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- Brockton, MA 02301
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Revenue Cycle Manager
Shields Health Care Group, Inc. • Brockton, MA
Posted 2 months ago
A.PURPOSE AND SCOPE:
The Revenue Cycle Manager will contribute to the success and advancement of the business by directing and coordinating the billing and collections for all centers. The ability to recognize and influence change to enhance revenue and improve processes in the organization by challenging the status quo.
B. PRIMARY RESPONSIBILITIES:
1. Manages billing, posting, denials and collection processes.
2. Significant involvement with clinical staff, and office managers to ensure the
understanding of new technology, what members enter charges, and processes that effect successful reimbursement.
3. Fosters positive joint venture partner relations.
4. Initiate and maintain relationships with insurance representatives to facilitate payment of claims.
5. Regularly communicates with the Provider Enrollment Team within Shields to understand contracts and payment expectations with payers.
6. Develop professional relationships with all medical and operational staff to foster understanding of each person’s impact on reimbursement, i.e. charge capture,
7. Assist in creation of EDI and ERA for all possible payers in conjunction with IT Department.
8. Core understanding of Recondo functions and the abilities of the tool
9. Coordinate, prioritize and streamline workflow as it relates to reimbursement and maintain knowledge base to perform all functions within department.
10. Manage members of Reimbursement staff, to include annual reviews, weekly payroll, and management of PTO, employee relations, and workflow.
11. Track payer trends, provide financial analysis, monitor collection activity
12. Oversee and participate in electronic charge captures of all clinical services, including technical and professional components.
13. Travel to off-site meetings, seminars, and trainings.
14. Data and claims analysis.
C. EDUCATIONAL REQUIREMENTS:
BA or BS in finance preferred
D. EXPERIENCE REQUIREMENTS:
5 years health care revenue cycle experience, including but not limited to billing, denials, collections and analysis. Supervisory experience is a must. Must be competent in Microsoft Excel, Word and Power Point.
Knowledge of anatomyand medical terminology required as well as experience in ICD and CPT coding.
E. PHYSICAL REQUIREMENTS:Ability to travel to centers and effectively utilize computer and phone systems with or without accommodation.
F. INTERNAL/EXTERNAL INTERACTIONS:
This position requires extensive interaction with co-workers, patients, insurance companies and the professional community.
NOTE: It is not intended that this Job Description include all details of the work functions of this position. The incumbent will perform work of lower or equivalent classification as required or directed, and work of higher classification for training and development purposes or as situationally warranted.