RI International is the leader in Peer-Powered Support to those in crisis for mental health and substance use.

Our Mission is to empower people to recover, succeed in accomplishing their goals, find meaning and purpose in life, and reconnect with themselves and others.

Our Vision is to activate the next generation of frame-breaking healthcare innovation to support people beyond their behavioral health needs and succeed in the community where they live, work, and play.

Job Type

Full-Time: Exempt

Shift

Monday-Friday

Shift Hours

8:00am to 5:00pm

Specialties / Licenses or Certifications

N/A

Work Setting

Hybrid (Live & Work within the State of Ohio)

Salary/Hourly Wage

$65,000 - $75,000

Our Position

Our Revenue Cycle Manager is responsible for managing, monitoring, and analyzing the Claims, Billing and A/R functions performed by both RI staff and contracted staff. Must provide leadership, direction and training to all billing staff and meet the needs of payers, co-workers, and customers in a culturally diverse and increasingly demanding healthcare environment. Oversee the month end process and ensure timely reporting to finance within prescribed timeframes. Act as Liaison between Netsmart/RCM, RevConnect our clearing house, and Topaz/ NextGen and Recovery Innovations.

Your Responsibilities

• Responsible for managing agency's client services billing functions to assure billing is prepared, submitted, and reconciled in a timely manner.
• Responsible for billing submissions to clearing house and funder portals and achieves a 95% clean claim adjudication within 30-45 days from date of service.
• For Fee-For-Service Responsible for AR more than 60 days reporting to Management in programs and investigate the source and root cause of non-payment.
• Analyzes actionable claims data, including rates per funder, revenue, and volume, by state, procedure code, and diagnosis codes for claims reimbursement.
• Supervise and assist billing office staff in the daily process of charge capture and billing.
• Ability to perform one on one and evaluate staff daily performance and use as a tool for annual evaluations.
• Supervise collections payment/adjustment, posting of EOB and reconciling for any short or no pay items, Then timely reporting of exceptions.
• Maintaining file maintenance of funding silos and pay for performance billing that are Supper Bill related.
• Work directly with eligibility and front office admin staff at each clinic to review first and secondary insurance eligibility and verification of eligibility and credentialing errors on reports.
• Work directly with Program Managers & staff to ensure successful submission of all billing.
• Reconciles claims submission with payments and denials as reflected on an Explanation of Benefits and resubmits denied claims within 30 days of denial.
• Responsible for tracking and distributing all incoming workload.
• Manage special projects as required by funders/ management.
• Monitors performance indicators for Revenue Cycle Management staff.
• Monitors reports to ensure contract compliance with various agency contracts.
• Monthly reports and quarterly analysis of accounts receivable and billing issues Assists managers in developing and implementing plans for correcting contract encounter/billing compliance problems.
• Oversees client enrollment function including accurate recording of client Title XIX status.
• Monitors encounter submissions by fund type against contract dollar amounts allotted.
• Provide direction and training to all direct reports and assist with team training as needed.
• Verifies contract accuracy with payers and the agency's contract program.
• Reviews service codes and billing requirements assuring compliance to obtain clean claim submission.
• Identifies need for Practice Management Systems enhancements and coordinates implementation with the Senior Director of Billing Operations
• Interacts daily with Company's external customers and funders.
• Understands and adheres to RI International compliance standards as they appear in the Code of Conduct and Conflict of Interest Policies.
• Performs other related duties as assigned.

Our Requirements

• At least 3-5 years of supervisory or management Healthcare experience required.
• Strong leadership, team development and business skills and thorough understanding of billing and collections and payment posting, revenue cycle. Medicare/Medicaid funder regulations.
• Detailed oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment.
• Intermediate to Advanced proficiency in Microsoft Excel.
• Ability to maintain a high level of confidentiality (HIPAA guidelines and regulations) and professionalism.
• Must have a valid driver license and be 18 years of age.
• Must have the ability to walk, climb, stoop, reach, crawl, crouch, kneel, push, pull and lift a minimum of 10lbs.
• Must have excellent written and verbal communication, with particular emphasis during telephone calls, follow-ups, and in-person correspondence.
• We are a Second-Chance Employer
  • Must be able to pass a seven-year background check.
  • Must be able to pass substance abuse testing and/or tuberculous testing (if applicable).
  • Must be able to pass an education verification check.
  • Must be able to pass a three-year motor vehicle report and meet minimum eligibility requirements criteria of insurance carrier (if driving is required for this position).

RI International is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran status, race, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable laws, regulations, and ordinances. RI International is a second chance employer and we consider qualified applicants regardless of criminal histories, consistent with legal requirements. If you need assistance and/or reasonable accommodation due to a disability during the application or the recruiting process, please send a request via the Accommodation request form.

Benefits/perks listed above may vary depending on the nature of your employment with RI International.

The wage range for this role considers the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. At RI International, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case.