REVENUE CYCLE MANAGER

The Revenue Cycle Manager (RCM) is responsible for managing and overseeing the

revenue cycle activities in accordance with the organization’s policies and procedures

and ensures accurate and timely processing, collections and postings of insurance

revenues. All employees are expected to identify opportunities to improve workflow,

work processes and patient care and to work cooperatively to implement those

improvements.

ESSENTIAL FUNCTIONS

• Serve as the practice expert for all coding and billing functions and processes
• Build and maintain an efficient billing process, including creating appropriate internal policies and procedures related to coding and billing
• Work cross-functionally with all internal departments to answer questions, resolve problems and train new staff on coding and billing practices
• Oversee the operations of the billing and collections vendor, including coding, charge entry, claims submissions, payment posting, A/R follow-up and reimbursement management
• Oversee internal patient insurance documentation to ensure accurate billing and efficient account collection
• Analyze weekly, monthly and yearly related financial reports and make recommendations to the CFO for improvements
• Ensure all billing activities are consistent with protocols and in compliance with government and payer regulations
• Develop reports for the finance department for use on the state and federal grants
• Other tasks as assigned by CFO

PRIMARY ACCOUNTABILITIES

• Ensure that all revenue cycle activities meet or exceed the organization’s financial and operational goals and are compliant with all internal policies as well as state, local, and federal laws, regulations, regulatory and/or best practices.
• Maximize reimbursement in a cost-effective manner that is in compliance with federal/state and payer-specific billing requirements.
• Develop systems and procedures to improve the quality and efficiency of the revenue cycle function.
• Collaborate effectively with appropriate departments across the organization.
• Develop and maintain favorable internal relationships and partnerships with co-workers.
• Ensure all actions, job performance, personal conduct and communications represent El Centro de Corazón in a highly professional manner at all times.
• Uphold and ensure compliance and attention to all company policies and procedures as well as the overall mission and values of the organization.

• Associate degree in business related field; Bachelor’s degree preferred
• Certified Professional Coder (CPC) or other medical coding certification preferred.
• EPIC experience preferred.
• 3 to 5 years of relevant healthcare revenue or medical billing cycle experience, which includes coding.
• Strong knowledge of clinical practice and revenue cycle management including third party reimbursement guidelines and procedures.
• Strong knowledge of CPT and ICD coding and related regulations and guidelines.
• Experience with short and long-term budgeting and forecasting.
• Experience with state and federal grant management preferred.
• Strong knowledge of billing and collections processes and procedures for dental, family planning, and behavioral health claims.
• Experience with FQHC billing and revenue cycle activities strongly preferred.

Salary : $78,000 - $85,000