Revenue Cycle Job Description
Revenue Cycle Duties & Responsibilities
To write an effective revenue cycle job description, begin by listing detailed duties, responsibilities and expectations. We have included revenue cycle job description templates that you can modify and use.
Sample responsibilities for this position include:
Revenue Cycle Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Revenue Cycle
List any licenses or certifications required by the position: CPC, CCS, PMP, HFMA, NAHAM, EPIC, RHIA, CPA, RHIT, HB
Education for Revenue Cycle
Typically a job would require a certain level of education.
Employers hiring for the 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, Health Care, Management, Public Administration, Education, Finance, Healthcare, Accounting, Associates, Business/Administration
Skills for Revenue Cycle
Desired skills for revenue cycle include:
Desired experience for revenue cycle includes:
Revenue Cycle Examples
Revenue Cycle Job Description
- Production of the monthly statistical and analytic reports for the Patient Business Services department other corporate entities
- Serve as a liaison to cross-divisional teams and management as necessary
- Oversees processes involved with Denial Management and performs monthly analysis to identify trends and training needs
- Oversees the management of select revenue cycle personnel
- Escalate high risk accounts to management in a timely fashion
- Establishes vision and identities goals and priorities for management staff
- Resolves escalated reimbursement issues with Payers, Practices, US Oncology and systems for optimal management of accounts receivable
- Strong analytical skills combined with strategic thinking and problem solving ability
- Ability to thrive in ambiguity and drive results with minimal direction
- Ability to work effectively, build trust, and partner at all levels of the company – from front line teammates to senior executives
- Strong written, verbal, and interpersonal skills, particularly when up against tight deadlines and in times of stress/changing priorities
- Demonstrated leadership skills and ability to work independently member of a team to foster a positive work environment
- Personal values in line with DaVita’s core values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun
- Requires communication skills to clearly and concisely communicate verbally and in writing with peers, superiors, payers, physicians, ancillary departments
- High school diploma or GED, additional training beyond high school preferred
- Previous experience with GE Centricity (IDX) and/or EPIC preferred
Revenue Cycle Job Description
- Potential 4 hours flexing one day each week
- This position will also be held to an on-call schedule 1-2 days per month and be required to work 3 holidays per year
- Determine insurance company and financial status classification
- Determine priority of work and work collaboratively with clinical staff in processing of paperwork, lab requests, patient requests
- Saturday and Sunday weekly
- Supervise work of Patient Account Representatives and/or Revenue Cycle Representatives
- Serve as a payer reimbursement expert and technical resource
- Develop new and current staff through training and mentoring to increase revenue cycle knowledge
- Gather and respond to requests for information in response to benchmark surveys or questionnaires required by external agencies
- Generate monthly and ad hoc reports for PFS Leadership
- Can identify major types of coverage, associated claims and payment processes
- Is aware of the payer's claim settlement practices
- Can identify the major activities of the claims function
- Understands basic principles, techniques and terminology of dental and medical claims processing
- Can identify major types of coverage and associated claims
- Is aware of the company's claim settlement philosophy
Revenue Cycle Job Description
- Utilize pattern analytics, industry best practice trends and commonly accepted business practices and tactics to yield highest impact recommendations available
- Participate in continual education programs and activities that pertain to healthcare management, specific functional areas
- Direct and oversee the operations of patient access, case management, health information
- Understands all payer guidelines related to claim submission
- Supports patient care by resolving pre-authorization issues with physicians, radiologists, radiology technologists, and ancillary staff
- Develop and monitor employee performance goals to enure compliance
- Develops work standards, monitors quality and quantity of work processed, and ensures that policies are communicated and administered consistently
- Meet or exceed applicable productivity and accuracy standards in each area deployed
- Maintains focus on attaining productivity standards
- Delivers a positive patient experience
- Proficiency with computer software applications, Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable programs and an ability to quickly learn and apply new systems knowledge
- Understands basic principles, techniques and terminology of claims processing and reimbursement
- Describes the implications of the law to own function
- Participates in implementing adherence to specific aspect of this law
- Describes major HIPAA-related challenges to the organization
- Identifies relevant procedures that demonstrate HIPAA adherence
Revenue Cycle Job Description
- Maintains strict adherence to and compliance with all internal and external policies, procedures, rules, regulations, HIPPA privacy laws
- Performs data quality review as needed
- Provides solutions to leadership and educators which are identified through daily work activities
- Assess revenue cycle performance in accordance with set goals and objectives
- Monitors effectiveness of software, vendors, payers
- Manages Practice-wide projects including any legal requests
- Responsible for quality work, meeting deadlines, and adherence to the Practices Standard Operating Procedures (SOPs)
- Monthly, prepares revenue cycle financial analysis, including aged accounts
- Develops, implements, and maintains the Practices revenue cycle training materials
- Attracts high caliber people, accurately assesses strengths and development needs of employees
- Describes types of plan conversions in compliance with HIPAA guidelines
- Experience with patient accounting systems and billing/claim submission software
- Basic knowledge of healthcare billing (healthcare revenue cycle)
- Previous experience in selling revenue cycle and operation improvement solutions and Consulting Services to the larger Health Provider profit, not for profit and academic clients
- 2-3 years experience with medical billing/collection
- Living in or willing to relocate to Malvern, PA, or Kansas City, MO
Revenue Cycle Job Description
- Analyses data, prepares and presents project reports for management, clients or others
- Review treatment transactions and submit claims to insurance and/or third party payers
- Provide financial counseling to patients and families
- Determine if appropriate payment has been made by various entities and work with patients and insurance companies to obtain correct payments
- Appeal claim payments and/or denials
- Meet targets set by supervisor regarding assigned areas of the revenue cycle
- Identify trends and submit to supervisor to facilitate opportunities for process improvement
- Utilize new tools and processes to maximize the efficiency of the revenue cycle
- Comply with the established cash handling policies of the department
- Compile results of work list and other revenue cycle reports and submit to supervisor
- Related industry certifications (CHFP, CRCR, CRCE, CRCP, PMP)
- 5 years of related and progressively more responsible work experience in medical practice billing, preferrably in an environment that spans multiple practices and specialties
- Extensive experience with billing software
- Basic knowledge of and experience with Electronic Medical Records systems
- Certification equivalency by MGMA and/or coding certification preferred
- Knowledge/experience utilizing the Epic software system preferred