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Revenue Cycle Manager

Company: Jefferson Center for Mental Health
Location: Wheat Ridge
Posted on: December 5, 2019

Job Description:

Overview

Identify client reimbursement issues, ensuring that claims, payments, denials, and appeals are efficiently processed, and resolve billing-related issues. Manage the Insurance and Billing department staff and ensure the team has effective operations, systems, and policies/procedures to effectively guide team performance.

Responsibilities

Essential Duties:

I. Manage the Insurance and Billing Dept

* Review Payment, Denial and Adjustment batches monthly.
* Help staff with any questions on preparation of monthly GL reconciliations.
* Run dept. monthly reports: Aging, collections, accounting close, ect.
* Help clients and therapists with any outstanding balance or billing policy questions.
* Review and sign any insurance/client refunds monthly.
* Managing staff performance by providing regular feedback, performance reviews, and one-on-one meetings.
* Reviewing financial hardship applications.
* Overseeing the hiring and training of staff.
* Ensure department goals are met and tracked using Waystar Perform
* Leads regular staff meetings to promote teamwork, sustain an aligned and energized work force, promote communication and provide team direction

II. NEO - Orientation

* Review Insurance/Billing policies and procedures with new employees weekly.

III. Electronic Medical Record System

* Responsible for Set-up changes and ensure billing rules are set up correctly
* Attend Center meetings regarding new projects, services, etc and determine if changes are needed to the EHR billing system/setup
* Run bi-monthly claims accurately and timely and submit to clearinghouse
* Monitor CCHA submissions and error reports. Participate in any monthly meetings to discuss issues.
* Run Eligibility files bi-monthly and review error reports and changes needed
* Work with IT staff on any edits/changes needed to existing crystal reports and billing console widgets.
* Work with IT staff on Data repairs
* Work with IT staff and test any new system updates provided by Netsmart
* Help coordinate payor audits
* Review all payor bulletins, new contracts and amendments and implement any billing system or procedure changes.
* Respond to questions and requests for information from customers (internal and external) and work collaboratively with other departments, clients and/or external third-party payers in a courteous, timely, and accurate manner
* Resolve unbilled and clearinghouse claims within the timely filing requirements
* Work with Controller during fiscal year end audit to answer questions/provide backup.

Note: Employees are held accountable for all duties of this job. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.

Qualifications

Education, Knowledge, Skills & Experience Required/Preferred:

* Bachelor degree (from an accredited university/college) preferred.
* 5 years of relevant experience required.
* Knowledge and proven healthcare billing experience in all of Jefferson Center's payor sources such as Private Insurance, Medicare, Medicaid and Client Pay.
* Proficient in all Microsoft Office applications as well as medical office software.
* Sound knowledge of health insurance providers.
* Strong interpersonal and organizational skills.
* Excellent customer service skills.
* The ability to work in a fast-paced environment.
* Prior supervision experience preferred.
* Basic knowledge/willing to learn crystal reporting and SQL preferred.

Keywords: Jefferson Center for Mental Health, Denver , Revenue Cycle Manager, Executive , Wheat Ridge, Colorado

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