Description

Position Description

This position manages all operational and strategic leadership functions related to the entire Revenue Department and all centralized revenue cycle functions in a multi-disciplinary, multi-specialty medical clinic setting. They oversee the teams and departments that manage accounts, communications with payor sources, collections, contract analysis, cash posting, billing transactions with clients, medical records and report creation: namely the patient collections, coding, insurance verification, insurance collections, medical records, liens, and accounts receivable departments within the Revenue Department. They implement quality control standards and audits to ensure that all coding is properly billed under the industry guidelines as set by the AAPC. 

Position Duties

The position requires the following primary duties to be successful:

• Managing the multiple components of the revenue cycle includes pre-authorization, eligibility and benefits verification, claims submission, payments, and payment posting, claims denial management, reporting, and any other functions that involve patient revenue management.
• Supervising the Coding and Charges Department in various duties, such as medical documentation review, proper CPT and ICD-10 documentation and entry, timely entry of all charges, and performing of quality control audits 
• Implementing and managing a system to ensure that accurate billing information is entered into the billing system
• Setting and meeting collections goals by department and for the organization overall. 
• Managing staff performance by providing regular feedback, performance reviews, and one-on-one meetings
• Overseeing the hiring and training of staff
• Attendees monthly and/or quarterly AAPC seminars to ensure all coding is aligned with the industry standard and changes 
• Planning and structuring the department workflow and staffing
• Correctly coding diagnoses and procedures
• Ensuring proper timely filing of all claims by implementing a timely standard of charge entry
• Annually reviewing and updating of chargemaster
• Collaborates professionally with clinical staff and all other departments to maintain unity and successfully resolve outstanding request
• Keeping updated records and tracking reports as required by management
• Ensuring proper filing of liens
• Other duties as requested of the Director of Revenue that are consistent with and appropriate for this position title and role

Position Expectations

To perform the position successfully, an individual is expected to:

• Provide proven experience as a manager of correct coding and documentation in the healthcare industry
• Demonstrable experience with coding and charge entry
• Knowledge of AAPC guidelines and industry-correct coding standards
• Sound knowledge of healthcare billing rules & regulations
• Working knowledge of MS Office & Excel
• Excellent communication and interpersonal skills
• A strong analytical mindset
• Outstanding organizational skills
• Be passionate and professional
• Be success-driven and metrics-focused
• Be smart; work smart
• Have a positive attitude
• Leadership by example
• Be a positive agent for change/improvements within their department

Position Metrics

The execution of the position is quantifiably measured by the following:

• Establishing, managing, and meeting department goals
• Maintains quality control standards for the department through documented quality control audits 
• Supports the successful attainment of the global revenue goal 

Position Requirements

• Minimum Education Level: Bachelor’s degree in Finance, Accounting, Healthcare Administration, or a related field. Master’s degree preferred.
• Revenue cycle certification is preferred.
• Minimum of 5-7 years of experience in revenue cycle management, preferably in a multi-specialty medical clinic or similar setting.
• Proven experience in a leadership role managing a revenue cycle team, as well as direct operational experience in all phases of the medical revenue cycle
• MS Office & Excel experience
• EHR and PM software experience
• Preferred: Ability to multi-task under time pressure. Strong communication and leadership skills 
• Be team-oriented and able to work with various departments. Be able to make sound decisions while on the move in a fast-paced organization.

Position Miscellaneous

• 40 hours per week; extended work hours from time to time to meet deadlines
• Setting goals, meeting deadlines, and being compliant with departmental policies
• Ability to interact, engage, and communicate effectively with executive management, managers, and clinic employees
• Physical Demands: Frequent sitting; limited lifting up to 10-15 pounds; frequent manipulation of documents; frequent typing or use of keyboard

Requirements

Position Requirements

Minimum Education Level: Bachelor’s degree in Finance, Accounting, Healthcare Administration, or a related field. Master’s degree preferred.

Revenue cycle certification is preferred.

Minimum of 5-7 years of experience in revenue cycle management, preferably in a multi-specialty medical clinic or similar setting.

Proven experience in a leadership role managing a revenue cycle team, as well as direct operational experience in all phases of the medical revenue cycle

MS Office & Excel experience

EHR and PM software experience

Preferred: Ability to multi-task under time pressure. Strong communication and leadership skills 

Be team-oriented and able to work with various departments. Be able to make sound decisions while on the move in a fast-paced organization.