Revenue Cycle Manager

Job Title: Revenue Cycle Manager   

Company Overview:

Eau Claire Cooperative Health Center, Inc. (dba Cooperative Health) is a leading community health center serving the Midlands of South Carolina. It is deeply rooted in its mission of providing accessible, high quality, compassion health care in the spirit of the Good Samaritan. The organization’s values of: treating each other with respect, putting people first, being excellent at what we do, promoting a collaborative work environment, improving community/population health, fostering innovative thinkers, and getting results, are core attributes of every employee at Cooperative Health.

Position Summary:

Revenue Cycle Director and is responsible for managing, supporting, training and disciplining the Revenue Cycle Staff. Additionally, the Revenue Cycle Manager is responsible for overseeing the day to day operations of the Revenue Cycle department, while consistently analyzing daily claims activity and communicating Billing updates and deficiencies that impact the Revenue Cycle to various department heads and the Revenue Cycle Director. The Revenue Cycle Manager adheres to Cooperative Health’s Mission, Vision and Values and exemplifies excellent leadership and work ethics. The Revenue Cycle Manager ensures that the proper results, controls and measurements are in place to optimize collections and maximize productivity. This position will report to the Revenue Cycle Director and will work collaboratively with the Senior Practice Management Revenue Cycle Analyst while working closely with all levels of management. 

Principal Accountabilities/Responsibilities:

• Develop, implement and oversee effective billing and collection procedures of staff.
• Develop, implement and oversee procedures for the review, appeal and resubmission of all claim denials.
• Manage, Develop, implement and oversee procedures for the posting/uploading of all third party payments received, confirmation of deposits and the reconciliation of discrepancies.
• Analyze claims data and suggest/implement procedures to maximize HEDIS and incentive revenue collections (i.e., level II HCPCS codes, ICD-10 and CPT modifiers).
• Conduct quality assurance and accuracy audits of staff.
• Compile requested statistical, financial, billing or auditing reports.
• Assure compliance with applicable laws and regulations related to billing.
• Perform billing analysis to ensure that the Billing Department is maximizing cash receipts.
• Continuously monitor Outstanding AR and address areas of concern.
• Analyze and monitor Denial trends amongst various payers.
• Assist Revenue Cycle Director with developing and updating billing policies
• Open cases with Practice Management vendor to troubleshoot and resolve issues as needed.
• Attend internal and external meetings that pertain to Billing.
• Implement processes and procedures to improve staff efficiency.
• Monitor and manage charge posting, claim creation, billing, and collection operations.
• Responsible for all Training and Development of Staff.
• Responsible for monitoring daily Claim Errors and Rejections.
• Manage processing of Patient Refunds.
• Assist with ongoing Training of various departments as directed by Revenue Cycle Director.
• Recruitment of staff.
• Conduct routine staff meetings.
• Responsible for delegating workload to staff.
• Responsible for disciplining staff.
• Build, maintain and improve billing and collections processes.
• Responsible for periodic, monthly and quarterly claim and GSP audits.
• Encourage motivation and cohesiveness amongst the staff.
• Responsible for Performance evaluations of staff.
• Responsible for monitoring and approving staffs attendance and Time off.
• Responsible for disciplining staff.
• Responsible for holding staff accountable and enforcing policy.
• Handle routine correspondence and other administrative tasks, as required.
• Performs other duties as assigned.

Education & Experience:

Associates Degree or higher, 10 years of relevant work experience, 10 years of supervisory experience, Proven record managing people and building teams, Demonstrated knowledge of medical coding, Medical coding or billing certification, RHC or FQHC billing/coding/rev cycle experience, Previous experience in EHR/PMS environment, Proficiency in Microsoft Office – Excel, Word, Outlook. 

Competencies

Knowledge of organizational policies, procedures, systems and objectives. Knowledge of various payer guidelines. Knowledge of CPT, CDT, ICD-10, EOB and ERA. Knowledge of computer systems and applications.

Skills in planning, organizing and multitasking. Skills in exercising initiative, judgment, problem-solving and decision-making. Skills in gathering and analyzing data. Skills in identifying and resolving problems. Excellent listening, written and communication skills. Effective Denials management, and excellent claims management experience from charge capture to receipt.

Ability to create an atmosphere which encourages cohesiveness, motivation, innovation and high performance.

Physical Demands

• Prolonged periods sitting or standing
• Must be able to lift up to 25 pounds.
• Be able to sit, stand, stoop, squat for extended periods of time throughout the day.
• Standing or walking for extended periods throughout the day.

Company Conformance Statement

In the performance of respective job assignments, all employees are required to conform with Cooperative Health’s:

• Board approved policies and procedures;
• Confidentiality and professional provisions;
• Compliance program; and
• Standards of conduct.