Revenue Cycle Manager

4 weeks ago

Paterson, United States Eva's Village Full time
Job DescriptionJob Description

Job Overview:

The Revenue Cycle Manager is responsible for all non-clinical aspects of patient billing. Responsibilities include ensuring that claims, denials, and appeals are efficiently processed, billing issues are timely resolved, and ensuring Eva’s Village maximizes fee for service revenues.

Duties

  • Coordinate with clinical staff to ensure accurate, complete and auditable data is maintained for all billings, including census data for residents and supporting records for outpatient services.
  • Responsible for all Fee for Service (FFS) billing which includes:
  • Billing for Residential Substance Use Disorder (SUD) clients, which are funded primarily by NJ Department of Human Services (NJDHS) Division of Mental Health and Addiction Services (DMHAS)
  • Billing for other “enhanced” services provided to residential clients, for example, Case Management, Psychological Evaluations, etc.
  • Outpatient billing for SUD and Mental Health Services, including billing for allowable services for Medicaid recipients.
  • Ensure the accuracy of billing information loaded into NJ DMHAS FFS billing system (NJDAS), NJ Family Care (Medicaid) and other future funders. Current NJ systems may require manual entry, which would be handled by this position.
  • Ensure compliance with all billing-related regulations. Minimize risk of audit findings by Federal and State entities and in our annual Financial Statement audit.
  • Develop and implement benchmarks for clinical staff and billable services.
  • Develop and implement standard weekly reporting on staff billable volume, highlight programs and employees not achieving revenue benchmarks.
  • Provide Reporting to Management which includes recommendations for corrective action on programs or employees not achieving revenue benchmarks.
  • Assist in the design and implementation of controls with Clinical and Senior Management when revenue losses are identified.
  • Follow-up on uncollected billing.
  • Assist with monthly financial close by generating required revenue and receivable journal entries.
  • Generate additional ad-hoc reports for Management and Board as requested.
  • Initiate self-directed learning and attend training to further abilities in the areas above.
  • Assesses the impact of changing regulations and appropriately informs management.
  • Perform other tasks as needed to support the Finance and Administration functions.
  • Any other projects as assigned.

Qualifications

  • Minimum of two (2) years' experience in healthcare billing/accounting required with Revenue Cycle experience preferred.
  • Experience in behavioral health and/or substance use disorder billing preferred.
  • Experience at a substance use disorder and/or mental health provider strongly preferred.
  • Bachelor’s degree in finance, business administration, healthcare administration, or related field preferred.
  • Proficient in all Microsoft Office applications. Excel proficiency a must (pivot tables, v-look ups).
  • Familiarity with Electronic Health Records Systems. Experience with Netsmart desirable but not required.
  • Ability to concisely communicate issues and recommendations to Senior Management.
  • Excellent organizational skills, a customer service attitude and a commitment to meeting all deadlines.

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