Manager of Revenue Cycle

Scope of Position & Technical Competency -:

Deliverables:

a) Oversee Central Business Office (CBO) for all aspects of Revenue Cycle. Functional areas include billing, collections, denial management, payment integrity, cash posting and insurance verification.

b) Manage and control the billing process, including timelines of billing, collections, and systems management.

c) Research and resolve inquiries involving billing discrepancies, client account status, adjustments, etc.

d) Acquisitions: implementation of joining company policies and procedures into a steady flow of parent company protocol.

e) Collaborate with the VP Revenue Cycle to report profitability of claims by insurance payers.

f) Communicate with Senior Management concerning insurance, therapists, clients and or vendor concerns and difficulties.

g) Reports on receivables status as required.

h) Implement internal controls, create and mandate policies and procedures to ensure consistency and standardization for automated billing process in all offices.

i) Review and document processes to maximize efficiencies of team tasks.

j) Responsible for interviewing, hiring, evaluations and discipline up to and including promoting or discharging.

k) Prepared daily, weekly, monthly and year end reports.

l) Communicate with Site and Program Directors concerning any program changes or new programs at facility level.

m) Direct contact with the insurance provider representative whenever there are claim disputes such as contract issues, non-par, large rejections, etc.

n) Oversight of vendor relationships.

o) Participated in payer’s meetings whenever required.

p) Other Duties as deemed necessary

Technical Competencies:

a) Accuracy of mathematics

b) Ability to work with multiple internal and external clients.

c) Ability to set priorities and meet deadlines

d) Knowledge of local, state and federal regulations related to billing of insurance claims

e) Knowledge of contracts and agreements and payer sources

f) Knowledge of rate setting process

Education, Experience:

Qualification: Bachelor’s degree required

6-10 years of experience and expertise in healthcare revenue cycle including staff management.

Must possess extensive knowledge of revenue cycle systems, functions, policies and procedures

Must knowledgeable about Medicare/Medicaid and other Governmental regulations.

Must have a proven record of identifying process improvement opportunities.

Experience with, insurance claims, denial and appeal processing, including ICD-10, CPT, HCPC codes, and UB and 1500 claim forms.

Proficiency with all Microsoft Office applications.

Job-related Behavioral Characteristics:

Demonstrates professionalism, leadership, confidentiality, strong social communication skills, time-management, organized. Must possess skills to communicate effectively and interact well with people of diverse backgrounds.