician, and other issues when necessary.
- Manages self-pay receivables including vendor relationships to help resolve AR. Inclusive of self-pay receivables is the process of charity review and bad debt management.
- Develop and implement policies and procedures for designated areas; evaluate new systems and methods and recommend changes as necessary.
- Communicate with payers and know when and how to escalate payer issues.
- Oversee the hiring, training, and supervision of department personnel.
- Maintains comprehensive knowledge of 3rd party billing requirements and reimbursement principles. Also maintains comprehensive working knowledge of payor contracts and ensures that payors are billed according to contract provisions.
- Conducts regular meetings with staff to discuss third-party reimbursement methodologies. Provides direction to staff on changes in managed care reimbursement and expectation of changes in insurance guidelines.
- Keeps abreast of compliance regulations, standards, and directives regarding governmental/regulatory agencies and/or third-party payers. Ensure communication and education of such to the Billing department as well as other Revenue Cycle Leaders.
- Must be able to meet deadlines given by Manager or Senior Leadership.
- Research and resolve discrepancies in a timely manner.
- Works with sensitive and confidential materials and must be able to exercise discretion.
- Verifies and updates patient registration information in the practice management system.
- The job holder must demonstrate current competencies for this position.
- High School diploma or equivalent working knowledge preferred.
- BA/BS in Business Administration, Accounting, Finance or equivalent is preferred.
- A minimum of five years of experience in a leadership role within a billing department in healthcare revenue cycle operations.
- Prefer experience working with multiple physician specialties.
- Previous supervisory experience and strong leadership skills with an ability to motivate with a positive attitude that positively impacts others.
- Demonstrated successful healthcare revenue cycle leadership experience.
- Experience analyzing and trending financial data.
- Excellent written and verbal communication and presentation skills.
- Excellent critical thinking, troubleshooting, and analytical skills.
- Excellent interpersonal skills including conflict management.
- Experience working in Excel (advanced formulas, pivot table)
- Well organized and able to meet deadlines.
- Excellent attention to detail.
- Knowledge of claims processing and editing systems.
- Strong knowledge of Medicare and Medicaid payer guidelines across multiple states.
- Knowledge of CPT, HCPCS, and diagnosis coding.
- Skill in effective data collection and analysis.
- Interpersonal skills essential to communicate effectively, written and oral, with internal and external personnel at various levels.
- Skill in effectively managing multiple projects simultaneously.
- Ability to multi-task and work well under pressure.
- Ability to analyze problems and interpret information and to prioritize and reprioritize, as necessary.
- Ability to work independently, and as part of a team.
- Ability to read and interpret payer contracts.
- Normal office environment.
- Extended work hours at or near month end to meet department objectives may be necessary.
- Requires sitting and standing associated with a normal office environment.
- Some bending and stretching are required.
- Manual dexterity using a calculator and computer keyboard.
At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:
- Competitive Health & Welfare Benefits
- HSA with qualifying HDHP plans with company match
- 401k plan after 6 months of service with company match
- Employee Assistance Program that is available 24/7 to provide support