Revenue Cycle Manager jobs in South Carolina

Description

The Revenue Cycle Support Manager is responsible for supporting the revenue cycle functions of Fetter Health Care Network. The Revenue Cycle Support Manager position will partner with the billing manager, billing team and other stakeholders across the revenue cycle path to identify and analyze the root causes of user and system issues regarding eligibility verification, provider enrollment, customer service, and billing denials, develop efficient workflows, and implement technology solutions within the revenue cycle's operating systems.

The Revenue Cycle Support Manager will be well-versed in healthcare revenue cycle positions within registration, scheduling, billing, cash application or denial management, and experienced in the healthcare reimbursement process. Also, in support of the billing manager, work collectively with the finance team to ensure timely accurate financial reporting and financial analyses for the leadership team’s effective decision making.

ESSENTIAL DUTIES AND RESPONSIBILITIES (Included but not limited to the following);

• Audits and ensures the sliding fee scale program is administered in accordance with HRSA compliance guidelines.
• Meets regularly and works with the team to address reimbursement and data needs while recommending target areas for reimbursement improvement.
• Reviews, modifies, and recommends changes to policies and procedures to improve Accounts Receivables Days.
• Performs ongoing trend analysis of payer rejections and denials. Supports the billing manager to perform proactive review of all recommended AR write-offs.
• Analyzes workflow and operational procedures to identify opportunities for improved reimbursement, develops and implements policies and procedures with leadership to ensure all services/charges are captured, recorded, processed, and bills in an accurate and timely manner.
• Maintains knowledge and understanding of insurance billing procedures to understand the reason for claims in hold and overpaid status to ensure resolution and timely payment.
• Gathers and analyzes denial information and identifies commonalities among denial reasons. Based on this data, creates training presentations for clinic leadership for overall reduction in denials and/or process improvements.
• Educates and communicates revenue cycle/financial information to patients, payers, co-workers, managers, and others as necessary to ensure accurate processes.
• Assists the billing manager in training new providers and financial eligibility specialists.
• Supports billing department functions including electronic charge capture, payment posting, and accounts follow up as directed by the billing manager.
• Collaborates with leadership team, revenue cycle operations, finance, billing IT, and finance.
• Supports the billing manager on monthly and other billing department reporting activities.
• Supports the billing manager on implementing and monitoring quality assurance programs.
• Participates fully on the middle management team regarding agency-related projects.
• Responsible for developing and implementing the agency mission and strategic vision in a collaborative leadership style.
• Oversees efforts for recruitment and staffing of the department in collaboration with the Human Resources Department.
• Represents the Agency in collaboration with executive leadership in its relationships with other health organizations, government agencies, third-party payers, and other stakeholders.
• Completes required continuous training and education, including department specific requirements. 
• Performs other duties as assigned

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:

• Reads, speaks, understands and writes proficiently in English. 
• Effectively communicates orally and in writing.
• Relates and interacts with staff at all levels of the organization.
• Represents the organization in a professional and effective manner to the community.
• Works independently and is self-directed.
• Provides operational and project management leadership across the organization.
• Supports, motivates and sustains a team-oriented culture. 
• Provides operational and project management leadership across the organization.
• Articulates organizational vision and implements organizational strategic initiatives.
• Demonstrates excellent analytical, quantitative and financial skills.
• Exercises sound judgment, tact and diplomacy.
• Evaluates and effectively addresses highly complex issues and problems.
• Delegates work, sets expectations and monitors activities of subordinate managers and staff appropriately.
• Demonstrates leadership and basic management skills.
• Proficiency in the use of Microsoft Office applications; Word, Excel, Outlook and PowerPoint.
• Valid drivers license and motor vehicle record that satisfy human resource policy 021.

Requirements

EDUCATION AND EXPERIENCE:

• Five years of experience in the health care industry, in particular an understanding of FQHC operations, including governmental payor billing, operating principles, guidelines, and bylaws.
• Knowledge of revenue cycle processes, payor billing, denials management and reporting.
• Knowledge of specialized reporting requirements and procedures in the preparation of accounting records and financial statements.
• Ability to compile and analyze data and prepare summary status reports based on the data utilizing automated systems, databases, spreadsheets, and word processing programs.
• Strong analytical and problem-solving skills.
• Exemplary communications skills (active listening, written & verbal).
• Excellent customer service skills.
• Utilized EMR/EMP software. Preferably eClinical Works.