Manager, Revenue Cycle Job Description
Manager, revenue cycle
provides ongoing formal and informal education to the medical staff regarding coding documentation rules and regulations, MS-DRG coding and reimbursement guidelines.
Manager, Revenue Cycle Duties & Responsibilities
To write an effective manager, revenue cycle job description, begin by listing detailed duties, responsibilities and expectations. We have included manager, revenue cycle job description templates that you can modify and use.
Sample responsibilities for this position include:
Perform Q/A for underpayment resolution functions
Arrange training of new employees
Review each staff member’s productivity on a monthly basis and performs annual evaluation
Resolve issues escalated by underpayment resolutions staff
Monitors assigned payer publications
Calling upon revenue cycle subject matter expertise, personal experience and knowledge of the company's revenue cycle operations, and using sound judgment and critical thinking skills, assigns a risk/priority category, determines impacted provider/supplier types, and assigns an internal review date for each item abstracted into RegTrack
Exercises judgment and discretion, and applies expertise and knowledge of the company's revenue cycle operations, to identify, research, filter, and annotate items that are out-of-scope or non-value-add for Conifer revenue cycle services
Ensures that all steps required to be taken with respect to payer publications in the individual's scope, including but not limited to those reflected in pre-transmission checkpoints, job aids, process documents, and policies related to state and federal regulations, are followed to ensure efficient and high quality output by the regulatory team
As required and assigned, validates that the operational revenue cycle teams have completed the steps necessary to address selected payer requirements (high level oversight and fulfillment tracking)
Identifies potential risk areas associated with existing payer requirements and communicates about such risk areas with revenue cycle teams
Manager, Revenue Cycle Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Manager, Revenue Cycle
List any licenses or certifications required by the position: CPC, PMP, CCS, CAP, ACHE, HFMA, BLS, RHIT, RHIA, CCDS
Education for Manager, Revenue Cycle
Typically a job would require a certain level of education.
Employers hiring for the manager, revenue cycle job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and High School Degree in Business, Healthcare, Finance, Administration, Education, Accounting, Management, Business/Administration, Associates, Healthcare Administration
Skills for Manager, Revenue Cycle
Desired skills for manager, revenue cycle include:
HCPCS
CPT-4
MS Excel & MS Word
Payer rules
Regulations and guidelines to ensure ethical and compliant standards and provide continued education for staff as appropriate
Hospital Administration
Hospital registration/billing systems
Medical terminology
Related hardware/software
Desired experience for manager, revenue cycle includes:
Analyzes performance data generated in the operation of all aspects of RegTrack (pre and post transmission)
Assists the Director, Revenue Cycle Regulations, and other members of the regulatory team in planning, preparation, and presentation of regulatory issues at User Groups
Strong business auditing skills and attention to detail, with the ability to identify, evaluate and report on financial transactions and internal controls
Effective decision making skills that allow for logical, sound judgment in the use of resources
Knowledge of insurance company practices regarding refunds and healthcare credits
Ensure program is operating according to contractual obligation by providing day-to-day guidance to team members, monitoring compliance to program policies and procedures and turn-around times, and ensuring adherence to quality expectations
Manager, Revenue Cycle Examples
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Manager, Revenue Cycle Job Description
Job Description Example
Our company is growing rapidly and is hiring for a manager, revenue cycle. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for manager, revenue cycle
- Staffing meetings, discussions and planning/interviews
- Building strong personal relationship with key associates of executive clients
- Creating and executing account strategy to assure that we are aligned with partnership
- Achieving SLAs (service level agreements) with high level of client satisfaction, diagnosing client issues for full resolution with root cause analysis
- Providing knowledge and industry expertise to our key partners
- Reviewing working reports to proactively identify potential issues and participating in business reviews and regular face-to-face meetings in conjunction with service delivery or senior service delivery peer
- Responsible for consistent communication with assigned practices regarding improvements and/or deficiencies around revenue cycle performance
- Evaluating the clients billing needs
- Creating and educating customers on best practice workflow
- Responsible for content build in the software to ensure good billing workflows
Qualifications for manager, revenue cycle
- Prior experience with auditing and internal controls review in a healthcare revenue cycle strongly preferred strong understanding of compliance issues, their importance and consequences
- Possess in-depth knowledge of local health care rules and regulations, insurance company laws and regulations, including billing, coding and documentation requirements
- Demonstrated ability to lead multi-disciplinary teams through complex, medical, social and financial conversations
- Ability to analyze trends, develop and maintain performance goals and regularly provide information to senior management
- Must be able to demonstrate effective written and verbal communication skills, training and facilitation skills
- Demonstrated ability to provide superior customer service
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Manager, Revenue Cycle Job Description
Job Description Example
Our growing company is searching for experienced candidates for the position of manager, revenue cycle. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for manager, revenue cycle
- Establish working relationships with key department heads and staff members throughout the institution
- Serve as a member of the institutional billing compliance committee and participate in standing and ad hoc institutional committees and work groups to address issues related to hospital or physician billing
- Review policies and procedures with a focus on continuous improvement efforts
