Revenue Cycle Manager

Job Details

Job Location
Stony Point Admin - Santa Rosa, CA

Position Type
Full Time

Description

POSITION TITLE: Director of Revenue Cycle

REPORTS TO (TITLE): Director of Revenue Cycle

SALARY RANGE: $84,936 - $114,148

Job Summary: The Revenue Cycle Manager is a full-time position for overseeing the billing unit (Billing Leads, Medical billers/payment posting staff) and making day to day decisions: responsible for understanding billing policies & procedures within regulatory

mandates, assists in following up on insurance, Medi-Cal, and Medicare claims. Assists in submissions of appeals as needed. Stays updated on all claims and their related AR statuses and issues for discussion with director. Effectively manage claim corrections and rejections.

Specific Tasks/Duties Include:

• Provides billing support to Billing Leads and billing team when unavailable (PTO, callouts, LOAs).
• Oversees Billing staff activities which includes work allocation and being available for staff needs.
• Plans, manages, and coordinates with management team as it relates to billing and collections work loading and productivity tracking.
• Assists in the follow up of claims and obtainment of statuses using payor outreach (website & phone), clearinghouse and EPIC.
• Understands and remains updated with current coding and billing regulations and compliance requirements.
• Motivates employees to achieve peak productivity and performance.
• Assist, resolve, and report any problems to the Director of Revenue Cycle regarding the day-to-day operations within the department.
• Support front end billing team with payer and customer related questions and issues.
• Perform quality reviews assessments to ensure employees meet departmental expectations and adhere to quality assurance guidelines.
• Provides performance coaching and constructive performance feedback to Billing and Payment Posters.
• Identify training opportunities through quality assurance reviews and prepare training materials for ongoing training resources.
• Work closely with the Billing Data Management team to continuously monitor and improve billing system rules and setup for clean claim submissions.
• Represents the Billing Department and interfaces with other departments as needed to respond to and resolve issues in absence of the Director of Revenue Cycle.
• Identify required missing billing information and assign appropriate attention level.
• Verifying and troubleshooting insurance eligibility and patient demographics.
• Identify system issues and trends - report findings to appropriate party.
• High level of Customer Service, internal and external communication.
• Maintains accuracy by following policies and procedures, reporting needed changes.
• Maintains customer confidence and protects data by following HIPAA compliant regulations.
• Assists with cross-training of other team members.
• This job description is not intended to be all- inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization.

Qualifications

Minimum Qualifications:

Education:

• Medical Billing Certificate
• Associate degree or equivalent experience
• Preferred Experience: FQHC experience or 5 years of experience in healthcare
• Capable of adapting to multiple application of software.
• Knowledge of reimbursement processes, billing, and accounts receivable.
• Solid computer skills with emphasis on MS Office products.
• Must be comfortable working in a close-knit, team environment where attitude and work ethics are a priority.
• Excellent written and verbal communication skills

Experience:

• FQHC experience preferred
• Experience successfully handling claims
• Experience with Epic and E-Clinical Works preferred.
• At least one-year related experience or equivalent preferred.

Knowledge and Skills:

• Knowledge of medical billing terminology.
• Ability to perform diversified clerical functions and basic accounting procedures.
• Commitment to excellence and high standards.
• Acute attention to detail.
• Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.
• Ability to work a calculator and computer keyboard.
• Demonstrated outstanding customer service.
• Fluency in English and Spanish (speak, read, and write) preferred.
• Ability to work flexible schedule.
• Demonstrates knowledge of compliance issues within the community clinic environment.
• Demonstrates a willingness to report any incident that is unusual or incompatible with accepted clinic procedures.
• Always maintains confidentiality of patients by complying with HIPAA policies.
• Strong interpersonal skills. Ability to be sensitive with persons of various social, cultural, economic, and educational backgrounds.
• Proficiency with Microsoft Office applications including Outlook, Word, Excel and PowerPoint.
• Strong organizational skills with ability to prioritize projects, work relatively independently, manage multiple tasks, and meet deadlines.
• Strong written and verbal communication skills.
• Ability to work independently and as part of a team.
• Good judgment, problem solving and decision-making skills.

SRCH is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation.

Physical Requirements:

While performing the duties of this job, this position is frequently required to do the following:

• Use standard office equipment and access, input, and retrieve information from a computer. Use computer keyboard with manual and finger dexterity and wrist-finger speed sufficient to perform repetitive actions efficiently for extended periods of time.
• Communicate effectively in person or via telephone in a manner, which can be understood by those with whom the person is speaking, including a diverse population.
• Give and follow verbal and written instructions with attention to detail and accuracy.
• Perform complex mental functions; collect, interpret, and/or analyze complex data and information.
• Vision: see details of objects at close range.
• Coordinate multiple tasks simultaneously.
• Reach forward, up, down, and to the side
• Sit or stand for minimum periods of one hour at a time and come and go from the work area repeatedly throughout the day.
• Lift up to 20 pounds.

SRCH is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation.