Revenue Cycle Manager
3 weeks ago
Position Overview:
AICA Orthopedics seeks a skilled Revenue Cycle Manager to oversee the entire Revenue Department and centralized revenue cycle functions in a multi-disciplinary, multi-specialty medical clinic setting. The successful candidate will manage operational and strategic leadership functions, including accounts, communications with payor sources, collections, contract analysis, cash posting, billing transactions with clients, medical records, and report creation.
Key Responsibilities:
- Manage the revenue cycle, including pre-authorization, eligibility and benefits verification, claims submission, payments and payment posting, claims denial management, reporting, and patient revenue management.
- Supervise the Coding and Charges Department, ensuring proper CPT and ICD-10 documentation and entry, timely entry of all charges, and quality control audits.
- Implement and manage a system for accurate billing information entry into the billing system.
- Set and meet collections goals by department and for the organization overall, managing collection processes for individual patients, attorneys, and insurance companies.
- Manage staff performance, providing regular feedback, performance reviews, and one-on-one meetings.
- Oversee the hiring and training of staff.
- Attend monthly and/or quarterly AAPC seminars to ensure coding alignment with industry standards and changes.
- Plan and structure department workflow and staffing.
- Correctly code diagnoses and procedures.
- Ensure timely filing of all claims by implementing a timely standard of charge entry.
- Annually review and update the charge master.
- Negotiate contracts with insurance companies.
- Collaborate with clinical staff and other departments to maintain unity and resolve outstanding requests.
- Keep updated records and tracking reports as required by management.
- Ensure proper filing of liens.
Requirements:
- Bachelor's degree in Finance, Accounting, Healthcare Administration, or a related field.
- Revenue cycle certification preferred.
- Minimum of 5-7 years of experience in revenue cycle management, preferably in a multi-specialty medical clinic or similar setting.
- Proven experience in a leadership role managing a revenue cycle team and direct operational experience in all phases of medical revenue cycle.
- MS Office & Excel experience.
- Experience with EHR and PM software, specifically NextGen platform preferred.
- Ability to multi-task under time pressure, strong communication and leadership skills, and a team-oriented approach.
Work Environment:
AICA Orthopedics offers a dynamic work environment with opportunities for growth and development. The successful candidate will work 40 hours per week, with extended hours from time to time to meet deadlines. The position requires frequent sitting, limited lifting up to 10-15 pounds, frequent manipulation of documents, and frequent typing or use of a keyboard.
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