Revenue Cycle Manager (Columbus)

compensation: DOE
employment type: part-time
job title: Revenue Cycle Manager
Job Description

We are seeking a detail-oriented and experienced Revenue Cycle Manager to join our team. As a Revenue Cycle Manager, you will play a crucial role in ensuring the financial success of our organization by managing the revenue cycle process. This includes billing, coding, claims management, and reimbursement analysis. If you have a strong background in healthcare revenue cycle management and are passionate about maximizing revenue and improving financial performance, we encourage you to apply.
The primary responsibility of this position is to identify and analyze circumstances that result in an open claim status across all regions in multiple states. This involves coordinating tasks to guarantee that both external and internal deadlines are adhered to, facilitating the prompt processing and resolution of open claims. The objective is to conclusively settle all claims within the designated timely submission period. This encompasses but is not limited to, overseeing the coordination of billing procedures and conveying identified trends and patterns to relevant stakeholders while accurately applying contractual obligations and service level agreements during the execution of billing operations.

· Identifies and performs a root cause analysis for any systemic issues associated with open claims that may impact upstream billing to the health plans and provides follow-up with internal and external parties as applicable to address reasons for denial.
· Demonstrates working knowledge of Medicaid regulations and policies, payment policies/guidelines, and the ability to communicate and work with payers to get claims resolved and paid accurately.
· Identifies and communicates trends and patterns that reflect deficiencies in the revenue cycle process that require multi-department collaboration and/or systematic development.
· Maintain the strictest confidentiality; adhere to all HIPAA (Health Insurance Portability and Accountability) and other industry rules and regulations.
• Review and analyze client accounts to ensure accurate and timely billing.
• Verify annual authorizations and utilization and obtain necessary authorizations for services in a timely manner.
• Submit claims electronically or by mail
• Follow up on unpaid or denied claims and resolve any billing discrepancies.
• Stay current with industry regulations and changes in billing and rule guidelines
• Provide support and training to staff regarding revenue cycle processes
• Studies, analyzes and reports on internal and external trends, recommends opportunities to drive functional performance to deliver continuously improving financial revenue cycle outcomes and processes
• Responsible for defining, managing to, and optimizing key performance metrics, including but not limited to DSO, Cash Conversion Cycle, Bad Debt, % of Billing/Revenue Collected, Employee productivity and capacity utilization, Denial Rates, Credit Balances, Contract effectiveness, Payer Performance, etc.
• Delivering Revenue Cycle efficiencies through Employee development, System selection/automation, Process design, Development of Payer Relations, avoiding waste/redundancy, and applying root cause assessment to deliver continuous Revenue Cycle improvements
• Establishes and maintains relationships with provider networks and other departments to create effective business partnerships and controls.
• Investigates, initiates, and manages process and cost saving initiatives.
• Prepares and submits projects and/or reports timely and within budget
• Ensures Revenue Cycle goals are always aligned with overall Business Goals and Objectives.

· College education in health services administration, accounting, business, or similar discipline or equivalent experience.
· Minimum of 5 years’ experience in end-to-end revenue cycle management.
· Experience working independently and as a member of various teams and/or workgroups.
· Strong computer skills and knowledge of MS Office products with intermediate Excel level.
· Ability to quickly navigate between different system platforms.
· Strong written and verbal communication skills.
· Strong organizational skills, problem-solving, and analytical skills.
· Acute attention to detail.
• Experience applying knowledge in collecting, analyzing and reporting revenue cycle management data used to identify opportunities and strategies for improvement.
• System assessment, implementation, and change control experience in a Revenue Cycle setting
• Light travel in Ohio

· Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification before acting; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. Writes clearly and informatively, Edits work for spelling and grammar.
· Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
· Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
· Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.
• 401(k) and 401(k) matching after 1 year
• Dental Insurance
• Medical Insurance
• Life Insurance
• Paid Time Off
• Paid Holidays
• Vision Insurance

For consideration, submit your resume, professional summary, and salary requirements.
  • Principals only. Recruiters, please don't contact this job poster.

post id: 7755454645


best of [?]