Senior Manager, Revenue Cycle

Description

SUMMARY:

The Senior Manager, Revenue Cycle manages and oversees areas of Revenue Cycle Management, which may include all or parts of insurance verification and authorization, billing, and collections for the organization. The Senior Manager, Revenue Cycle is responsible for maximizing the productivity and minimizing the errors of the Revenue Cycle Department using structured auditing and reporting methodologies combined with follow-up training. The Senior Manager, Revenue Cycle will assume a strategic and practical role in the Revenue Cycle department to include day-to-day responsibility for processing and strategy, planning, management and analysis, and policy development and automation.

ESSENTIAL FUNCTIONS:

To perform this job successfully, an individual must be able to perform each essential function satisfactorily with or without accommodation. The requirements listed below are representative, but not all inclusive, of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

• Oversees the day-to-day activities of full Revenue Cycle Management tasks including insurance verification and authorization, billing, collections, and/or payment posting.
• Oversees denials management and appeals, including reporting, accountability, and resolution.
• Works directly with Revenue Cycle Director to meet all department goal, projects and KPIs.
• Protects confidentiality within the parameters of federal guidelines and established policy and process as well as compliance with payer and provider contracts.
• Leads in development and implementation of policies/procedures to assure compliance with new regulatory standards affecting billing/revenue.
• Managing, training, and coaching Leads, Senior Leads and individual team members, including creating personnel development and succession plans and partnering with HR as needed to maintain an engaged and productive team.
• Summarizes and communicates revenue cycle successes, challenges, and trends to the Revenue Cycle Director.
• Creates and implements metrics for productivity and quality.
• Creates, develops, and implements Standard Operating Procedures (SOP), streamlines processes.
• Collaborates with the Finance team to manage the month-end close and annual audit processes.
• Manages all hiring, time keeping, performance reviews, performance actions and termination.
• Manages all assigned projects to ensure the deliverables are fulfilled.
• Maintain an appropriate professional appearance and demeanor in accordance with Company policies.
• Keep commitments and keep direct supervisor informed of work progress, timetables, and issues.
• Maintain strict compliance with State, Federal and other regulations (e.g., OSHA, WC, HIPAA, ADA, FEHA, DOL, HR policies and practices).
• Other duties as assigned by management.

Requirements

QUALIFICATIONS:

REQUIRED: Bachelor’s Degree in Business, Finance, Accounting, Healthcare Administration or equivalent. Minimum 5-7 years of billing experience, including minimum 3-5 years of staff management experience. Experience with working in an integrated health care system required. Must have experience and be A/R oriented, daily and monthly closings, and understand the revenue cycle for all payers. Demonstrated knowledge of all Insurance companies, HMO's, PPO's, Medicare, third party payers. Directly overseeing payer and provider billing, collections, and cash posting. Facilitating communication between and extracting relevant information from a variety of stakeholders in order to comprehensively identify problems and subsequently create sustainable and scalable solutions. Knowledge of Microsoft Office Suite.

DESIRABLE: Master’s Degree in Business, Finance, Accounting or Healthcare Administration. Considerable prior coursework or on-the-job training in ophthalmology, insurance, and management. Knowledge of CareCloud and Advantix.

CERTIFICATES/LICENSES/REGISTRATIONS:

• Revenue Cycle Certification (preferred).

KNOWLEDGE/SKILLS/ABILITIES/TALENTS:

• Ability to optimize the Revenue Cycle (through the team members, operational processes and detailed data analysis).
• Results driven; aligns and allocates time and energy on key drivers.
• Understands key metrics, revenue drivers, and ROI expense analytics.
• Strong research and auditing skills. Can analyze financial information and determine impact on the business.
• Ability to identify and resolve issues in a timely and proactive manner.
• Clearly communicates vision an