Billing Revenue Cycle Manager

Billing Revenue Cycle Manager

Website Borrego Health

Summary: 

Revenue Cycle Manager is responsible for providing leadership, planning, managing, and monitoring of the outcomes of Borrego Health’s daily revenue cycle operations and staff. Identifies improvement opportunities and facilitates process standardization and improvement to promote outcomes in alignment with the strategic and operational goals by maximizing resource utilization and improving organizational efficiencies. Performance improvement initiatives to improve revenue recognition and software automation. Provides financial support and leadership to VP of Finance and Senior Leadership Team in the development of entity revenue cycle initiatives and other duties as assigned.

Essential Duties and Responsibilities: 

1. Overall Department Management: Evaluates effectiveness of billing and collection workflow. Recommends and implements changes to policies and procedures as appropriate.  Responsible for timeliness of charge activity and account follow-up.  Develops innovative methods for increasing staff productivity, quality, and effectiveness of revenue cycle management. 

2. Personnel Management: Manages day-to-day operations including determining specific employee work assignments; reviewing employee activities for completeness, accuracy, and effectiveness; monitoring conformity with policies and procedures; and monitoring individual staff productivity. Completes employee performance reviews; interviews candidates and makes hiring decisions.  Determines staffing requirements.

3. Contract Management: Maintains current contract management tables and payor grouping in Intergy to ensure the expected payment calculations are timely and accurate in collaboration with the Managed Care Department. Supporting Borrego Health in developing financial models of care to support value-based purchasing and/or share risks contracts.

4. Establishes effective training program Communication Skills: Communicates policies and procedures effectively and regularly to staff. Document’s policy and procedures. Provides analysis and recommendations to managers and clients. Organizes and runs meetings with clients. Prepares and delivers oral presentations. Assists as primary liaison and senior resource to customers — Divisions, families, 1payors, collection agencies and other departments — on all issues related to revenue cycle management. Provides educational sessions when significant changes occur in Federal and/or State regulations.

5. Analytical Skills: Responsible for developing and maintaining entity-based revenue cycle key performance indicators utilizing business intelligence and data analytics as directed. Analyzes and reports on revenue cycle management, such as: identifying and minimizing preventable denials and write-offs, monitoring systems workflow.  Evaluating trends for individual programs and physicians. 

6. Computer Skills: Manages computer system functions in support of revenue cycle management. Generation and analysis of routine reports (daily, weekly, monthly, quarterly, and annually).  Use of report writer for ad hoc analysis and problem solving, Development and generation of appropriate forms (i.e., appropriate letters, charge documents, notices, etc.).  Modification of data dictionaries, and Analysis and implementation of new modules and systems.  Oversight of special projects. 

Qualifications:

Minimum Qualifications:

1. Bachelor’s degree in business administration, health administration, finance or related required. 

2. Certified Professional Coder (CPC) or equivalent desirable. 

3. At least five (5) or more year’s managerial level experience in billing and collections in a medical group, hospital or payor setting preferred. 

4. Managed care and contracts management experience preferred. Knowledge of OSHA, Title XXII, HIPAA, Corporate Compliance, and Rural Health Regulations preferred

5. Knowledge of healthcare reimbursement and billing procedures, CPT and ICD-10 coding, and medical terminology.

6. Compensation Commensurate with Experience.
7.     Driver’s License and Reliable Transportation.  

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