Revenue Cycle Manager

Description

Position Summary: 

Analyzes and interprets data to initiate and facilitate implementation of solutions for process, quality, and procedural improvements within the Enterprise Revenue Cycle by understanding Enterprise Revenue Cycle operations, processes, systems, regulations, clinical practice, payer changes and data.

RESPONSIBILITIES:

• Assess team members for potential, strengths and development needs and conduct career development discussions to grow the talent pipeline.

• Translate and oversee organizational strategies for assigned goals.

• Investigate and partner with HR in the resolution of associate issues.

• Manage the resolution of client issues and ensure appropriate follow-up is done to manage client relationship.

• Manage & administer program policies & procedures.

• Analyzes, designs, and redesigns processes, workflow, and systems to ensure quality, effectiveness, and efficiency, identifies resource impact, and leads and facilitates process improvements by understanding system dependencies.

• Prepare ad hoc analysis to assist hospital and corporate leadership in understanding the various elements impacting the Revenue Cycle

• Runs reports, tracks operational and financial Revenue Cycle metrics (staff productivity, quality)

• Collaborates with Financial Clearance and Billing Supervisor to audit samples of patient accounts on a monthly basis to ensure accuracy of financial clearance, charge entry, payment posting, and denial management follow-up procedures.

• Define and document scope and objectives with project sponsors across the revenue cycle.

• Maintains strictest confidentiality and abides by all HIPAA requirements and standards.
• Participation in new hire/annual training is a condition of employment. 
• Other duties as assigned.

Benchmarking:

• Indicators (Appointment no show rates, charge lag, net collections, net days in receivables, denials as a % of revenue, bad debt, cost to collect,), and patient-level data (e.g., types of patients, diagnosis, etc)

Requirements

Other Requirements:

1. Ability      to maintain effective in busy and/or stressful situations. 
2. Ability      to communicate effectively in person, by phone and in writing. 
3. Requires      adherence to all policies and procedures, including but not limited to      standards for safety, attendance, punctuality, and professional appearance.      
4. Must      be able to establish and maintain effective working relationships with      managers and peers. 
5. Exposure      to Blood Bourne Pathogens (BBP) and Other Potentially Infectious Materials      (OPIM) is rare but possible. Vaccinations and training are offered upon      hire. 

KNOWLEDGE, SKILLS and ABILITIES:

• Identify & generate proposals for potential projects to improve processes, cost to collect and cash yield.

• Develop and manage revenue cycle project dashboards, results and benefits realization, track progress, identify opportunities to accelerate implementation plans or create corrective plans as needed.

• Provide guidance to and support to the revenue cycle organization on change management and performance improvement strategies.

• Evaluate Revenue Cycle department processes and procedures.

• Participate in requirements gathering and implementation of new IT applications Understanding of the various roles, responsibilities, and technical aspects of the entire revenue cycle, specifically in the healthcare, medical, or ambulatory surgery center industry.

• Knowledge of medical terminology and health insurance billing

EDUCATION: 

• Bachelor’s Degree required, Masters in Business or Healthcare Finance preferred

• Minimum two years of management experience within the revenue cycle functions in the healthcare, medical, or ambulatory surgery center industry.

PHYSICAL REQUIREMENTS:

Hearing: Adequate to perform job duties in person and over the telephone. 

Speaking: Must be able to communicate clearly to patients in person and over the telephone. 

Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens. 

Other: Requires occasional lifting and carrying items weighing up to 15 pounds unassisted. Requires frequent bending, reaching, and repetitive hand movements (specifically keyboarding and writing), standing, walking, squatting and sitting, with some lifting, pushing and pulling exerted regularly throughout a regular work shift. Assisting with patient mobility may be required. This may require you to on occasion wear gloves and/or other Personal Protective Equipment (PPE). 

The above is intended to describe the general content and requirements for the performance for this position. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements.