Revenue Cycle Manager

The Revenue Cycle Manager is responsible for overseeing all aspects of the organization's billing and revenue cycle. This role focuses on optimizing cash flow, enhancing customer relations, and ensuring compliance. The manager collaborates with the team to address revenue cycle issues, develops processes, and provides training for a cross-functional revenue cycle team.

Duties and Responsibilities:

• Revenue Cycle Oversight: Manage the entire revenue cycle process, including identifying issues, leading performance meetings, and implementing improvements.
• Strategic Development: Develop strategies to enhance daily, weekly, monthly, and quarterly revenue cycle metrics for optimal reimbursement while ensuring compliance and cost-effectiveness.
• Analysis and Reporting: Analyze trends, conduct audits, and provide reports to address and prevent claims denials. Supervise Billing Coordinators and assist in problem resolution.
• Performance Meetings: Conduct regular meetings to review analysis results, identify improvement opportunities, and discuss financial impact, metrics progress, and action items.
• Collection Rate Monitoring: Monthly review of Gross Collection Rate (GCR) by payor and client to proactively identify billing/insurance concerns. Recommend workflow changes as needed.
• Performance Management Call: Design and lead the Performance Management call.
• Reporting: Provide detailed monthly reports on top issues affecting metrics, including financial impact to the Financial Operations Director.
• Secondary Billing: Assist with secondary billing with urgency and set collection rate expectations.
• Management Reporting: Design reporting to identify problems promptly and collaborate with operations for decision-making.
• Data Accuracy: Audit the accuracy of company programs and software data, manage system integrations or transitions, and audit funding source rates.
• Compliance: Ensure compliance with policies and procedures and stay updated on Revenue Cycle trends impacting healthcare systems.

Day-to-Day Oversight:

• Review and reconcile weekly claims for submission.
• Monitor payor correspondence and follow up as necessary.
• Ensure accurate data uploads to practice management software.
• React to news affecting Revenue Cycle Management (RCM).
• Track recoupment/takeback requests and follow up.
• Prioritize high-priority A/R.
• Ensure compliant documentation and billing practices.
• Research information impacting RCM.

Team Management & Development:

• Oversee the RCM team and support skill development.
• Provide training and ongoing education for RCM employees, conduct performance reviews, and offer coaching and counseling.
• Handle complex situations, such as sudden insurance changes.
• Monitor incoming payor mail and communicate important updates to the team.
• Mentor, support, and interview job applicants as needed.
• Conduct monthly staff in-services on payer issues and collection techniques.

Reporting:

• Create and review collection reports to assess collection balance status and evaluate collection policies and procedures.
• Establish and track benchmarks and key performance indicators (KPIs) for the RCM department.
• Generate reports for management on a regular basis and as needed.
• Utilize software systems for data analysis, trend identification, and solution implementation.

In this role, you will lead efforts to optimize the revenue cycle, ensure compliance, and foster a high-performing team focused on maximizing cash flow while maintaining strong customer relations.

Requirements

• Experience with ABA billing and CentralReach a plus
• Extensive critical and analytical thinking skills required
• Professional presentation skills
• Extensive data mining capabilities with the ability to derive operational opportunities
• Three or more years of management experience
• Five or more years of experience working with insurance in operations, compliance, clinical, or finance areas
• Experience and knowledge in federal, state, and commercial billing, compliance, and reimbursement regulations
• 3 years of medical billing experience required
• Strong knowledge and experience working with medical EOBs, patient deductibles, co-payments, co-insurances, electronic remittances, contractual payments, and adjustments
• Ability to motivate team
• Should be oriented and sensitive to patients' needs and aware of the importance of confidentiality regulations, including HIPAA
• Strong working knowledge of Collection Policies and Procedures
• In-depth knowledge of Medicaid and other payor Guidelines
• Thorough understanding of payor contracts
• Strong, in-depth knowledge of revenue cycle management principles and practices, including medical billing, coding, collections, managed care products, regulatory compliance, payer credentialing, and financial reporting
• Must have bachelor's degree or equivalent experience, or equivalent, required
• Proficient in all Microsoft Office applications as well as medical office software
• Advanced Excel knowledge, preferred
• Must be at least 18 years of age, required
• Strong interpersonal and organizational skills
• Effective Troubleshooting, cognitive reasoning, and problem-solving skills – think outside the box.
• Excellent customer service skills
• Familiarity with electronic devices, i.e. tablets, cell phones, computers
• The ability to work in a fast-paced environment
• Must be able to independently set and organize work priorities for self and team members
• Reliable means of transportation, required
• Background and fingerprinting clearance, Required
• Cleared TB test, where required
• Register/ Certified Behavioral Technician Certificate, optional
• Central Reach: 1+ year (Preferred)
• Artemis: 1+ year (a plus)
• RCM for ABA organizations: 1+ year (Preferred)

Benefits

• Competitive pay - Pay scale: $80,000 - $100,000 (DOE)
• Health insurance (Medical, Dental, and Vision)
• 401K plan
• Paid Vacation and Sick Time Off
• Paid Holidays
• Professional growth and career development opportunities
• Access to discounted rates towards coursework at both National University and Purdue University Gloabal for all undergraduate and graduate programs and certificates
• Employee Assistance Program (EAP) (available to all employees)
• Generous Employee Referral Program