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Revenue Cycle Operations Manager
2 months ago
Planned Parenthood Los Angeles is in search of a skilled Revenue Cycle Systems Manager with strong administrative capabilities to operate from our headquarters. The Revenue Cycle Systems Manager will oversee the effective execution of revenue cycle systems and initiatives aimed at enhancing operational workflows. This role will also involve conducting revenue cycle analysis across various departmental areas, including analytics and dashboard reporting to uncover business trends and discrepancies.
For over a century, Planned Parenthood has championed the belief that everyone deserves access to the information and care necessary to lead healthy lives and achieve their aspirations. Established over 50 years ago, Planned Parenthood Los Angeles stands as one of the foremost providers of reproductive health care services in the region. Our team is dedicated to delivering high-quality, affordable reproductive health care to individuals across Los Angeles County. At PPLA, you will find a community of passionate individuals committed to making a positive impact in their community and advancing the Planned Parenthood mission.
Qualifications:- High school diploma or GED required; a Bachelor's degree in business, Finance, Healthcare, or a related field is preferred.
- Certification in EPM systems is advantageous.
- A minimum of five (5) years of experience with CMS (Medicare / Medicaid) billing regulations is essential.
- Five (5) to seven (7) years of experience with ICD10, CPT/HCPCS, revenue codes, CMS billing regulations, and healthcare reimbursement is required.
- Comprehensive knowledge of private and governmental insurance eligibility and verification, charge capture, CPT maintenance, coding, billing and collections, payment posting, and self-pay processes.
- Strong understanding of clinical practice and revenue cycle management, including third-party reimbursement guidelines and procedures.
- Advanced computer proficiency, particularly in Microsoft Office and Excel.
- Extensive expertise in end-to-end revenue cycle operations.
- Experience in process analysis, documentation, and optimization is preferred.
- A minimum of five (5) years of experience in end-to-end Revenue Cycle Management is required.
- At least three (3) years of supervisory experience is necessary.
- Willingness to travel as needed.
- Reliable transportation for both onsite and off-site responsibilities.
- For those using a personal vehicle for work, a valid CA driver license and current auto insurance compliant with CA vehicle code minimum requirements are mandatory.
- All employees play a vital role in supporting the care provided to abortion patients at our health centers through administrative, support, and non-clinical services.
- Enhance revenue cycle operations by implementing and evaluating systems and initiatives that improve efficiency and uncover business opportunities.
- Oversee and refine the revenue cycle processes within the organization.
- Analyze data related to revenue cycle processes to pinpoint areas for improvement.
- Collaborate with stakeholders to ensure the successful rollout of revenue cycle initiatives.
- Stay informed about healthcare information systems, revenue cycle operations, and relevant regulations.
- Provide training and mentorship to team members on revenue cycle processes and associated software.
- Develop and document policies and procedures pertinent to revenue cycle operations.
- Monitor and report on the performance of revenue cycle systems and initiatives.
- Establish and maintain effective relationships with external vendors.
- Assist the Revenue Cycle supervisory team in identifying and implementing solutions for operational challenges.
- Ensure timely processing and resolution of rejected claims.
- Identify opportunities for charge capture and reimbursement improvement through various management tools and techniques.
- Report on productivity metrics of Revenue Cycle staff to ensure high standards of productivity and proficiency are met.
- Support monitoring and follow-up to ensure timely repayment for all identified overpayments.
- Ensure compliance with existing and new regulations set forth by CMS and CA DHCS, as well as other relevant laws.
- Analyze financial, productivity, performance, and quality data to identify root causes and propose solutions for performance enhancement.
- Serve as backup for the system analyst for NextGen and other applications.
- Communicate with external entities regarding identified issues and recommend actions beneficial to the organization.
- Assist in tracking revenue cycle goals and reporting inconsistencies to management.
- Monitor and update communication logs and provide updates to staff regarding changes impacting operations.
- Identify patterns from payers and recommend improvements to maximize revenue.
- Other responsibilities as assigned by the Senior Director of Revenue Cycle and Insurance Verification and/or CFO.
- Medical, dental, and vision coverage options for you and eligible dependents.
- Complimentary basic life/AD&D policy with additional voluntary coverage options.
- Short Term Disability, Critical Illness, and Accident policies.
- 403(b) Retirement plan with up to 6% employer match.
- Flexible Spending Account plans for medical and dependent expenses.
- Public Transportation and Commuter Pre-Tax Reimbursements.
- Generous vacation, sick, and holiday benefits.
- Salary range of $86,000 to $103,000 (Exempt).
At Planned Parenthood Los Angeles, we strive to uphold our values of Justice, Equity, Diversity, and Inclusion in our compensation philosophy. We recognize that decisions regarding pay and benefits significantly impact our staff, and we are committed to ensuring that all positions are defined by competencies, duties, responsibilities, and qualifications, and that they are compensated fairly, considering both internal equity and market data for similar roles.
Equal Employment Opportunity: We provide equal employment opportunities to all applicants and covered individuals without regard to protected characteristics. Protected categories include race, color, religion, national origin, physical or mental disability, medical condition, marital status, sex, gender, age, sexual orientation, veteran status, and any other characteristic protected under applicable law. We will consider qualified applicants with criminal histories in accordance with the Los Angeles Fair Chance Initiative for Hiring.
