What are the responsibilities and job description for the Revenue Cycle Manager position at Shenandoah Valley Medical System Inc?
The Revenue Cycle/Billing Manager is responsible for the oversight and management of the Billing Office. S/He manages staff for efficiency and effectiveness, monitors benchmarks and reviews performance statistics. The manager is responsible for working with individual departments and Practice Managers alone or in conjunction with the assigned Billing Specialist to support the goals and protocols of revenue cycle workflow or revenue affecting tasks. The individual must be able to process large quantities of data to monitor Key Performance Indicators (KPI) and research all barriers to successful revenue cycle management. This position requires applicant to “lead” the revenue cycle process.
Role & Responsibilities:
- Oversight and management of Revenue Cycle Management functions. Lead monthly RCM meetings.
- Successful distribution of work among staff members to drive work allocation and productivity management.
- Measure and monitor efficiency and effectiveness of staff.
- Manage new staff onboarding, including compliance, training, testing, and shadowing.
- Ability to research and process large quantities of data, analyze trends and identify areas where behavior is not compliant with expectations. Communicate accordingly through prescribed avenues based on organizational policy and process.
- Identify organization improvement opportunities based on performance metrics and trends. Be innovative in ways to eliminate waste in processes.
- Research and direct claims resolution in Athena using associated system knowledge of upstream and downstream impact of work.
- Oversight and management of revenue cycle system tables (i.e. insurance, interface, fee schedule).
- Work with individual departments and practice staff to support the goals and protocols of revenue cycle workflow or revenue tasks.
- Research and assist Practice Managers and Accounting team with any/all barriers to successful revenue
cycle management and monitor KPI’s for all locations.
- Define root cause analysis and drive claims resolution.
- Utilize all available reporting tools to provide insight into the financial health of the organization.
- Communicating with Managed Care companies acting as a liaison representing the Revenue Cycle Management for all reimbursement issues and goodwill communications.
- Personally practice the fundamentals of Influencing Options and Core Dimensions. Ensure staff adheres to IOCD principles.
Essential Skills and Education Requirements:
- Excel Spreadsheets, Microsoft Word, and other general office processes and tools such as scanning, faxing, email, and interfaces systems.
- Relative State specific laws; Relative State Insurance Laws.
- Process of credentialing / enrollment.
- Modifiers, CPT, and ICD-10 resources.
- Registration, scheduling, check in and check out, pre-visit workflow (including eligibility), Day End Review, and other procedures, processes, and tools both in organizational policy and PM system.
- Bachelor’s degree from an accredited college in healthcare administration, business, accounting, or finance, preferred.
- 10 years of experience in medical billing, with knowledge of current trends in Medicaid and commercial insurance.
- 5 years of experience in management.
- CPC, CPB, CRCR or similar revenue cycle certification.