Revenue Cycle Manager

4 weeks ago

Gaithersburg, Maryland, United States Adventist HealthCare Full time
Revenue Cycle Manager Job Description

Adventist HealthCare is seeking an experienced Revenue Cycle Manager to join our team. As a key member of our Patient Financial Services department, you will be responsible for managing relationships with external vendors, maintaining billing and practice management software, and providing education to clinical, billing, and coding staff.

Key Responsibilities:

  • Manage relationships with external vendors for practice management software and clearinghouse vendors.
  • Responsible for management and maintenance of billing and practice management software platform.
  • Provide up-to-date education for clinical, billing, and coding staff on coding trends.
  • Manage, develop, and mentor all revenue department staff, including billers, coders, and RCM Supervisors and Team Leads.
  • Reconcile all receivables and revenue reports and work closely with the finance department in the development of the monthly financial statements.
  • Conduct monthly analysis of Medicare/Medicaid/Third Party Payers.
  • Review and resolve issues related to claim generation and rejected/denied billings.
  • Responsible for weekly/monthly status reporting (development/preparation/maintenance)
  • Keeps abreast of all reimbursement billing procedures of third-party and private insurance payers and government regulations.
  • Participates in the development of coding and billing strategies, evaluating processes relative to the revenue cycle, and making recommendations while ensuring compliance with any relevant rules or regulations.
  • Participates in scheduled payer meetings to escalate the resolution of denials and outstanding appeals.
  • Generates and manages initiatives for cash acceleration through targeted projects, ensuring baseline is identified, projects are tracked, and outcomes reported.
  • Responsible for maintaining and developing workflows and assisting in backlog reduction.
  • Conduct routine scheduled meetings with staff to ensure consistency, ongoing education, and training.
  • Assists in developing, maintaining, and implementing standard operation procedures (SOP) associated with AR follow-up, collection efforts, and operations.
  • Works collaboratively with clinical departments to establish effective communications to further the efficiency of the revenue cycle process.
  • Monitors established KPIs and ensure that benchmarks are met. Deploy resources to address priorities and receivables inventory. Identifies trends and conducts root cause analysis. Makes recommendations to close identified goals in patient, people, process, and technology.
  • Directs staff to ensure daily productivity benchmarks and quality measures are achieved.
  • Evaluate staff performance and take corrective action in accordance with departmental HR guidelines.

Qualifications:

  • Bachelor's degree or equivalent in education and experience. An equivalent combination of education and experience will be considered.
  • Minimum of three years in a supervisory role preferred.
  • Knowledge of professional fee billing, reimbursement, and third-party payer regulation and medical terminology is required.
  • Working knowledge of regulatory requirements about health care operations.
  • Demonstrated coding and billing knowledge/experience preferred.
  • Ability to work independently and in a team environment.
  • Strong analytical and problem-solving skills.
  • Excellent verbal and written communication skills.
  • Ability to participate in an environment that promotes staff development, productivity, satisfaction, and efficiency.
  • Intermediate to advanced level proficiency in Microsoft Office (Word & Excel)

Work Schedule: Day Shift (Hybrid)

Pay Range: $83,124.675.20

Adventist HealthCare offers a comprehensive benefits package, including medical, prescription, dental, and vision coverage for employees and their eligible dependents, as well as employer-paid short and long-term disability, basic life insurance, and AD&D. We also offer paid time off, employer retirement contribution and match, and voluntary benefits such as flexible spending accounts, legal plans, and life, pet, auto, home, long-term care, and critical illness & accident insurance.

Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer and is committed to attracting, engaging, and developing the best people to cultivate our mission-centric culture. We do not discriminate in employment opportunities or practices on the basis of race, ethnicity, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, pregnancy and related medical conditions, protected veteran status, or any other characteristic protected by law.

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