Revenue Cycle Manager

3 hours ago

Springfield, Illinois, United States Behavioral Health Network, Inc. Full time
Revenue Cycle Supervisor Job Description

Under the direct supervision of the Billing Operations Manager, the Revenue Cycle Supervisor role is responsible for analyzing incoming and outgoing revenue sources as well as performing advanced, highly complex levels of technical and analytical reporting. The Revenue Cycle Supervisor will directly oversee third-party Billing Representatives and is responsible for reviewing outstanding aging on a regular basis to identify trends and assign workloads to staff as necessary. The goal of the Revenue Cycle Supervisor is to improve the efficiency, quality, and financial outcome of the third-party Revenue Cycle.

Key Responsibilities:
  • Ensures adequate staff coverage to meet department needs in addition to hiring and terminating staff in conjunction with Billing Operations Manager. Performs recruitment and personnel evaluations as necessary for direct reports.
  • Forecasts expected revenue, reconciles forecasted earnings with payment receipts, reports, organizes, and analyzes requested data to internal and external department staff. Presents data collected and escalates topics to higher-level management when necessary.
  • Meets regularly with all direct staff and provides guidance and direction to all day-to-day claims work in relation to claim submission, denial management, and outstanding AR.
  • Ensures integrity and timeliness of payments are received by all pay sources, identifies and researches deficiencies and inconsistencies for escalation and resolution.
  • Builds and utilizes analytic reports from clearinghouse to direct denial management and assist team with working receivables efficiently. Reviews denials and outstanding aged receivables to identify and assign workloads to Billing Representatives based on various data points on a daily/weekly/monthly basis.
  • Participates as an active team member in regards to development of new programs/coding within the Electronic Health Records systems. Confirms billing and payments for new programs or new coding/guidelines are in compliance with direction published by pay sources.
  • Acts as a liaison between the Billing department and program staff, vendors, and payer representatives. Establishes and maintains relationships to improve dialogue and processes.
  • Attends trainings and conferences as required which may result in occasional travel.
  • Analyzes and researches trends in denials and aging to identify the cause and possible solution(s). Communicates findings and develops a plan to resolve under the guidance of the Billing Operations Manager, assists in the execution of the plan.
  • Completes regular audits of claims worked by Billing Representatives to ensure claims are worked effectively in addition to tracking weekly productivity measures; compiled data will then be reviewed by the Billing Operations Manager.
  • Proactively escalates claim processing concerns with management.
Requirements:
  • Associate's degree or 3-5 years prior healthcare revenue cycle analyst experience (if no degree) preferred.
  • 2-3 years management experience.
  • Ability to resolve conflict and delegate tasks within scope of work.
  • Ability to schedule, meet, and maintain daily and monthly routines, as well as preserve the integrity of the EHR.
  • Ability to identify team goals and evaluate progress, in addition to coaching team members to achieve these goals.
  • Extensive knowledge of medical insurance and an overall understanding of managed care products (HMO, PPO, ACO, etc.) as well as billing and collections with CPT, ICD-10, and HCPC coding and medical terminology.
  • Understanding and ability to read and edit 5010 HIPAA transaction standards including, but not limited to, 837, 999, 277, and 835 file types.
  • Proficient in Microsoft Office products with strong skills in Excel (VLOOKUPs, pivot tables, formulas, etc.).
  • Extremely detail-oriented with strong analytical and problem-solving skills.

BHN maintains its commitment to social justice and diversity and strongly encourages diverse candidates to apply.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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