RCM Supervisor (Revenue Cycle Manager)

RCM SUPERVISOR (REVENUE CYCLE MANAGER)

Essential Job Responsibilities:

• Maintains knowledge of the operational details of all positions in the Billing and Collections    department, which includes but not limited to insurance claim submission, clearinghouse and payor claim rejections, payment posting, insurance claim denial management, and patient collections.
• Initiates modifications of all procedural paperwork related to accounts receivable-encounter forms, billing verifications, etc.
• Meets with Billing and Collections staff monthly to analyze A/R reports, days in receivable, and collection statistics.
• Performs weekly billing audits to ensure timely and accurate processing of charge and payment posting.
• Conducts detailed audit of Explanation of Benefits forms from commercial and managed care payors at least biweekly; prepares or presents results to Executive Management.
• Meets with Collections staff to discuss difficult claims and provide solutions.
• Meets with Billing and Collections staff monthly to discuss key issues, overall accounts receivable performance, and opportunities for improvement.
• Trains and oversees performance of Billing, Collections and Verification staff; assists with recruitment, discipline, and termination.
• Monitors overall workload in the department and distributes work accordingly; ensures all posts are filled in case of vacation and sick days.
• Maintains fee schedule as well as CPT, ICD-10 CM, adjustment, payment, and payor files in the computer system.
• Maintains and distributes payment contracted schedules as received from contracted carriers; inputs/updates schedule into computer system.
• Requests payment schedules from contract carriers as needed.
• Prepares fee/payment comparative report quarterly.
• Maintains carrier contract files and the Compliance Binder.
• Completes all credentialing applications and reapplications as requested.

• Seeks and recommends ways to use technology to improve operational efficiency.
• Maintains patient confidentiality by following the HIPAA Compliance Plan established by the practice.
• Attends all meetings as requested and performs any additional duties as requested by Executive Management.

Job Requirements:

• Minimum 5 years of management experience within a hospital or medical billing company setting.
• Proven knowledge of Rev, CPT and ICD-10 CM coding (medical, mental health and substance abuse preferred)
• Integral knowledge of the A/R process.
• Proven managerial success in analyzing A/R reports.
• Proven successful management skills.
• Bachelor’s degree in business or related field a plus.

An Equal Opportunity Employer