Why You’ll Love This Job
The Revenue Cycle Manager will be responsible for the accurate day-to-day management of all aspects of billing and accounts receivable. This role will also work closely with the Chief Financial Officer and assist with credentialing, contracting, and payor management. While the Manager will help to build out the department and processes, it is also a hands-on role that will require one to be able to perform all daily tasks of the team. The ideal candidate will be comfortable in a fast-paced, innovative, startup environment.
Job Duties and Responsibilities
To perform in this position successfully, an individual must be able to perform each key responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned to meet business needs.
Revenue Cycle Oversight:
- Manage and oversee all aspects of the revenue cycle process, including patient registration, charge capture, coding, claims submission, payment posting, denial management, and collections.
- Develop and implement strategies to improve revenue cycle performance, enhance cash flow, and minimize financial risk.
- Monitor key performance indicators (KPIs) related to revenue cycle operations, identify trends or issues, and take appropriate actions for improvement.
Billing and Coding Compliance:
- Ensure compliance with coding guidelines, billing regulations, and payer requirements.
- Stay updated with industry changes, such as coding updates and reimbursement policies, and communicate necessary updates to relevant staff members.
Claims Processing and Denial Management:
- Oversee the timely and accurate submission of claims to insurance companies or government payers.
- Monitor claim status, analyze denials, and implement corrective measures to minimize claim rejections and denials.
- Coordinate with Medical Billing Specialist to address claim discrepancies, resolve issues, and ensure proper reimbursement.
Financial Analysis and Reporting:
- Analyze revenue cycle performance data, financial reports, and trends to identify opportunities for improvement and optimize revenue.
- Generate regular financial and operational reports for management, highlighting key performance metrics and areas of concern.
- Develop and implement strategies to reduce accounts receivable days, increase collections, and decrease bad debt.
Staff Training and Leadership:
- Foster a collaborative and supportive work environment, promoting teamwork and professional development.
- Stay informed about industry best practices and advancements in revenue cycle management.
Compliance and Regulatory Adherence:
- Ensure compliance with healthcare regulations, such as HIPAA and other privacy laws, as well as billing and coding standards.
- Stay updated with changes in regulatory requirements and communicate necessary updates to the revenue cycle team.
- Conduct regular audits to identify compliance gaps and implement corrective actions.
Qualifications
Education and Experience Requirements
- Bachelor’s degree in healthcare administration, finance, or a related field (additional certifications such as Certified Revenue Cycle Representative (CRCR) or Certified Revenue Cycle Professional (CRCP) are desired).
- 3-5+ years of proven experience in revenue cycle management, preferably in a healthcare setting.
Knowledge, Skills and Abilities
- In-depth knowledge of healthcare revenue cycle processes, including billing, coding, claims processing, and reimbursement.
- Familiarity with medical coding systems (such as CPT, ICD-10, and HCPCS) and billing software.
- Strong analytical and problem-solving skills, with the ability to interpret financial data and make data-driven decisions.
- Effective communication and interpersonal skills, with the ability to collaborate with diverse stakeholders.
- Knowledge of healthcare regulations and compliance standards, including HIPAA.
- Proficiency in using computer systems and software for data analysis and reporting.
- Strong ethical standards and the ability to maintain confidentiality.
- Willingness to undergo background checks, drug screenings, and comply with relevant financial and health regulations.
OFFOR Health Benefits
OFFOR Health currently offers full competitive employee benefits including medical, dental and vision insurance, LTD, STD and Group Life insurance, 401(k) retirement plan, flexible time off and paid holidays.
OFFOR Health does not discriminate on the basis of actual or perceived race, religion, color, national origin, ancestry, disability, medical condition, marital status, sex, age, sexual orientation, gender identity or expression, family responsibility, personal appearance, genetic information, matriculation, political affiliation, or any other status protected under law.
Type: Full Time (Salaried)
Job ID: 144464