Manager of Revenue Cycle Operations in Procedural Areas

2 weeks ago


Washington, Washington, D.C., United States MedStar Medical Group Full time

Overview of the Role

MedStar Medical Group is seeking a Revenue Cycle Manager for Procedural Areas to enhance our operational efficiency. This role is crucial in overseeing the revenue cycle processes, billing, and coding for specialized procedural departments.

As the Revenue Cycle Manager, you will be responsible for managing revenue cycle services, ensuring compliance with billing regulations, and supervising the billing and charge entry teams. Your expertise will guide effective patient scheduling, registration, and all billing functions, including charge entry reconciliation and third-party reimbursement facilitation. You will also optimize accounts receivable management and ensure adherence to federal and local regulations, particularly concerning Medicare and Medicaid.

Key Responsibilities

  • Formulate and enforce policies and procedures related to revenue cycle functions across procedural areas.
  • Oversee daily billing entry and reconciliation processes, addressing any discrepancies promptly.
  • Supervise billing and charge entry personnel, collaborating with department leaders on administrative staff management.
  • Provide training and support to healthcare providers and billing staff on systems related to patient care and accurate billing practices.
  • Coordinate with Compliance to fulfill auditing requests and resolve any inquiries.
  • Stay informed on reimbursement optimization strategies and regulatory changes, training staff accordingly.
  • Maximize revenue through effective insurance verification, authorizations, and payment collections.
  • Maintain strong collaborative relationships with finance and patient financial services departments.
  • Initiate and refine billing policies, conducting audits to identify and rectify billing errors.
  • Analyze reimbursement issues and implement solutions to enhance revenue collection.
  • Audit documentation and coding for accuracy, working with Compliance to meet audit requirements.
  • Conduct annual reviews of coding and fees, ensuring all documentation is current.
  • Participate in clinical value analysis teams, focusing on revenue cycle implications of new procedures.
  • Establish performance standards for staff, ensuring ongoing training and development.
  • Manage procedural denials, analyzing root causes and developing preventive measures.
  • Oversee coding and device edits management within the facility.
  • Ensure timely and accurate entry of hospital charges through continuous auditing.
  • Conduct regular reviews of coding and fees, updating superbills as necessary.

Qualifications

Education

  • Associate degree required; Bachelor's degree in business or healthcare-related field preferred.

Experience

  • 3-4 years of progressively responsible experience in revenue cycle management.

This position offers a competitive salary range.



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