Employer: | Integrated Medical Services, Inc. |
Type: | FULL TIME |
Skills: | billing,coding,denials,management,auditing,key performance indicators (KPI) |
Specialties: | multi-specialty, primary care, cardiology, general surgery, orthopedics, allergy & immunology, gastroenterology |
Required Certifications: | Bachelor's degree |
Preferred Certifications: | CPC |
Required Experience: | 3 to 4 years |
Preferred Experience: | 5 to 7 years |
Location: | Phoenix 85020, AZ, US |
Date Posted: | 8/17/2018 |
The Revenue Cycle Manager is responsible for the successful management, administration, and supervision of all functions related to insurance billing and collections performed in the central billing office. The Revenue Cycle Manager will create and review monthly reports, analyze outcomes, identify trends, and ensure timely and proactive communication to the Revenue Cycle Director and Leadership team. The Revenue Cycle Manager originates, implements, and leads billing office objectives that will provide IMS an employee-oriented, high performance culture that emphasizes empowerment, quality, productivity and standards, goal attainment, and the recruitment and ongoing development of a superior workforce.
Essential Job Functions
1.Development of the Billing Office Department•Works collaboratively with the Revenue Cycle Director on Key Performance Indicators (KPI’s) and effectiveness of the revenue cycle team.
•Manage all billing functions ensuring all claims are billed accurately, in complete compliance with regulatory and company requirements, and timely. Ensures accurate reimbursement is being received for services rendered.
•Manage the daily activities of the business office including front end coding, billing, claim review, denial management and payments.
•Active knowledge of CMS guidelines, contracted insurance guidelines and coding policies.
•Oversees and manages the work of billing office staff and encourages the ongoing development of the billing office staff.
•Respond to provider/staff request accurately and in a timely fashion.
•Participates in management staff meetings and attends other meetings and seminars.
•Works daily with the Revenue Cycle Director to define daily revenue expectations, discuss opportunities and resolve challenges.
2.Electronic Healthcare System•Maintain a strong working knowledge of the systems used and be prepared to provide support to staff and management when requested.
•Serve as a resource for the revenue cycle team and practice leadership by assisting them with the analysis of current performance through data. Support and help with interpreting the data to identify process improvements that support revenue cycle services.
•Remains current on the specific data requirements as dictated by various government and private insurance carriers and ensures the system/s are appropriately updated.
•Analyze, review, and develop reports necessary for the billing office to ensure IMS goals and guidelines are achieved.
3.Training and Development•Be hands-on in supporting the team with daily tasks.
•Encourages and assists with the ongoing development and education of staff.
•Defines billing office training programs by adequately supplying, identifying, and developing the resources required to achieve the IMS goals and expectations of billing operations.
•Responsible for managing the on-going user training for new hires and existing staff in the business office and clinics to ensure the systems are utilized to their fullest capabilities.
•Provides continuing education with regard to insurance carrier changes and updates.
4.Employee Relations•Partner with Revenue Cycle Director on policies and procedures throughout the billing operation to standardize operations, communicate expectations, and establish agreed upon outcomes.
•Partners with management to communicate policies, procedures, and programs that impact the practices within IMS.
•Supervise the performance and provide evaluation of the Revenue Cycle operations team and business office.
5.Organization Development•Leads the development of departmental goals and metrics for billing office to include but not limited to days in AR, Collection ratio, accepted timeframe of charge entry and payment posting.
•Trend and analyze denials and front end failed claims for training and development of clinic staff and revenue cycle team.
•Manages employee communication and feedback through such avenues as office/ departmental meetings, memos, and one-on-one meetings.
•Monitors revenue cycle worklists and buckets with the EHR and delegates accordingly.
•Mentor and monitor the volume of employees work in all departments of the central billing office.
•Maintains and understanding of front offices process and procedures for improvement initiatives as it applies to revenue cycle workflows.
•Ensures annual audits of providers and staff as needed to ensure accurate and timely coding and billing activities.
Education and Experience
Education and Certificates:
1. Bachelor degree in Health Care, Finance, Business Administration or a related field is required.
2. Certified Professional Coder (CPC) certification preferred.
Experience:
1. 2-5 years’ experience required, specifically overall revenue cycle management of a large (50-100+ providers) medical group practice with knowledge of the physician billing and insurance claim follow-up and denial management process.
2. 2-5 years minimum of direct management experience of a large staff (50-100), knowledge of the health plan websites, CAQH, Intelli App software program, GACCP, licensing boards, NPPS (NPI), Medicare (PECOS), National Provider DB and hospital CVO's preferred