Revenue Cycle Manager

Company: Edc Of Denver Llc
Location: Denver
Posted on: September 3, 2024

Job Description:

Job Title: Revenue Cycle ManagerDepartment: Administration, Finance and AccountingSupervisor: Chief Financial Officer, Chief Executive OfficerFLSA: Exempt, SalaryThis is an on-site position in Denver, CO.Schedule: Monday- Friday, 8am-5pmCompensation: $80,000-$95,000Sign-On: $5,000Summary of Major Functions:The Revenue Cycle Manager plays a crucial role in maximizing revenue, ensuring compliance, streamlining billing processes, overseeing PAR (Patient Account Representative) staff, and providing data-driven insights to improve the financial performance of the billing and collection department.Duties and Responsibilities:Revenue Cycle Management-Contracting:Researches and analyzes the healthcare market in all markets where the company operates or plans to operate to identify insurance providers for potential partnershipsincluding SCA (Single Case Agreements).Negotiates and renegotiates insurance contracts at renewal on a timely basis.Establishes and maintains strong business relationships with insurance providers.Monitor insurance reimbursement trends in all EDCares programs and markets,Maintains current and ongoing census and reimbursement data on EDCares payor mix and insurance payors.Revenue Cycle Management-Patient:Creates an atmosphere that is welcoming and friendly to patients, families and all EDCare departments and employees.Manage the patient billing process from admission to discharge.Ensures that admissions departments receive patient VOB (verification of benefits) within 4 hours of request by admissions counsellors.Ensure that all patients in program have complete financial admissions paperwork, and that insurance coverage is adequate and appropriate for level of care.Develop and implement patient payment plans and policies subject to CFO approval.Ensure that all payment plans are properly documented, updated, and signed by the patient.Revenue Cycle Management-Internal:Responsible for managing the timely submission and posting of first time claims on a daily basis.Monitor and follow-up of unpaid claims through regular supervision of billing staff.Ensure follow-up on rejected, denied, or outstanding claims to ensure timely resubmission and payment.Oversea the timely refund process for both patients and insurance carriers.Actively pursue collection on aging or difficult accounts subject to CFO approval.Responsible for overseeing and reporting daily cash deposits.Responsible for mid and end of month reconciliations of revenue, cash, and accounts receivable.Insures that CFO authorizes all accounts receivable write offs and refunds before processing.Ensuring compliance and quality of all claims before submission to government and commercial insurance payers.Identifying and rectifying any issues that interrupt the revenue cycle process.Ensures monthly departmental collection goals are met.Revenue Cycle Management-Systems:Maintains billing software database for accuracy, efficiency and best practices.Improving or maintaining accurate and timely data by fully utilizing all components of EDCares billing and EMR software.On a regular basis, verify that billing software has the latest contractual rates loaded.Administrative and Staff Management:Attend and participate in EDCares weekly Tuesday admissions meetings.Attend and participate in EDCares weekly Wednesday Managers MeetingsDistributes workload within PAR staff and creates work processes to maximize collections and efficiency.Supervises billing staff on a regular basis and in no event less than monthly to evaluate performance metrics including but not limited to collections, DSO, denied claims and other benchmarks as recommended and approved by the CFO.Maintains office staff performance through hiring, coaching, counseling, disciplining discharging employees.Ensures appropriate, courteous and timely response and resolution to patient, insurance and department inquiries and problems.Complete performance reviews in a timely mannerReporting and Analytics:Producing comprehensive financial reports, analytics, and key performance indicators (KPIs) related to all aspects of the revenue cycle.Monitoring metrics, including but not limited to, billings, collections, aging accounts receivable, denial rates, and lag times between services and billing.Analyzing data to identify areas for improvement in coding accuracy, billing efficiency, and revenue optimization.Provides the CFO with timely and regular Revenue Cycle reports.Special projects or other responsibilities as reasonably requested by the CFO or CEO.Computer Skills:Strong Excel skills i.e.): pivot tables, formulas, filtering, tagging, merging data, downloading data, etc.Must be able to master an office scheduling system, Electronic Medical Record systems, medical billing software and systems. Experience with Sigmund preferred.Proficiency in Microsoft Office suite including Word, Excel, and Outlook.Must be able to efficiently learn and effectively work within an electronic medical records system.Physical Demands and Environment:Sitting frequently, standing occasionally, walking occasionally, talking frequently, hearing frequently, seeing constantly, reaching with arms and hands occasionally, crouching occasionally and frequently using fingers intricately. Must be able to extensively use a keyboard, mouse and be able to write legibly. This position requires lifting/carrying up to 20 pounds occasionally. This is a full-time job that requires all hours are performed in EDCares office. Circumstances may require working remotely and can only be approved by the CFO.Environmental conditions of this job include but are NOT limited to:95% inside, 99% normal temperature and 99% normal noise as expected in a neighborhood home environment.Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.Minimum Qualifications:Bachelor's degree in healthcare administration, business, business administration, finance, or a related field required.Minimum of 5+ years of experience in contracting, medical billing, with a focus on behavioral health or mental health services required.Healthcare Billing/Finance/Coding Certification preferred.Strong understanding of medical coding, especially behavioral health and substance abuse treatment codes (CPT, ICD, HCPCS, etc.) and coding guidelines required.Familiarity with insurance verification, claims submission, denials management, and appeals processes for behavioral health services preferred.Knowledge of healthcare regulations, compliance requirements (e.g., HIPAA), and payer policies related to behavioral health reimbursement required.Proficiency in revenue cycle management software, electronic health record (EHR) systems, and data analysis tools required.Excellent analytical, problem-solving, and decision-making skills to identify and resolve revenue cycle issues.Strong leadership, communication, and interpersonal skills to manage and train revenue cycle staff effectively.Experience in developing and implementing revenue cycle policies, procedures, and best practices for behavioral health organizations.by Jobble

Keywords: Edc Of Denver Llc, Denver , Revenue Cycle Manager, Executive , Denver, Colorado