The Revenue Cycle Manager is responsible for directing, organizing, and managing the entire revenue cycle, including all personnel involved in revenue cycle efforts;developing and monitoring productivity standards; and preparing/reviewing frequent and standard performance reports. Improve the operations of PCHS in support of its stated mission: provides accessible, affordable, quality health and wellness services for our communities.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: Other duties as assigned. The Revenue Cycle Manager directs and oversees all functions of coding, claim management, billing, payment, collections and coordinates credentialing processes. Establishes revenue cycle benchmarks, standard of practices with policies and procedures consistent with organizational goals, infrastructure, state and federal requirements. Oversight of all staffing functions and provides leadership with training. Develops and maintains the highest standards of professionalism and accountability.This position will support the Clinical Operations Director to ensure the quality of the insurance, demographics and eligibility data entered, as well as, monitoring all time of service collections by providing revenue cycle reporting and training materials.Establishes & maintains revenue cycle duties across the organization that include prioritization of work (e.g. ensure there is a system of prioritization for claims processing and accounts receivables management depending on the volume, revenue, payer mix, etc.)Oversees the development, maintenance, implementation, and training of protocols, policy and procedures for all functions related to the revenue cycle.Plans and conducts revenue cycle staff meetings on a regular basis. Communicates changes and updates to the CFO in a timely fashion.Works with Clinic Director to ensure best practices related to patient access and the revenue cycle.Monitors, educates and codes appropriate procedures performed by the practice. Evaluates and maintains managed care contracts and makes recommendations as required.Abides by Health Insurance Portability and Accountability Act of 1996 in reference to all confidential information obtained through job tasks.
Education: High School diploma or general education degree (GED) required, BA preferred but not required; trained and an active Certified Professional Coder (CPC).
Certificates, Licenses, Registrations: The following are required for this position: