As the Revenue Cycle Manager for HOPE Clinic, you focus on partnering with our patients to clearly understand their institutional goals, challenges, organizational structure, and key business drivers. The role of the Revenue Cycle Manager oversees the Billing and Insurance Verification team's daily activities and follows up with teams to drive the overall performance and daily management of multiple assigned providers' schedules. The Revenue Cycle Manager serves as a liaison between the Billing and Insurance Verification team and other HOPE Clinic departments and the patients.
Major duties and responsibilities include managing overall medical billing operations, overseeing aggressive follow-ups with accounts receivables, tracking fee schedules and insurance denials, identifying and implementing strategies to improve internal and patient billing processes, incorporating and executing quality assurance processes, reviewing and analyzing patient accounts, collaborating with other team members to improve the work environment, providing high-level customer service, researching and completing appeal processes for denied claims, preparing and transmitting claims using billing software, following up on unpaid claims, collaborating with the billing team to make coding changes, staying current with payer trends, analyzing root causes of denials, identifying areas of concern regarding the revenue cycle, sharing trending and feedback to reduce denials, hospital billing, applying insurance and patient payments to the Practice Management system, reconciling payments, answering patient inquiries, attending community engagement activities, and performing other duties as assigned.
Qualification requirements include 5-7 years of experience with revenue cycles, medical billing, collections, and payment posting, understanding regulatory and compliance requirements associated with submitting claims to payers, experience with Electronic Medical Records, strong communication and interpersonal skills, expertise with medical and billing terminology, excellent organization and time management skills, and proficiency in computers, particularly Word and Excel.
Education and/or experience desired includes a Bachelor's degree from a four-year college or university, or 5-7 years related experience and/or training, or an equivalent combination of education and experience, 1-2 years of supervisory experience, knowledge of medical billing, front-office, physician practice management, and healthcare business processes, strong understanding of medical billing/coding, with an understanding of various insurance carriers, including Medicare, private HMOs, and PPOs, and previous FQHC (Federally Qualified Health Center) RCM experience.
Other skills and abilities preferred include bilingual (Vietnamese, Chinese, Arabic, and/or Spanish with English), above average skills in language ability as well as public speaking and writing, and having good transportation and a valid Texas Driver's license.