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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 oversee operations at our headquarters. The Revenue Cycle Systems Manager will take charge of the effective execution of revenue cycle systems and strategies aimed at enhancing operational workflows. This role involves leading revenue cycle assessments across various departments, utilizing analytics and dashboard reporting to pinpoint business trends and discrepancies.
With a legacy spanning over a century, Planned Parenthood was established on the principle that everyone deserves access to the information and care necessary for healthy living and achieving their aspirations. As one of the largest providers of reproductive health services in Los Angeles County, Planned Parenthood Los Angeles (PPLA) is committed to delivering high-quality, affordable reproductive health care to individuals across the region. Our organization fosters a culture of collaboration among individuals dedicated to making a positive impact in their community and advancing the Planned Parenthood mission.
Qualifications:- High school diploma or GED is required; a Bachelor's degree in business, finance, healthcare, or a related field is preferred.
- Certification in EPM systems is preferred.
- A minimum of five (5) years of experience with CMS (Medicare/Medicaid) billing regulations is required.
- 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 practices 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 required.
- Willingness to travel as necessary.
- Reliable transportation for both onsite and off-site responsibilities.
- If using a personal vehicle for work, a valid driver’s license and current auto insurance compliant with state regulations are required.
- All employees play a crucial role in supporting the care provided to patients at our health centers through administrative and non-clinical services.
- Oversee the enhancement of revenue cycle operations by implementing and evaluating systems and initiatives that boost efficiency and uncover business opportunities.
- Manage and refine the revenue cycle processes within the organization.
- Analyze data related to revenue cycle processes to identify areas for improvement.
- Collaborate with stakeholders to ensure the successful execution of revenue cycle initiatives.
- Stay informed about healthcare information systems, revenue cycle operations, and relevant regulations.
- Train and mentor team members on revenue cycle processes and associated software.
- Develop and document policies and procedures related to revenue cycle operations.
- Monitor and report on the performance of revenue cycle systems and initiatives.
- Build 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 correction of rejected claims.
- Identify opportunities for charge capture and reimbursement improvement through various management tools and reviews.
- Report productivity metrics of Revenue Cycle staff to ensure high standards of productivity and proficiency are maintained.
- Support monitoring and follow-up to ensure timely repayment for all identified overpayments.
- Ensure compliance with existing and new regulations set forth by relevant authorities.
- Analyze financial and performance data to identify root causes of issues and propose solutions for improvement.
- Serve as backup for system analysts for various applications.
- Communicate with external entities on behalf of PPLA regarding identified issues and recommend appropriate actions.
- Assist in monitoring revenue cycle goals and report inconsistencies to management.
- Update communication logs and provide updates to staff regarding changes impacting operations.
- Identify trends from payers and recommend actions to enhance revenue maximization.
- Perform other duties as assigned by senior management.
- Comprehensive medical, dental, and vision coverage options for employees and eligible dependents.
- Basic life/AD&D policy at no cost, with additional voluntary coverage options available.
- Short-term disability, critical illness, and accident policies.
- 403(b) retirement plan with employer matching contributions.
- Flexible spending accounts for medical and dependent care expenses.
- Pre-tax reimbursements for public transportation and commuting costs.
- Generous vacation, sick leave, and holiday benefits.
- Competitive salary range based on experience and qualifications.
Equal Employment Opportunity: Planned Parenthood Los Angeles is committed to providing equal employment opportunities to all applicants without regard to protected characteristics.
