Revenue Cycle Operations Manager
1 week ago
The Revenue Cycle Manager is a key position responsible for overseeing the billing unit and making day-to-day decisions. This role requires a strong understanding of billing policies and procedures within regulatory mandates, as well as the ability to effectively manage claim corrections and rejections.
Key Responsibilities- Provide billing support to the billing team and assist with follow-up on insurance, Medi-Cal, and Medicare claims.
- Oversee billing staff activities, including work allocation and being available for staff needs.
- Plan, manage, and coordinate with the management team as it relates to billing and collections work loading and productivity tracking.
- Assist in the follow-up of claims and obtainment of statuses using payor outreach, clearinghouse, and EPIC.
- Understand and remain updated with current coding and billing regulations and compliance requirements.
- Motivate employees to achieve peak productivity and performance.
- Assist, resolve, and report any problems to the Director of Revenue Cycle regarding the day-to-day operations within the department.
- Support the front-end billing team with payer and customer-related questions and issues.
- Perform quality reviews assessments to ensure employees meet departmental expectations and adhere to quality assurance guidelines.
- Provide performance coaching and constructive performance feedback to billing and payment posters.
- Identify training opportunities through quality assurance reviews and prepare training materials for ongoing training resources.
- Work closely with the Billing Data Management team to continuously monitor and improve billing system rules and setup for clean claim submissions.
- Represent the Billing Department and interface with other departments as needed to respond to and resolve issues in the absence of the Director of Revenue Cycle.
- Identify required missing billing information and assign appropriate attention level.
- Verify and troubleshoot insurance eligibility and patient demographics.
- Identify system issues and trends - report findings to the appropriate party.
- High level of customer service, internal and external communication.
- Maintain accuracy by following policies and procedures, reporting needed changes.
- Maintain customer confidence and protect data by following HIPAA compliant regulations.
- Assist with cross-training of other team members.
- Medical Billing Certificate
- Associate degree or equivalent experience
- Preferred experience: FQHC experience or 5 years of experience in healthcare
- Capable of adapting to multiple applications of software
- Knowledge of reimbursement processes, billing, and accounts receivable
- Solid computer skills with emphasis on MS Office products
- Must be comfortable working in a close-knit, team environment where attitude and work ethics are a priority
- Excellent written and verbal communication skills
- Experience: FQHC experience preferred, experience successfully handling claims, experience with Epic and E-Clinical Works preferred
- At least one year related experience or equivalent preferred
This position requires frequent use of standard office equipment and access, input, and retrieval of information from a computer. The ability to communicate effectively in person or via telephone is essential, as well as the ability to give and follow verbal and written instructions with attention to detail and accuracy.
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