Revenue Cycle Manager

2 weeks ago

Lincoln, United States Zelle HR Solutions Full time
Job DescriptionJob Description

Position Summary: The Revenue Cycle Manager will oversee all the functions of the billing office, including policies and procedures.

Essential Job Functions

  • Select, train, orient, and supervise billing department personnel. Assume supervisory duties including but not limited to, coaching, counseling, and progressive discipline of staff. Conduct performance evaluations of staff.
  • Ensure Coders accurately process claim charges in a timely manner.
  • Ensure all paper and electronic claims are submitted in a timely manner.
  • Monitor tasks in NextGen and E-solutions Clearinghouse and ensure they are resolved in a timely manner.
  • Review department performance and ensure compliance with laws and regulations.
  • Interpret and enforce third party payer rules and regulations.
  • Review billing and collection patterns and make corrective recommendations.
  • Identify problems and accept responsibility for problem-solving and advise administrative staff to make informed decisions.
  • Maintain knowledge of payer coverage determinations and guidelines, including FQHC requirements for Medicaid payers and Medicare.
  • Ensure timely follow up on unpaid charges, denials, or rejections.
  • Ensure daily posting of patient payments and all other non-ERA/EOB third party payments.
  • Ensure adjustments are made appropriately in the NextGen system for all sliding fee patients.
  • Manage will appeal and work to resolve unpaid claims where applicable.
  • Ensure patient statement file is uploaded on a weekly basis.
  • Ensure inbound and outbound patient phone calls regarding all billing issues are handled daily.
  • Ensure timely identification of patient accounts with credit balances and processing of refunds.
  • Ensure small balance adjustments are done before patient statements are issued.
  • Run bi-weekly billing meetings as well as other scheduled meetings with staff for discussing, processing, training, and managing billing functions.
  • Ensure claims via the NextGen Red Edit are resolved in a timely manner.
  • Ensure that Electronic Clearing House claim errors and rejections are worked in a timely manner.
  • Draft all Billing Policies and Procedures for acceptance by the Board of Directors.
  • Work with the Clinic Managers to ensure front desk staff are trained and knowledgeable on insurance verification and patient demographics.
  • Maintain user access on insurance verification websites.
  • Ensure all previous month's transactions are posted and reports for the CFO are completed no later than the end of the business day on the 15th of each month, which may be adjusted dependent upon the date of the Finance Committee meeting or other unusual circumstances discussed with the CFO.
  • Update/add fee schedules and payer contracts in the billing software.
  • Perform all other duties as assigned.

Qualifications

  • Bachelor's degree in accounting, finance, business administration, or related field, preferred.
  • Minimum 2 years of supervisory and healthcare related billing experience, preferred.
  • Medical coding certification, required.
  • Strong computer skills, including data-entry and working knowledge of Microsoft Excel and Word.
  • Excellent written and verbal communication skills.
  • Excellent problem-solving skills.
  • Highly organized with the ability to meet deadlines.
  • Strong attention to detail, quality, and accuracy.
  • Self-starter and the ability to work with minimal supervision.
  • Ability to interrelate with a wide variety of people.
  • Ability to maintain a high level of confidentiality.

Zelle is an Equal Opportunity Employer Minorities/Women/Veterans/Disabled

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