The Revenue Cycle Manager performs oversight and planning of the billing and revenue cycle processes with special attention to billing outcomes and performance. This includes strategic planning, analysis of process, understanding of electronic health information system, and leadership in implementing change over multiple departments, as well as management of day-to-day operation with staff. Duties include responsibility for the Hospital’s Registration/scheduling department, Health Information Management department, and Business Office department. With team building skills and healthcare billing experience this position will lead staff and implement productive processes to assure optimum billing performance and patient experience.
Plans, organizes, and directs activities of registration/scheduling department. Responsible for efficient admission of inpatients, outpatients, emergency, and/or clinic patients, and accurate effective record keeping of relevant data. Scheduling includes the management of call center for scheduling and other Hospital and Clinic calls. Maintains high patient experience by promoting a welcoming and inviting interaction with patients and managing up the excellent and quality service provided.
Plan, organize and direct functions of the Business Office. Establishes policies and goals of the department. Administers programs of patient accounting insurance processing, collection, and government reimbursement programs. Responsible for denial management and ensuring timely submission of bills. Reviews and develops procedures and processes to ensure services provided are appropriately captured and charged. Coordinates and facilitates compliance audits on billing data elements. Directs compliance and quality reviews and provides feedback, discussion, education, and process improvement. Facilitates and influences the certification and enrolling process with payers for the Hospital and practitioners to meet any new requirement or for any new professional providers to assure prompt ability to bill for services rendered.
HEALTH INFORMATION MANAGMENT
Plan, organize and administer the hospital's Health Information Management Department. Implements policies and methods to assure that the most accurate and efficient systems are used for appropriate coding to ensure adherence to third party payer regulations and standards and for services rendered. Provides payer regulatory billing and reimbursement training and education to physicians, providers, and staff to communicate documentation requirements. Appropriately maintains medical records of patients and establishes standard procedures and instructions in accordance with regulations and compiles statistics for reports and surveys. Ensures an appropriate charge master is maintained with appropriate code setup and pricing.
WORKFLOW AND PROCESS IMPROVEMENT
Works collaboratively with Hospital leaders, the electronic health record system support team and employees for effectiveness and integrity in the charging and billing functions. Serves as a leader in education on payment and billing and is responsible for educating and reeducating on billing and payment rules and updates to ensure compliance with changing policies, guidelines, and regulations. Analyzes reports and gives periodic or necessary presentation for tracking work process effectiveness. With analysis and employee feedback, sets appropriate goals and expectations for staff to obtain improvements.
Experience in strategic planning, analysis of processes, understanding of electronic health information system, and leadership in implementing change over multiple departments as well as management of day to day operations with staff are preferred. Previous experience in a hospital along with prior management experience is required. Familiarity with EPIC health information system is a plus.
Education: Associate’s degree in related field. Bachelor’s degree in related field is preferred.
Experience: For bachelor degree with a related major, 2 years of experience; otherwise 5 years of related experience. Preferred experience is 5 years or more of healthcare related experience
Certificates held in related fields preferred.
· Analytical Skills
· Attention to Detail
· Communication Skills
· Computer Skills
· Financial Matter Knowledge
· Leadership Skills
· Social Skills
· Speaks and writes fluent in English
· Software knowledge (EPIC, Excel, Word, PowerPoint)
· Presentation skills
· Project implementation experience
· Knowledge in insurance billing and coding