Revenue Cycle Manager
Job Details
Management
Family Health/La Clinica-Stevens Point - Stevens Point, WI
Full Time
4 Year Degree
Negligible
Finance
Description

Revenue Cycle Manager is responsible for managing the overall functions of the revenue cycle for FHLC. Responsible for the maximization of revenue and cash flow while maintaining the highest levels of patient, physician and employee satisfaction and relations. This includes management oversight of all business-related functions of the patient visit from point of entry to accurate adjudication of the patient's account. Specific areas of responsibility include coding, billing and collections, patient insurance data processing, denials management, integrity of patient accounts and accounts receivable management. The Revenue Cycle Manager is responsible for the direction of these efforts to ensure the accuracy and timeliness of charge capture, coding, claims submission, follow-up, denial and underpayment management.

 

  • Directs and oversees the overall policies, objectives, and initiatives of the revenue cycle activities to optimize the patient financial interaction with FHLC.
  • Reviews, designs, and implements processes surrounding pricing, billing, third party payer relationships, compliance, collections and other financial analyses to ensure that clinical revenue cycle is effective and properly utilized.
  • Responsible for oversite of all areas of Revenue Cycle functions of coding, billing and collections, patient insurance data processing, denials management, integrity of patient accounts and accounts receivable management. Serves as a point of contact for issues related to insurance, Medicaid, Medicare, and the sliding fee program.  
  • Manages relations with payers and providers to generate high reimbursement rates and a low level of denials.
  • Tracks numerous metrics related to the patient engagement cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.
  • Plans and prepares monthly revenue reports for review and utilization by CFO.
  • Prepares and analyzes statistical data identifying Key Performance Indicators. These key performance indicators include areas related to, cost to collect, aged A/R by Payer, Days in A/R, Collection vs. Net Revenue with ongoing improvement to key performance indications.
  • Supervises billing office personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
  • Perform regular billing and coding audits, including compliance audits.
  • Strong working knowledge of clinic revenue cycle management, applicable Federal and State laws and regulations, all aspects of third-party reimbursement policies and practices, and knowledge of Current ADA, CPT, HCPCS & ICD-10 coding.
  • Assist in the development of a revenue cycle departmental budget and is responsible for managing the department within the established budget.
  • Performs other duties as assigned.

 

 

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. This position requires an individual, who has the ability to work independently, is able to work under pressure, is analytical and has excellent problem-solving skills. Ability to establish and maintain effective working relationships with patients, employees and public.

 

  • Bachelor's degree strongly preferred however equivalent experience may be substituted.
  • Minimum of five to seven (5-7) years previous billing experience in medical or dental operation required, understanding of billing rules and regulations for behavioral health preferred.
  • Experience in self-pay collection processes desired.
  • Experience with community health center billing processes preferred.
  • Minimum of 3 years Managerial/Supervisory experience in billing operation.
  • Knowledge of business management and basic accounting principles to direct the billing and coding office.

 

English and/or Spanish language preferred. Ability to read & interpret documents, reports & correspondence. Ability to speak effectively before groups and/or individuals.

 

 

Family Health La Clinica is an Equal Opportunity Employer.

 

 

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