The Revenue Cycle Manager is responsible for directing, organizing, and managing the entire revenue cycle, including all personnel involved in revenue cycle efforts; developing and monitoring productivity standards; and preparing/reviewing performance reports.
Duties and Responsibilities
Essential Functions
• Establishes revenue cycle benchmarks, and standards of practices with policies and procedures consistent with organizational goals, infrastructure, state, and federal requirements. Oversight of all staffing functions (i.e. Billing & Front Desk) and provides leadership with training. Develops and maintains the highest standards of professionalism and accountability.
• Oversees the development, maintenance, implementation, and training of protocols, policy and procedures for all functions related to the revenue cycle.
• Works with executive management, providers, and accounting to create financial and reporting regarding the revenue cycle.
• Gather productivity, quality, and financial data from EHR and other sources and use to provide meaningful information to appropriate staff.
• Plans and conducts regular department meetings. Communicates updates to the Chief Financial Officer (CFO), Chief Operations Officer (COO), and Business Operations Director in a timely manner. Works with Business Operations Director to ensure best practices related to patient access and the revenue cycle.
• Develops departmental goals, objectives, established staffing patterns, and organizes the work of the departments.
• Prioritizes daily departmental workflow in conjunction with supervisory team.
• Implements new processes and protocols as these become necessary and assigned.
• Ensures an appropriate education and feedback process is in place to provide regular education to FQHC providers on revenue cycle.
• Ensures department staff provide the highest level of customer service.
• Interacts with the Business Operations Director to develop strategic plan for all functions related to the
revenue cycle.
Billing
• Directs and oversees all functions of coding, claim management, billing, payment, and collections.
• Monitors, educates, and codes appropriate procedures performed by the practice.
• Responsible for overseeing posting of charges, adjustments, and payments to patient accounts and assuring accuracy and timeliness.
• Keep abreast of Medicare, Medicaid (Medi-Cal), and other third party payer rules and regulations with respect to billing and other matters and communicates this information to the physicians and appropriate
• Conducts re-imbursement monitoring for individual insurance carriers.
• Works with CFO, COO, and Business Operations Director to ensure proper cash controls are in place and payments received are posted accurately and timely.
• Work closely with CFO to prepare month-end and year-end financial close.
Front Desk
• Supervise and support Front Desk Leads to ensure the quality of the insurance, demographics, and eligibility data entered, as well as monitoring all time of service collections by providing revenue cycle reporting and training materials.
Qualifications for position
• Bachelor's Degree in Accounting, or related field desirable. Experience substitutes for education requirements.
