Revenue Cycle Manager - Western OTP's

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SUMMARY

Revenue Cycle Manager leads, develops and implements processes for all functions related to the revenue cycle to ensure maximum and timely cash flow while improving processes and payer denials. Works collaboratively with the Director of Revenue Cycle Management, Vice President of Finance, and Chief Financial Officer.


Timely and accurate billing and collections, as well as optimizing efficiency in the RCM functions are essential. Goals will include utilizing automated claims bill out tools, reducing days in A/R, minimizing rejections and denials, streamlining insurance verification processes and improving on other relevant key performance indicators.

EMPLOYMENT REQUIREMENTS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


  • Degree in related healthcare field and/or equivalent minimum 10 years progressive experience in clinical RCM/billing/collection function

  • Minimum 5-10 years management experience. Ability and track record of effectively building and leading a coding, billing and collections team.

  • California Drug Medical experience preferred.

  • Experience with electronic patient registration, EMR and PM systems.

  • Broad-based exposure to/knowledge of relevant insurance regulations including state and federal regulations.

  • Proficient in Microsoft Suite with an emphasis on Excel and PowerPoint for board level dashboard.

  • Experience developing, implementing revenue cycle processes, controls and automated systems.

  • A strong understanding of / commitment to utilizing technology to improve the business.

  • A self-starter, able to help build, implement and track facility level and company-wide metrics.

  • Strong understanding of healthcare, insurance, managed care contracting.

  • Strong organization and communication skills.

  • Creatively and cooperatively work in a fast-growing organization.

  • Possess the skills to be independent, motivated and results-driven in centralizing RCM functions for new and acquired entities, following through with communication, and being held accountable for the cash reimbursement predictability and performance of the business.

  • 10% travel requirement


    RESPONSIBILITIES AND DUTIES

  • Build appropriate tools such as KPI reports and incentive plans to help track and maintain top performing staff.

  • Ongoing evaluation of denial reports by location, ongoing feedback to locations on how to improve denials stemming from desk and verification errors.

  • Develop, manage and maintain the annual billing.

  • Work with coding to ensure compliance with applicable laws, regulations, policies, and procedures.

  • Propose & present revenue cycle automation and process improvement opportunities.

  • Develop strategies to improve reimbursement and collection KPI’s for Billing staff as well as each Facility/County locations as they relate to RCM.

  • Provide leadership for insurance verification, billing and collections processes.

          Collaborates with Operations on cash pay patients to ensure we are managing cash AR through financial counseling and minimizing bad debt expense.

  • Train and coach Billing and staff on new developments with contracts, Drug Medical, and Medicare.

  • Create and maintain manuals/handouts for processes for Billing departments.

  • Manage day-to-day functions of Billing Department such as time off and disciplinary actions.

  • Support/approve patients for collections and Financial Discharge.

  • Perform other duties as assigned.




 
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