REVENUE BILLING CYCLE MANAGER
Apply NowCompany: Habilitative Systems, Inc.
Location: Chicago, IL 60629
Description:
About the Role:
The Revenue Billing Cycle Manager is responsible for overseeing revenue activities, organization strategies to increase profitability, and meeting all related MRO and MCO financial objectives by performing necessary monitoring and oversight of the billing and reporting functions. Serves as an intra-agency liaison between clinical program services and administration. Provides programmatic technical assistance and training to ensure compliance with MRO certification and licensing rules and regulations. The Revenue Billing Cycle Manager will actively assist in identifying and preparing operational goals and objectives associated with the MRO implementation and billing processes and maintain accountability for the design as it relates to the funding sources, licensing, and certification requirements. Provides direct support to the acquisition of agreements with HMOs and private insurance companies, and ensures conformance with requirements for third party billing. Remains vigilant in the prevention or reporting of fraud, waste, and abuse and ensures client privacy.
Minimum Qualifications:
Preferred Qualifications:
Responsibilities:
Skills:
The required skills for this role include strong analytical abilities, which are essential for interpreting billing data and identifying trends that can lead to improved processes. Excellent communication skills are necessary for collaborating with various departments and addressing customer inquiries effectively. Leadership skills are vital for training and mentoring the billing team, ensuring they are equipped to handle their responsibilities efficiently. Proficiency in financial software and ERP systems will be utilized daily to manage billing operations and generate reports. Preferred skills, such as advanced data analysis and project management, will enhance the ability to implement strategic improvements and drive the billing cycle toward greater efficiency.
The Revenue Billing Cycle Manager is responsible for overseeing revenue activities, organization strategies to increase profitability, and meeting all related MRO and MCO financial objectives by performing necessary monitoring and oversight of the billing and reporting functions. Serves as an intra-agency liaison between clinical program services and administration. Provides programmatic technical assistance and training to ensure compliance with MRO certification and licensing rules and regulations. The Revenue Billing Cycle Manager will actively assist in identifying and preparing operational goals and objectives associated with the MRO implementation and billing processes and maintain accountability for the design as it relates to the funding sources, licensing, and certification requirements. Provides direct support to the acquisition of agreements with HMOs and private insurance companies, and ensures conformance with requirements for third party billing. Remains vigilant in the prevention or reporting of fraud, waste, and abuse and ensures client privacy.
Minimum Qualifications:
- Bachelor's Degree in human service, healthcare administration, or an alternative public health related field and/or billing experience in the healthcare industry.
- (10) years of professional experience in Healthcare or Behavioral Health, with at least five (5) of those years providing administrative, quality improvement, billing and reporting oversight, and/or related supervision or 3 + years managing a Billing and revenue cycle program.
- Must be familiar with federal/state/local HFS, DASA Medicaid, and 3rd Party insurers' guidelines and certification standards. Key knowledge of Affordable Care Act, Healthcare and Family Services mandates and provisions for relevant entities (e.g. Care Coordination Entities), Third Party billing procedures with key MCOs (e.g. Illini, BC/BS, etc.). Solid experience in managed care and government programs.
Preferred Qualifications:
- Master's degree in a relevant field.
- Experience with ERP systems and billing software.
- Certification in revenue cycle management or related professional credentials.
Responsibilities:
- Works directly with the key supervisors in all related programs to identify Medicaid and Rule 132 service billing categories.
- Develop a menu and schedule of individual and group activities for residential trainers and match those activities to Medicaid billing service categories and codes.
- Establishes reasonable service unit and revenue projections before the onset of and during the fiscal period for each case management and outpatient program, and for each MI residential facility, determine modifications to these projections based on assessed trends.
- Establishes daily service hours and billing requirements for each case manager, therapist, and MI residential facility, usually a minimum of 5 hours of billable service per day.
- Identify per client billing projection based on treatment plan service menu.
- Works directly with program supervisors to Monitor and evaluate client treatment plans, to ensure that the services identified connect to a billable service, are documented appropriately in progress notes, and are billed on a consistent basis following related guidelines and procedures.
Skills:
The required skills for this role include strong analytical abilities, which are essential for interpreting billing data and identifying trends that can lead to improved processes. Excellent communication skills are necessary for collaborating with various departments and addressing customer inquiries effectively. Leadership skills are vital for training and mentoring the billing team, ensuring they are equipped to handle their responsibilities efficiently. Proficiency in financial software and ERP systems will be utilized daily to manage billing operations and generate reports. Preferred skills, such as advanced data analysis and project management, will enhance the ability to implement strategic improvements and drive the billing cycle toward greater efficiency.