Job Description

Job Type:

Regular

Scheduled Hours:

40

Job Summary:

Reports to the Administrator of Coding and Education, the Revenue Cycle Manager is responsible for day to day operations of the Charge Editing and HCC Departments.

Job Description:

Job Title: Revenue Cycle Manager (Charge Entry)

BENEFITS:

• No Nights, Holidays, or Weekends.
• Paid Time Off
• Medical, Dental, and Vision
• 403b with Match
• Opportunity for career growth

REQUIRED SKILLS AND KNOWLEDGE:

Ability to manage and prioritize multiple tasks, knowledge of Excel, Word, Outlook and PowerPoint and the ability to learn other computer skills. Must have good organizational skills and work professionally with doctors, hospital administration and management, SEP associates and the public

DUTIES AND RESPONSIBILITIES:

• Monitors claim submission to ensure all claims are filed and denials are fixed.
•  Maintains, evaluates, and prepares payroll.
• Monitors associates with regards to attendance, job performance, and training. Audits their daily work within department.
•  Coordinates associate schedules and maintains appropriate staffing levels.
•  Coordinates and assesses the training of associates.
•  Maintains leadership role and assists in promoting growth and development of associates. 
• Responsible for tracking changes in insurance companies and coding.
• Delegates job responsibilities accordingly to associates.
• Handles complaints and irate patients in a professional manner.
• Reviews practice management work files for completeness and accuracy.
• Ensures associate productivity measures are fair, accurate and being reached by each associate. Develops a workplan for those not meeting productivity.
• Responsible for assuring all designed billing processes are being followed accurately. Suggests changes and improvements if billing processes appear to be failing.
• Maintains the highest level of associate confidentiality.
• Works in conjunction with HR to interview candidates for openings. Uses corrective action when appropriate.
• Evaluates associate performance and provides feedback in a timely manner. Obtains physicians and mid-level practitioner feedback as necessary and appropriate.
• Oversees preparation and processing of insurance claims, patient statements, and financial analysis statistical reports.
• Analyzes claim denials to improve clean claim submission. Reviews payments received to ensure desired reimbursement rates are received. Reviews and approve accounts receivable refunds requests.
• Attends and participates in insurance provider rep meetings.
•  Other duties as assigned.

OTHER REQUIRED SKILLS AND KNOWLEDGE:

• Understanding and knowledge of Explanation of Benefits from insurance carriers.
• Able to key transactions with a 95% or better cumulative error rate.
• Knowledge of computer and applications.
• Knowledge of Family Practice/Internal Medicine/Pediatric billing, various multi-specialty and hospital charges.
•  Knowledge of medical insurance, managed care plans, CPT and ICD-9-CM &ICD-10-CM, HCPCS codes, and collection laws.
• Skills in establishing and maintaining effective working relationships.
•  Effective communication with patients/family members, insurance company representatives, co-workers, and management.
• Ability to work independently and perform job duties with minimal direction.
• Knowledge of company policies and procedures and the associate handbook.
• Demonstrated ability to work successfully in a team-based decision-making culture.
• Demonstrated ability to work independently resulting in effective outcomes and on-time performance.
• Experience in planning and coordinating multi-disciplinary communications strategies, strategic initiatives, and events. 
• Must respond and follow through to requests from customers promptly.
•  Must work carefully and precisely with attention to detail.
• Must utilize resources wisely.
• Performs duties willingly and with initiative. Shares necessary information so co-workers can do the same.
• Cooperates with other departments and work groups.

EDUCATION:  

High School Diploma or GED

YEARS OF EXPERIENCE:

Required: 3+ years in a medical billing office.
Desired: 1 – 2 years Management experience desired.

LICENSES AND CERTIFICATIONS:

CPC required within seven months for supervision of charge entry department

FLSA Status:

Exempt

Right Career. Right Here. If you have a passion for taking care of the community and are interested in Healthcare, you will take pride in the level of care we provide at St. Elizabeth. We take care of patients and each other. 

Job Tags

Work at office, Weekend work,

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