Revenue Cycle Manager, Procedural Areas
23 hours ago
MedStar Health is seeking a highly skilled Revenue Cycle Manager, Procedural Areas to oversee revenue cycle services, billing, and coding for the Cardiac-Arrhythmia Center. This role is responsible for managing all business-related revenue cycle operations, including effective and compliant patient and procedural scheduling and registration, billing functions, and third-party reimbursement and payment reconciliation.
Key Responsibilities- Develop and implement policies and procedures relating to revenue cycle functions of procedural areas and other assigned areas.
- Manage daily facility billing entry and reconciliation for procedural areas, reviewing missing charge reports and following up with providers and staff as needed.
- Oversee billing/charge entry staff and work with department directors to handle personnel-related activities, including hiring, termination, and evaluation of administrative/clerical staff.
- Educate and provide direction, training, and support to providers and coding/billing staff on systems related to patient care, accurate charge capture, documentation, and billing submission for procedural areas.
- Work with Compliance to meet auditing requests and resolve queries.
- Maintain current knowledge of reimbursement optimization methods for all payors and implement procedures to improve collections and reduce insurance accounts receivable (IAR) days.
- Responsible for maximizing revenue, including insurance verification and eligibility, insurance authorizations, collections of payments, and reconciliation of charges.
- Maintain strong relationships with MWHC finance department, Patient Financial Services (PFS), Revenue Control, and PUBS.
- Initiate billing policies and procedures for assigned departments, conduct charge audits, identify inconsistencies, billing errors, and missing charges, and analyze results of audits including denials.
- Identify reimbursement problems and/or trends, develop and implement solutions, and resolve problems to ensure reimbursement for procedural areas.
- Audit documentation and coding to ensure accuracy and legitimacy, working with department directors and the Compliance Office to meet audit requests and re-train physicians as needed.
- Conduct annual code and fee reviews and ensure encounter forms are updated.
- Participate in the clinical value analysis team and responsible for revenue cycle analysis of new procedures and products in both inpatient and ambulatory settings and maximization of reimbursement.
- Develop performance evaluation standards and objectives and monitor and evaluate staff performance, ensuring training and development of staff and resolving staff grievances to ensure compliance with Hospital contractual stipulations.
- Manage system-wide procedural denials for facility, including analysis of root cause and development of prevention process, and manage appeals for outpatient and acute care claims.
- Provide oversight on facility Coding and Device edits management.
- Maintain oversight of supply add process for routine related items requiring CMS approval letter as well as appropriate CPTs and price mark-up.
- Continuously audit documentation and coding to ensure accuracy and legitimacy, ensuring staff enters hospital charges correctly and in a timely manner.
- Conduct quarterly code and fee reviews and ensure all superbills are updated as necessary.
- Associate degree required; Bachelor's degree in business or health care related field preferred.
- 3-4 years of progressively more responsible job-related experience required.
This position has a hiring range of $80,995 - $144,102.
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Washington, Washington, D.C., United States MedStar Medical Group Full timeOverview of the RoleMedStar Medical Group is seeking a Revenue Cycle Manager for Procedural Areas to enhance our operational efficiency.In this pivotal role, you will be responsible for managing revenue cycle activities, including billing and coding processes for the Cardiac-Arrhythmia Center. You will lead the billing and charge entry teams, ensuring...
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Washington, Washington, D.C., United States MedStar Medical Group Full timeOverview of the RoleMedStar 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...
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Washington, Washington, D.C., United States MedStar Medical Group Full timeOverview of the RoleMedStar Medical Group is seeking a Revenue Cycle Manager for Procedural Areas to lead our operations. This role is essential in managing revenue cycle services, billing, and coding for specialized clinical departments. As the Revenue Cycle Manager, you will be responsible for overseeing all aspects of revenue cycle operations, ensuring...
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