JOB SUMMARY:

Under the direction of the Chief Financial Officer, the Revenue Cycle Manager is responsible to develop, plan, organize and implement current and future strategies to bill customers, process payments, minimize bad debt, improve cash flow and manage the overall health of the company’s receivables. Also responsible for managing the day-to-day activities of the company as they relate to revenue cycle functions.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. Assists in developing policies, guidelines, and implementing procedures and ensures consistent company-wide implementation.
2. Reviews the payer listing and ensures the payers are correctly set up in the systems.
3. Establishes and monitors standards for controlling the registration flow as well as the integrity and quality of data throughout the revenue cycle.
4. Evaluates and implements tools to improve efficiency and productivity in the management of fee schedules, payer contracts and accounts receivable.
5. Champions revenue cycle improvements throughout the organization including working with appropriate individuals including medical records, billing, denial management, etc. to aid in the resolution of identified revenue cycle issues.
6. Performs ongoing trend analysis on third party payer payment levels to ensure that reimbursement is in accordance with allowable amounts stated in agreements and contracts. Works with appropriate individuals to resolve discrepancies.
7. Performs ongoing trend analysis of third party payer rejects and denials. Develops training programs for registration, billing, and coding staff to eliminate/reduce rejects/denials.
8. Provides direction and leadership within the reimbursement, coding and compliance, information systems, and credentialing business units.
9. Monitors timeliness and effectiveness of department activities, ensuring that outstanding patient accounts and accounts receivable is no more than the agreed upon limit and that bad debt is within budgeted target.
10. Monitors effectiveness of collection efforts and maintains insurance billings are current within the established time frame specified in the department policy.
11. Monitors and makes decisions regarding the value and collectability of accounts receivable (AR). Makes recommendations and procedures to keep days of revenue in AR at acceptable levels. Prepares monthly analysis and reports pertaining to AR.
12. Implements and monitors collection procedures, minimizing contractual and bad debt write offs, and maximizing cash collections.
13. Compiles and prepares various status reports for management in order to analyze trends and make recommendations.
14. Assists in reviewing the lead for annual fee schedule updates and develops fees. Ensures that fee schedule is current with reimbursement trends.
15. Designs and develops training programs that are relevant and necessary for the continuous development of the technical competencies of the team.
16. Recommends and implements for appropriate training programs that will further enhance and hone the technical competencies of the staff.
17. Develops and formulates performance measures and standards for the team, as basis for the conduct of annual performance management review program.
18. Reviews and evaluates the performance of the team, on regular and periodic basis, and ensures the overall performance of the team is on track, and well within the pre-established goals and objectives.
19. Establishes and maintains proper internal control throughout the organization.
20. Ensures that HIPAA Notice of Privacy Practices is on display, if applicable.
21. Implements state and federal regulation on clinic records management.
22. Perform all other duties as directed either formally or informally, verbally or in writing.