Revenue Cycle Manager, Health Sciences Deans Office
Job no: 496647
College / VP Area: College of Health Sciences
Work type: Staff
Categories: Health Services, Full Time
PAY GRADE: 30E
CONTEXT OF THE JOB:
The Revenue Cycle Manager provides operational and analytical support to establish and achieve revenue cycle goals and objectives. Using industry guidelines and best practice standards, the Revenue Cycle Manager reviews clinic performance including scheduling, registration, coding, claims submission and adjudication. This position manages the relationship with the outsourced billing company and collection agency and ensures they adhere to University/Clinic policy and industry standards. Standard and ad hoc reporting is used to identify areas in need of improvement.
- Serve as a revenue cycle subject matter expert and function as the primary contact for questions and assistance.
- Manage the relationship with the outsourced billing company.
- Work with clinic management, legal counsel and others to review and update payer agreements.
- Review and advise clinic staff regarding changes and updates to CPT, ICD-10 and HCPCS codes and all laws, rules or regulations affecting documentation, coding and billing for services.
- Ensure payments are consistent with contract terms.
- Develop, implement, revise, and monitor procedures in support of billing and coding policies.
- Identify reimbursement issues, and research root causes of system failure and/or determine procedural issues impacting workflow and/or reimbursement.
- Troubleshoot and resolve system processes &/or operational issues.
- Ensure revenue cycle processes/workflows support data driven feedback both internally and to the billing company to improve revenue cycle processes and reduce re-work.
- Monitor on going performance of revenue cycle results through use of key performance indicators.
- Review and analyze standard monthly billing reports.
- Create new and ad hoc reports as needed or requested.
- Ensure monthly reports are distributed timely and clinic staff are able to interpret them and take appropriate action to address issues.
- Facilitate monthly meetings with clinics and billing company to review revenue cycle performance and metrics. Coordinate agendas, minutes and next steps to ensure improvements are identified and process improvement strategies are implemented.
- Review payer denials for each area and provide feedback to clinicians, practice managers and clinic directors.
- Provide trended metrics to identify areas that are performing well and areas in need of further development/review.
- Identify revenue cycle improvement opportunities.
- Support efforts to increase revenue through targeted claims analysis and identification of systematic errors that affect revenue.
- Document information obtained from payer newsletters, etc., to develop payer, coding and/or billing playbooks for all specialties.
- Facilitate education/training as needed.
- Facilitate annual coding and documentation reviews by working closely with the Operations/Compliance Director.
- Supervise the credentialing coordinator and credentialing process to ensure the integrity and timeliness of the credentialing process.
- Participate and lead revenue cycle projects and address opportunities and barriers as they arise.
- Provide regular project status updates to clinic management especially when there are delays or challenges.
- Prepare reports and presentations to targeted audiences in support of project goals.
- Work with the outsourced billing company and the College CFO to facilitate the development of budgets, revenue projections and new program proformas to ensure revenue integrity.
- Perform other job-related duties as assigned.
- Bachelor's degree in Healthcare Administration, Business Management, Accounting or related field and three years of professional billing experience, or an equivalent combination of education and experience.
- CPC Certified with working knowledge of medical Coding using CPT, ICD-10, HCPCS and Modifiers preferred.
- Experience with rehab coding preferred.
- Medical or rehab practice front end experience preferred.
- Excellent written, verbal, interpersonal, organizational, presentation skills, and attention to detail.
- Advanced analytical skills including data analysis and report production.
- Proficient in Microsoft Office, including Excel, Word, and PowerPoint.
- Highly developed customer service skills.
Notice of Non-Discrimination, Equal Opportunity and Affirmative Action
The University of Delaware does not discriminate against any person on the basis of race, color, national origin, sex, gender identity or expression, sexual orientation, genetic information, marital status, disability, religion, age, veteran status or any other characteristic protected by applicable law in its employment, educational programs and activities, admissions policies, and scholarship and loan programs as required by Title IX of the Educational Amendments of 1972, the Americans with Disabilities Act of 1990, Section 504 of the Rehabilitation Act of 1973, Title VII of the Civil Rights Act of 1964, and other applicable statutes and University policies. The University of Delaware also prohibits unlawful harassment including sexual harassment and sexual violence.
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