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Revenue Cycle Manager

3 months ago

Bergen County, United States A great organization! Full time
Job DescriptionJob Description

Revenue Cycle Manager- Bergen County, NJ

1. **Leadership and Team Management:**

- Provide strong leadership and direction to the billing department.

- Supervise, train, and mentor billing staff to ensure high performance and professional development.

- Conduct regular team meetings to communicate updates, address issues, and promote a collaborative work environment.

- Evaluate staff performance, provide constructive feedback, and implement improvement plans as needed.

2. **Billing and Coding:**

- Oversee the entire out of network billing process, including charge entry, claims submission, payment posting, and account receivables.

- Ensure accurate coding of diagnoses, procedures, and services performed by healthcare providers in accordance with CPC standards.

- Monitor and audit billing processes to ensure compliance with federal and state regulations, as well as payer requirements.

- Resolve coding discrepancies and billing issues in a timely manner.

3. **Revenue Cycle Management:**

- Manage the revenue cycle to optimize financial performance and cash flow.

- Analyze billing data and generate reports to identify trends, opportunities for improvement, and potential areas of revenue leakage.

- Implement best practices to improve billing efficiency, reduce denials, and expedite claims processing.

- Collaborate with other departments, such as finance and clinical operations, to align billing practices with overall practice goals.

4. **Policy and Procedure Development:**

- Establish, implement, and maintain billing policies and procedures to ensure consistency and compliance across the practice.

- Continuously review and update policies and procedures to reflect changes in regulations, payer requirements, and best practices.

- Ensure that all billing staff are trained and adhere to established policies and procedures.

5. **Follow-Up and Compliance:**

- Implement strong follow-up procedures to ensure timely resolution of unpaid claims and outstanding balances.

- Stay current with changes in billing regulations, coding guidelines, and payer policies.

- Ensure that the billing department adheres to all compliance standards, including HIPAA.

- Maintain accurate and up-to-date billing records, documentation, and coding manuals.

- Conduct regular internal audits to verify compliance and accuracy of billing activities.

6. **Patient Relations:**

- Address patient billing inquiries and concerns with professionalism and empathy.

- Provide clear explanations of billing processes, insurance coverage, and payment responsibilities to patients.

- Assist patients with resolving billing issues and setting up payment plans if necessary.

**Qualifications:**

- Certified Professional Coder (CPC) certification preferred .

- Bachelor's degree in healthcare administration, business, or a related field preferred.

- Minimum of 5 years of experience in medical billing and coding, within an OUT OF NETWORK environment with at least 2 years in a supervisory or managerial role.

- Strong knowledge of medical billing software, electronic health records (EHR), and practice management systems.

- Excellent leadership and team management skills.

- Strong analytical and problem-solving abilities.

- Excellent communication and interpersonal skills.

- Detail-oriented with a high level of accuracy in work.

- Ability to work independently and collaboratively in a fast-paced environment.

Contact Lynda Fombon at Professional Search Network for more details: lynda@prosearchnetwork.com