Revenue Cycle Manager

The Revenue Cycle Manager (RCM), reporting to the Senior VP of Revenue Cycle Management (RCM), acts as a strategic leader for all revenue cycle functions and activities with the goal of optimizing revenue. This position is responsible for ensuring compliance with third party payor requirements as well as all applicable state/federal laws and regulations.

The Manager of RCM is accountable for ensuring the coordination of operations, procedures, and best practices for billing, collections and follow up, and denials management for the assigned practices and specialty service lines. Specific functional areas of oversight include payment posting; EDI claims and statement submission; AR follow up for insurance and self-pay; and collections workflows. The director works closely with registration, coding and clinical areas to optimize revenue collection while ensuring a seamless billing experience for patients.

Responsibilities

• Directs all activities for assigned revenue cycle areas, ensuring optimal revenue collection and patient satisfaction with the billing experience and ensuring compliance.
• Leads a team of revenue cycle managers, supervisors and team members ensuring efficient and compliance in all areas of revue cycle, while optimizing collections.
• Works closely with IT department to optimize the use of technology to automate revenue cycle functions
• Performs RCA (Root Cause Analysis) to resolve problems affecting the revenue cycle and develop solutions to implement.

• Monitors and develop key performance indicators
• Develops and maintains appropriate internal controls in the Patient Accounts department
• Ensures compliance with USAVC policies and procedures, health plan requirements, and federal and state laws and regulations
• Additional duties as assigned

Requirements

• Bachelor's Degree required; Masters preferred in a related field
• Minimum of 8 years progressively responsible revenue cycle experience is required
• Minimum of 4 years prior revenue cycle experience in a physician-driven Patient Accounts department is required
• Proven success in achieving revenue cycle efficiencies and improving cash
• Track record of employee development
• Thorough understanding of physician billing practices and procedures, including knowledge of state, local and federal laws
• Strong knowledge of reimbursement rules and methodologies for both physician and ambulatory surgery billing
• Strong knowledge of Microsoft Excel (VLOOKUP and Pivot Tables)

Benefits

• Health
• Dental
• Vision
• 401K