Healthcare Revenue Cycle Manager
3 days ago
As a Senior Associate in the revenue cycle management department, you will be responsible for overseeing and managing various aspects of revenue cycle operations. Your primary goal will be to optimize revenue generation, maximize collections, and minimize denials.
- Revenue Cycle Oversight: Manage and supervise the revenue cycle operations, ensuring compliance with regulatory requirements and industry best practices
- Develop and implement strategies to optimize revenue generation and enhance cash flow
- Monitor key performance indicators (KPIs) and financial metrics to identify trends, areas for improvement, and potential revenue leakage
- Collaborate with cross-functional teams, such as clinical departments, finance, coding, and compliance, to streamline revenue cycle processes
- Billing and Claims Management: Oversee the timely and accurate submission of claims to third-party payers, including Medicare, Medicaid, commercial insurance companies, and self-pay patients
- Monitor claim status and work closely with the billing team to resolve any coding or billing discrepancies
- Analyze denial patterns, identify root causes, and implement corrective measures to minimize denials and maximize collections
- Stay updated with changes in healthcare regulations, payer policies, and coding guidelines to ensure compliance and accurate billing
- Accounts Receivable Management: Review and analyze accounts receivable aging reports to identify delinquent accounts and take appropriate actions for timely payment
- Implement strategies for effective accounts receivable follow-up, including phone calls, appeals, and negotiations with payers and patients
- Collaborate with the finance team to reconcile payments, identify posting errors, and resolve outstanding balances
- Provide guidance and support to the team in resolving complex billing and reimbursement issues
- Process Improvement: Continuously assess revenue cycle processes, identify inefficiencies, and recommend process improvements to enhance operational efficiency and revenue integrity
- Implement automation and technology solutions to streamline workflows and reduce manual intervention
- Conduct regular audits and reviews to ensure compliance with coding guidelines, billing regulations, and internal policies
- Develop and deliver training programs to educate staff on revenue cycle best practices, coding updates, and compliance requirements
- Qualifications:
- Bachelor's degree in Healthcare Administration, Business Administration, or a related field (master's degree preferred)
- Experience in revenue cycle management or healthcare finance
- Strong knowledge of healthcare reimbursement systems, billing regulations, and coding guidelines (e.g., CPT, ICD-10, HCPCS)
- Proficiency in using revenue cycle management software and electronic health record (EHR) systems
- Familiarity with third-party payer requirements, including Medicare, Medicaid, and commercial insurance
- Excellent analytical and problem-solving skills with the ability to interpret financial data and identify trends
- Strong leadership and team management abilities
- Effective communication and interpersonal skills to collaborate with various stakeholders
- Certified Professional Biller (CPB) or Certified Revenue Cycle Specialist (CRCS) certification is a plus
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