Revenue Cycle Manager

Revenue Cycle Manager

About Us:
 San Francisco Community Health Center is a Federally Qualified Health Center (FQHC) providing culturally competent, high-quality medical care, mental health services, education, and outreach. We are a safety-net for the LGBTQ community, the unsheltered community, people who use substances, and those with mental health needs. We are an anchor-organization for San Francisco’s Tenderloin neighborhood and we also lead regional, statewide, and national programming. We believe that everyone deserves access to the highest quality care served with dignity and respect!
 

About You: 

• You focus and center your work around giving a high level of service.  
• You are empathetic, responding to any situation with compassion and curiosity. 
• You are driven by your own internal integrity as well as that of the agency. 
• You have a justice and equity mind-set.  
• You feel that everyone deserves dignity and respect.
•  You pay attention to details no matter how big or small.  

Position Description: 

Revenue Cycle Manager [RCM] oversees the financial flow of patient services at San Francisco Community Health Center.  The Manager is crucial to the cash flow improvement of SFCHC through accurate coding, timely billing and collections, denial management and effective patient accounts management.  RCM collaborates with clinical operations on patient eligibility and insurance verification to securely compile accurate billing information.  The RCM commits to highest level of patient confidentiality in adherence to HIPAA and Protected Health Information [PHI].   
 

Essential Duties:

• Reconciles all receivable and patient service revenue reports, working closely with the Controller on producing monthly financial reports 
• Creates patient revenue, visit utilization and productivity provider, by financial class and payer weekly, monthly and year-to-date 
• Tracks metrics, such as visits or encounters, charges, denials and rejections, coding error rates, patient engagement and billing turnaround times 
• Meets weekly with clinical operations to ensure charges are closed, captured and coding issues are resolved  
• Creates weekly patient revenue reports, payments and adjustments, denials and rejects, productivity and utilization  
• Serves as main contact for third-party billing [OCHIN], DHCS-M-CAL, CMS-Medicare, clearing house vendor [Tri-Zetti] and commercial insurances 
• Sets the annual fee schedule and the publication of Sliding Fee Discount table in accordance with federal poverty guidelines 
• Implements coding changes and provides up-to-date education for clinical, billing and coding staff on CPT and ICD-10 coding trends 
• Develops, evaluates, revises and implements polices and procedures related to billing, coding, rate reimbursements and improvement strategies 
• Meets with the 3^rd party outside service [Ochin Billing Services] weekly, ensuring that invoices for clinical services are processed accurately and timely 
• Keeps abreast of all reimbursement billing procedures and regulatory requirements 
• Monitors and accounts for collection adhering to SFCHC bad debts and write-offs policy 
• Participates in negotiating contracts with payers and maintaining relationships with insurance companies 

Minimum Qualifications: 

• Deep understanding of billing and coding policies and procedures in the healthcare sector, preferably in a federally qualified health clinic[s] 
• Exceptional analytical and problem-solving skills to identify areas of revenue weakness and gaps and devise strategies to increase revenue 
• Excellent communication skills to clearly explain coding errors to clinical providers 
• Good understanding of medical billing software and other relevant applications 
• Strong ethical standards to ensure compliance with all relevant laws, regulations and industry standards 
• Ability to handle multiple tasks and prioritize workload for efficient management patient billing issues and other concerns related to revenue cycle 
• Detail-oriented with the ability to maintain accurate and thorough financial records 
• Fully vaccinated against COVID-19, complete with booster shot(s) and able to show proof of vaccination 
• Up to date with vaccinations, especially seasonal flu shot vaccine 
• Proof of TB clearance (issued within the past 12 months or less) 
• Comfortable and culturally competent in working with LGBTQ communities 

Education, Training, and Experience:

• Bachelor’s degree in finance, health management, or a related field with certification in billing or medical coding is highly desirable 
• Deep understanding of health care finance, business management, CPT-ICD coding, health information systems, healthcare laws and ethics. 
• Proficiency and relevant experience in California Medi-CAL billing and health payment methods, CAL-AIM or expanded Medi-CAL, whole person care, enhanced care management and provider credentialing or plan enrollment 
• Seven to ten years’ experience in medical billing or medical coding with an FQHC or CHC 
• Five to seven years as supervisor or 3 years relevant experience in management. 

Benefits: 

• Competitive compensation  
• Comprehensive health, vision, and dental insurance  
• Company sponsored life, and long-term disability insurance  
• Generous paid time off including paid holidays  
• Company-sponsored retirement plan  
• Opportunities for professional growth and development  
   

EEOC Statement: 

San Francisco Community Health Center is an equal opportunity employer committed to identifying and developing the skills and leadership of people from diverse backgrounds. San Francisco Community Health Center does not discriminate on the basis of age, ancestry, citizenship status, color, creed, disability status, gender identity, HIV status, marital status, medical condition, genetic information, national origin, pregnancy, race, religion, sex, sexual orientation, veteran status, or any other legally protected class.