- Facilitate closes processes within the assigned function(s) on a routine basis
- Within new or expanded services, deliver RCM and coding expertise against defined Product initiatives
- Drive and execute the relative pilots/alpha/beta testing experiences, from the Product standpoint, including recruitment of customers/prospects, identification and organization of targeted learnings to bring an opinion to other teams, gap-filling, and service requirement to GA - affording overall program support to all the various stakeholders
- Financial Operation
- Audit Productivity
- Maintains effective, consistent communication with Revenue Cycle team
- Identifies issues and risks and communicates to the appropriate parties
Qualifications for manager, revenue cycle
- Skilled in coaching, counseling, and developing others to achieve operational objectives
- Eligibility requirements for special circumstance coverage
- Comprehensive knowledge of laws, rules, regulations, procedures and departmental policies relating to admissions and eligibility for reimbursement from Medi-Cal, Medicare and other public and private medical/financial assistance programs including Title 22 of California Administrative Code
- Experience with healthcare organization preferred
- Ability to travel up to 100% by various conveyances
- Minimum of 5 years of Hospital Revenue Cycle environment experience
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Manager, Revenue Cycle Job Description
Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of manager, revenue cycle. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for manager, revenue cycle
- Identify internal and external opportunities (contract language, processes) to facilitate effective operations
- Work as a liaison between the overpayment resolution staff and other SSC staff
- Define the scope of the project in collaboration with senior management and transfer them into a project plan
- Establish improved systems functionality to ensure goals of RCM team are met
- Collaborate with IT department in support of billing processes and management reports
- Aid in test of system functionality prior to release of changes to production environment
- Document policy and procedures relating to programs
- Lead and facilitate meetings and team activities
- Report and escalate to manager as needed
- Adept in problem solving and resolving conflicts
Qualifications for manager, revenue cycle
- Strong written and verbal communication skills and a strong affinity for customer service and dealing with people
- Ability to work in a fast paced, self-directed and team environment excellent problem solving, organizational skills and professionalism
- Ability to work and speak to (influence) all levels of leadership within client organizations, TPS
- Perform highly complex management-level duties supporting all aspects of revenue cycle and billing operations for the UW Medicine Reference Lab with responsibility for $30M+ revenue annually
- Preauthorization Program, Registration, Claims, Payments & Credits, Insurance Follow-Up, Client Follow-Up, Patient Accounts & Inquiry, Revenue Cycle Reporting, Funds Flow Management
- 3+ years working in a client service, business development, or sales role
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Manager, Revenue Cycle Job Description
Job Description Example
Our growing company is looking for a manager, revenue cycle. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for manager, revenue cycle
- Develops recommendations for departmental budget in consultation with the Director
- Monitors budget performance
- Authorizes purchase of office supplies and equipment under $500.00
- Manages staff and has responsibility for hiring, firing, performance management, and results of the assigned area
- Approves PTO usage and overtime requests
- Assures that initial and ongoing training occurs for all employees
- Approves initiation of disciplinary proceedings for any subordinate, in consultation with Human Resources
- Solves difficult payment and associated Mount Sinai practices or network problems (whether Hospital or FPA based)
- Initiates and answers pertinent correspondence
- Prepare and communicate month end summary reporting schedules to hospital and corporate leadership
Qualifications for manager, revenue cycle
- Must be detail oriented, organized, and have strong multitasking abilities
- Ability to demonstrate supportive relationships with peers, vendors, partners, and corporate/facility executives
- Experience with MS PowerPoint preferred
- Bachelor’s Degree in Accounting, Healthcare Administration or equivalent and five years of professionally related experience in a physician practice setting
- 3+ year years of medical billing experience preferred
- Knowledge of Medicare, Medicaid, commercial paper and electronic claims processing
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Manager, Revenue Cycle Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of manager, revenue cycle. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for manager, revenue cycle
- Develop action plans and track progress towards successful implementation
- Develop deep understanding of company product offerings for effective communication with patients, payers, and clients
- Identify and communicates changes in regulatory environment
- Oversee the job functions of staff as it relates to the process flow and encourages ongoing skill development and hands-on problem solving within and outside the department
- Act in a proactive manner to identify issues, develop resolution and implement change within department/organization objectives
- Assists in the development of short and long term goals and objectives for the RCM Department
- Serves as the central point of communication for the Revenue Program
- Provides regular status reporting and issues escalation/resolution to the Access and Revenue Application Manager and Program Manager
- Responsible for the oversight of front office duties to include scheduling, check-in, and co-pay/co-insurance collection
- Lead engagements and analyze and document provider revenue cycle processes, while focusing on specific areas of concern identified by using current revenue cycle methodologies
Qualifications for manager, revenue cycle
- Ability to work independently part of an extended, cross-functional teams
- Two to four years' experience in healthcare reimbursement, working specifically with collections preferred
- Minimum of two years' related supervisory experience preferred
- Billing, collection and posting experience
- Able to interact with providers and practice managers
- Intermediate to Advanced computer skills and proficiency in MS Word, Excel, Outlook, Database management/maintenance, and Internet usage