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Revenue Cycle Manager (RCM) Position Summary:
The Revenue Cycle Manager is responsible for overseeing revenue cycle management including coding, billing, collections, and denial management as well as financial reporting within the organization. This position is responsible for ensuring claims, denials, and appeals are efficiently processed, and resolving billing-related issues. The Revenue Cycle Manager will minimize bad debt, improve cash flow, and effectively manage accounts receivables. This role will also manage Provider credentialing. The Revenue Cycle Manager will be the main contact for any RCM vendors, Medicare contacts, and Clearing House vendor. They will be responsible for setting the annual practice fee schedule. This position is to stay apprised of coding and revenue trends; and is responsible for coding education to clinical and coding/ billing staff. In addition, this position will manage all Revenue Cycle Management staff including billers, coders, team assistants, and the RCM/Admissions supervisor; this will include day to day supervision as well as development opportunities, training, and mentorship.
Revenue Cycle Manager Education and Qualifications:
· Bachelor’s degree and 3-5 years of related work experience
· Knowledge of third-party payer requirements including federal, state, and private health care plans and authorization process
· Proven experience in healthcare billing, including Medicaid/Medical Assistance
· Knowledge of basic insurance policies, procedures, and reimbursement practices with Medicare coding
· Experience supervising staff
· Prior experience with process development and execution
· Excellent communication and interpersonal skills
· This is a financially sensitive position and is contingent upon clear results of a thorough background screening.
· Certified coder, coding auditor, or coding education experience
Revenue Cycle Manager Essential Functions:
1. Oversee and manage entire revenue cycle including billing, coding, collections, and denial management
2. Manage relationships with external vendors for practice management software and clearinghouse vendor
3. Communicate professionally with various payers
4. Manage, develop, and mentor all revenue department staff, including billers and coders and RCM/Admissions Supervisor
5. Responsible for management of billing and practice management software platform
6. Provide up to date education for clinical, billing, and coding staff on coding trends
7. Develops, evaluates, implements, and revises policies and procedures related to billing, coding, reimbursement activities and improvement strategies
8. Reconcile all receivables and revenue reports and work closely with the finance department in the development of the monthly financial statements
9. Manage and update the charge master based on the current CMS fee schedule and negotiated contracts
10. Conduct monthly analysis of Medicare/Medicaid/Third Party Payers
11. Oversees the processing of credentialing and provider enrollment applications, initial, and re-enrollment status with all Medicaid, Medicare, and Commercial Payors
12. Responsible for the generation and management of revenue, admissions, and credentialing metric reports
13. Review and resolve issues related to claim generation and rejected/denied billings
14. Commit to highest level of business and patient confidentiality possible adhering to all HIPAA and security guidelines when accessing and sharing patient information
15. Keeps abreast of all reimbursement billing procedures of third party and private insurance payers and government regulations
16. Maintains appropriate internal controls over accounts receivable, RCM process
17. Monitors accounts sent for collection and reimbursements from insurance companies and other third-party payers
18. Reviews, monitors, and evaluates third party reimbursement and researches variances
19. Participates in the development of coding and billing strategies, evaluating process relative to revenue cycle, and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific 3rd Party Payors)
20. All other duties as assigned.
Job Type: Full-time
Pay: $65,000.00 - $80,000.00 per year
Benefits:
Schedule:
Experience:
Ability to Relocate:
Work Location: Hybrid remote in Harrison, NY 10528
Full Time
$105k-145k (estimate)
05/23/2024
09/18/2024
The job skills required for Revenue Cycle Manager include Billing, Accounts Receivable, Medical Billing, HIPAA, Practice Management, Confidentiality, etc. Having related job skills and expertise will give you an advantage when applying to be a Revenue Cycle Manager. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Revenue Cycle Manager. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Revenue Cycle Manager positions, which can be used as a reference in future career path planning. As a Revenue Cycle Manager, it can be promoted into senior positions as a Revenue Cycle Director that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Revenue Cycle Manager. You can explore the career advancement for a Revenue Cycle Manager below and select your interested title to get hiring information.
If you are interested in becoming a Revenue Cycle Manager, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Revenue Cycle Manager for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Revenue Cycle Manager job description and responsibilities
Revenue Cycle Manager helps to ensure transparency, alleviate patients’ financial stress, collect earlier, and accelerate reimbursement in a healthcare facility.
03/17/2022: New Britain, CT
Perform a revenue cycle claims tracing analysis.
04/03/2022: Grand Rapids, MI
Ensure Timely and Accurate revenue documentation.
02/12/2022: New Brunswick, NJ
Align their roles to the organization’s business or strategic plan.
04/18/2022: Long Beach, CA
Evaluate the effects of price, length of stay, demand, and availability controls on revenue.
01/31/2022: Benton Harbor, MI
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Revenue Cycle Manager jobs
An organization can purchase data analytics software and use dashboards to set and monitor revenue goals.
01/23/2022: Bergenfield, NJ
The revenue cycle begins when the patient makes the appointment and ends with successful payment collection.
03/31/2022: Helena, MT
Poor quality data and future revenue cycle complications can occur without the ability to streamline the digital workflow.
02/26/2022: Augusta, GA
Establish performance standards.
03/27/2022: Lawrence, MA
Generate the actionable data that allows health system leaders to understand financials at a nuanced level, promoting effective processes that lead to financial sustainability and optimum revenue cycle management.
03/21/2022: Corpus Christi, TX
Step 3: View the best colleges and universities for Revenue Cycle Manager.