Revenue Cycle Manager

JOB TITLE: Revenue Cycle Manager

EMPLOYER: Twelfth One, LLC dba Aspen Infusion

DEPARTMENTS: Billing

REPORTS TO: President

SUMMARY: Under the direct supervision of the President and working in conjunction with the Director of Finance, the Revenue Cycle Manager will develop, organize, direct, and manage all aspects of the revenue cycle functions to ensure timely, legally compliant, and accurate billing in order to maximize cash flow related to the collections of Accounts Receivables. This position will lead and direct all local revenue cycle functions including but not limited to registration, pre-cert/per-authorization, insurance verification, documentation completion and improvement, timely charge entry, coding, denial management, patient collections, and Charge Description Master (CDM). The Revenue Cycle Manager will be a subject matter expert of CMS, Medicare, Medicaid and other primary Third-Party Payer rules and requirements for all billing. The Revenue Cycle Manager will directly supervise the staff of the Billing department, consisting of approximately 20 FTE’s.

DUTIES AND RESPONSIBILITIES:

• Work collaboratively with the President and Director of Finance to develop and maintain the revenue cycle structure, duties, and procedures within the department that include efficient and accurate processing of encounters, denial management, payment posting, accounts receivable management and collections.
• Monitors and makes decisions regarding the value and collectability of accounts receivable. Makes recommendations and procedures to keep Days of Revenue in AR at acceptable levels. Prepares monthly analysis and reports pertaining to AR.
• Implements and monitors collection procedures, minimizing contractual and bad debt write offs, and maximizing cash collections
• Develop benchmarks and standards for each duty within the revenue cycle for a reportable analysis, on a monthly basis.
• Ensure compliance with state and federal statutory requirements including the Centers for Medicare and Medicaid services (CMS), Arizona Medicaid program, and all Third-Party payers.
• Manage and maintain relationships with all payers to improve patient revenue.
• Lead continuous performance improvement efforts and continually seek mechanisms to streamline and automate processes within the department.
• Create and monitor reporting to identify revenue gaps, denial issues and areas of opportunity for maximizing revenue.
• Develop and implement plans to close revenue gaps, resolve denials issues and maximize revenue.
• Performs ongoing analysis regarding third-party payment levels to ensure reimbursement is correct and analysis of third-party payer rejections and denials.
• Prepares financial analysis for use in the third-party and managed care negotiation payer process
• Oversee all month-end processes.
• Work collaboratively with departmental leaders that have a direct correlation to the revenue cycle on areas of improvement concerning compliance and revenue generation.
• Provide leadership, team building, and supervision to include hiring, training, disciplinary actions, and performance reviews for direct reports.
• Participate in professional development activities, including keeping current with trends and best practices in health center operations, and personal leadership and management development.
• Provide leadership and management of special projects as assigned.
• Performs other related duties as assigned by management.

SUPERVISORY RESPONSIBILITIES:

• Directly supervises approx. 20 employees within the department.
• Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
• Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

QUALIFICATIONS:

• 5 years of progressive revenue cycle experience to include Medicaid, Medicare, and Third-Party reimbursement preferably in a Critical Access Hospital & Rural Health Clinic setting.
• Demonstrated mastery of critical thinking, analytics, problem-solving and sound decision-making skills
• Established leadership and management skills, effective communication skills, professionalism, integrity, responsibility, and dependability.
• Knowledge and experience with CPSI software preferred but not required

COMPETENCIES:

• Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Leadership - Exhibits confidence in self and others; Inspires and motivates others to perform well; Effectively influences actions and opinions of others; Accepts feedback from others; Gives appropriate recognition to others.
• Managing People - Includes staff in planning, decision-making, facilitating and process improvement; Takes responsibility for subordinates' activities; Makes self available to staff; Provides regular performance feedback; Develops subordinates' skills and encourages growth; Solicits and applies customer feedback (internal and external); Fosters quality focus in others; Improves processes, products and services.; Continually works to improve supervisory skills.
• Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.
• Visionary Leadership - Displays passion and optimism; Inspires respect and trust; Mobilizes others to fulfill the vision; Provides vision and inspiration to peers and subordinates.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

• Continually required to stand, walk, sit, hear, and talk
• Continually required to utilize hand and finger dexterity
• The employee must occasionally lift and /or move up to 25 pounds
• Specific vision abilities required by this job include: Close vision; Distance vision; Peripheral vision; Depth perception and the ability to adjust focus

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Job Type: Full-time

Pay: $75,000.00 - $80,000.00 per year

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Management: 2 years (Preferred)
• Medical billing: 5 years (Preferred)

Ability to Commute:

• Chandler, AZ 85286 (Required)

Ability to Relocate:

• Chandler, AZ 85286: Relocate before starting work (Required)

Work Location: In person