Revenue Cycle Manager Job Description

SALARY: TBD

REPORTS TO: Chief Operating Officer

SUMMARY: The Revenue Cycle Manager manages all aspects of the patient billing process, including billing, coding, compliance, reimbursement, and receivables. Responsibilities include accurate and timely completion of the revenue cycle process and supervising a team of billing specialists, monitoring and supporting their efficiency and effectiveness. This role will take the lead in the development of effective processes, maintaining current knowledge of changes in coding and compliance standards and payer policies, analyzing data for reimbursement trends, managing denial processes, and interfacing with internal and external leaders to resolve identified issues within the revenue cycle. The person in this position must be able to multi-task and function in a fast-paced environment. 

DUTIES AND RESPONSIBILITIES: 

• Manages the electronic and paper claim submission process.
• Ensures all data elements are properly loaded in the billing system and updated as needed.
• Ensures claims are submitted timely for processing by payers.
• Ensures and reviews all payer-related items are accurate and up to date.
• Manages billing error reports to ensure claims are being submitted to payers accurately.
• Manages projects for all insurance plans for payment of services.
• Manages patient collections, reimbursement, and provider enrollment issues regarding payment of claims.
• Addresses escalated patient calls and ensures situations are resolved in a tactful and professional manner.
• Serves as backup for billing specialists as needed.
• Provides education and shares knowledge with team and providers to enhance coding and documentation practices to maximize organizational reimbursement.
• Updates and manages practice chargemaster and ensures allowables are correct. 
• Other duties and responsibilities as assigned

SUPERVISORY RESPONSIBILITIES:

• Directly supervises staff in there office
• Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
• Responsibilities include planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. 

QUALIFICATIONS:

• Excellent verbal and written communication skills.
• Commitment to excellence and high standards.
• Strong organizational, problem-solving, and analytical skills; able to manage priorities and workflow.
• Ability to work independently and as a member of various teams and committees.
• Acute attention to detail.
• Ability to deal effectively with a diverse group of individuals at all organizational levels.
• Good judgement with the ability to make timely and sound decisions
• Demonstrated ability to plan and organize projects.
• Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.

EDUCATION AND EXPERIENCE:

• Bachelors Degree and 3-5 years experience in revenue cycle management in a physician provider setting, or equivalent combination of education and experience, required. 
• 1-2 years of supervisory experience required.
• Pediatric coding experience required

COMPETENCIES:

• Customer Service--Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Interpersonal Skills--Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. 
• Oral Communication--Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. 
• Written Communication--Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
• Teamwork--Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. 
• Change Management—Develops workable implementation plans; Communicates changes effectively; Builds commitment and overcomes resistance; Prepares and supports those affected by change; Monitors transition and evaluates results 
• Delegation--Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities; Provides recognition for results.
• Leadership--Exhibits confidence in self and others; Inspires and motivates others to perform well; effectively influences actions and opinions of others; Accepts feedback from others; Gives appropriate recognition to others.
• Managing People--Includes staff in planning, decision-making, facilitating and process improvement; Takes responsibility for subordinates' activities; Makes self-available to staff; Provides regular performance feedback; Develops subordinates' skills and encourages growth; Solicits and applies customer feedback (internal and external); Fosters quality focus in others; Improves processes, products and services; Continually works to improve supervisory skills. 
• Diversity--Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; educates others on the value of diversity; promotes a harassment-free environment; Builds a diverse workforce.
• Ethics--Treats people with respect; Keeps commitments; inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
• Judgment--Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
• Professionalism--Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. 
• Quality--Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality. 
• Safety and Security--Observes safety and security procedures; Determines appropriate action beyond guidelines; Reports potentially unsafe conditions; Uses equipment and materials properly.
• Adaptability--Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
• Attendance/Punctuality--Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time. 
• Dependability--Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan. 

Equal Employment Opportunity

It is the policy of AKP to provide equal employment opportunity to all employees and applicants for employment and not to discriminate on any basis prohibited by law, including race, color, sex, age, religion, ancestry, national origin, marital status, veteran status, or other legally protected group status. It is our intent and desire that equal employment opportunities will be provided in employment, recruitment, selection compensation, benefits, promotion, demotion, layoff, termination and all other terms and conditions of employment. AKP is committed to this policy and its enforcement

Other Duties

Travel: Travel is required between the various Angel Kids Pediatrics locations at times.

Work Environment

This job operates in a professional medical office environment. This job also operates in a fast paced, highly customer service environment, working with Children and Family/ Guardian’s. This role routinely uses standard office equipment such as laptop computers and smartphones as well as medical equipment.

Physical Demands

While performing the duties and responsibilities of office manager, you will be required to stand, walk or sit for long hours. The employee must be able to occasionally move or lift at least 10 lbs. The employee must be able to communicate efficiently in front of large or small crowds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. 

Position Type/Expected Hours of Work

This is a full-time position expected to work 40 hours per week. The office hours are Monday through Friday, varying from 9am to 9pm with weekend hours. The manager may be needed during those hours but is expected to work between 8:30am to 6pm. Occasionally the manager may be needed to take calls on the weekend.