Responsible for directing the Revenue Cycle activity. This position manages the processes and provides guidance, direction and support for one or more of the following areas: registration, financial clearance, referrals/authorization processing, charge capture, coding, insurance follow-up and research billing.
- Responsible for day- to-day management of Revenue Cycle activities within the guidelines/policies and procedures.
- Reviews and manages A/R ; to include oversight of days in A/R, gross billings, gross collections, net revenue, percent of collections to net revenue and monitoring and management of denial rates and denial categories related to activity.
- Responsible for monitoring A/R and cash trends and instituting measures to control negative trends. Continually monitors processes and identifies problems or areas of concern and recommends corrective actions.
- Implements enhancements to Revenue Cycle efforts; works on process improvement across multiple A/R functions; including registration, verification of benefits, interaction with patients/families, self pay amounts, prior authorizations, insurance verification/follow up/denials, charge capture, timeliness and accuracy of coding and documentation, compliance, payer correspondence and cash posting.
- Collaborates and coordinates activities with clinical departments to improve processes, resolve problems and enhance communications.
- Management duties include interviewing, selecting and training employees; setting and adjusting pay rates and hours of work; planning and directing work; appraising productivity and efficiency, handling complaints/grievances and disciplining when necessary.
- Performs all other duties as assigned.
- Coding Certifications from AAPC or AHIMA is highly preferred
- Broad knowledge of health care compliance and insurance billing guidelines and rules.
- Experience with EPIC.
- Knowledge of budgets and budget processes, and ability to make sound financial decisions.
- Ability to coordinate and manage cost, quality and budgetary requirements; works with others to accomplish goals and objectives.
- Ability to lead, direct and contribute to initiatives and processes within the institution while creating a collaborative and respectful team environment and improving workflows.
- Ability to coordinate the diverse components of the project by quality project planning, execution and change control to achieve required balance of time, cost and quality.
- Strong ability to communicate verbally and in written form.
- Must be able to effectively communicate and present complex information clearly to a variety of audiences.
