Revenue Cycle Manager

Found in: Careerbuilder One Red US C2 - 2 weeks ago


Washington DC United States Planned Parenthood of Metropolitan Washington Full time

The Revenue Cycle Manager is responsible for the implementation, execution, and completion of all day-to-day Revenue Cycle functions, while ensuring workflows remain aligned with strategy, commitments, and goals of PPMW. The Revenue Cycle Manager will lead or direct the work of Reimbursement Specialists and Insurance Benefit Verification specialists to improve billing processes, minimize denials, and ensure timely and correct posting and follow up. The Revenue Cycle Manager will collaborate with health center managers and staff on trends, denials, and areas needing training and retraining. The Revenue Cycle Manager will perform all billing and collection functions in order to meet affiliate goals and deadlines. The Revenue Cycle Manager will play a key role in managing any projects alongside the routine workflows of PPMW.

  • Lead, direct and coordinate daily ERA, EOB, and patient payment posting and billing. Ensure month-end reconciliation processes are completed on time and accurately.
  • Analyzation of self-pay balances, trends, and identification of training needs
  • Ensure PPMW's KPIs are satisfied. Monitor and report on progress, challenges, and solutions to internal stakeholders.
  • Conduct follow-up with team members and provider reps to track action items and affiliate progress.
  • Implement and manage workflow change.
  • Ensure month-end activities are completed in a timely manner and that month-end reconciliation is accurately completed.
  • Coordinate, participate in, and manage communications (calls, updates) as needed with internal and external stakeholders (e.g. affiliate staff, payer groups.
  • Run appropriate Epic reporting to track and monitor payer-specific claim adjudication trends.
  • Provide detailed weekly/monthly/quarterly reporting, as needed, for management review.
  • Submit daily electronic and paper claim files, and correct all claim and charge review edits, warnings and errors; run statement files; and download ERAs/EOBs as needed.
  • Perform daily ERA, EOB, and patient payment posting.
  • Maintain relationships with contracted payers, and other contracted entities to ensure maximum reimbursement.
  • Audit work of reimbursement specialists and insurance benefit verification specialists; arrange for any needed retraining or provide areas for improvement, as applicable.
  • Oversee and improve billing and collection strategies and systems.
  • Perform payment posting functions, participate in billing line call center, and claim follow-up as needed.
  • Run all reports needed to manage the claims business for assigned affiliates.
  • Participate in Revenue Cycle team meetings/conference calls, and provide the necessary reporting, feedback, and training required to improve processes.
  • Complete special projects as needed.
  • Other responsibilities as assigned.


Compensation details: 76000-121000 Yearly Salary



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