Revenue Cycle Manager

Description

Summary

The Revenue Cycle Manager oversees the billing unit (Billing Leads, Medical billers/payment posting staff) and makes day-to-day decisions at Alliance Medical Center. The manager is responsible for understanding billing policies & procedures within regulatory mandates, assisting with follow-up on insurance, Medi-Cal, and Medicare claims. Assists in submissions of appeals as needed. Stays updated on all claims and their related AR statuses and issues for discussion with the director. Effectively manages claim corrections and rejections.

Some Essential Duties and Responsibilities Include:

· Provides ongoing billing leadership and support to Biller/Coder.

· Oversees Billing staff activities, which include work allocation and being available for staff needs. 

· Plans, manages, and coordinates with the management team as it relates to billing and collections work loading and productivity tracking. 

· Assists in the follow-up of claims and obtaining statuses using payor outreach (website & phone), clearinghouse, and EPIC. 

· Understands and remains updated with current coding and billing regulations and compliance requirements.

Requirements

Qualifications:

The requirements listed below are representative of the knowledge, skills, and/or abilities required to successfully perform the duties of the position.

Education and/or Experience:

· Associate degree or equivalent experience, required.

· 2+ years of supervisory experience or equivalent, required. 

· Medical Billing Certificate, required.

· Experience with EPIC, required. 

· FQHC experience or 5 years of experience in healthcare, required.

· Knowledge of reimbursement processes, billing, and accounts receivable, and successfully handling claims, required.

· Strong computer skills with emphasis on MS Office products and intermediate-advanced Excel abilities, required. 

· Must be comfortable working in a close-knit, team environment where attitude and work ethic are a priority, required. 

· Excellent written and verbal communication skills, required.

Certificates, Licenses, Registrations:

· Current and valid state licensure as CPC, CPMA, CRC, CCS, or CDEO.

Skills and Abilities:

· Capable of adapting to multiple applications of software. 

· Advanced proficiency with coding systems such as CPT, ICD-10, and HCPCS

· Medical terminology: a strong understanding of medical terminology is crucial for accurately interpreting clinical documentation

· Anatomy and physiology: knowledge of the human body and how diseases and conditions work.

· Attention to detail: The ability to focus and accurately process large amounts of detailed information.

· Active OCHIN Epic resolute billing or ambulatory coding proficiency.

· Computer skills: Familiarity with medical classification software, preferably EPIC, and other office 

· Certification as Medical Coder (CPCP or Certified Coding Specialist (CCS) designation.