Revenue Cycle Manager

Essential Functions

• Serves as the primary clinical services representative to ensure that maximum patient billing and collections results are achieved
• Monitor the effectiveness of CHN/PPSNE revenue cycle functional team efforts and develop strategies to improve overall RCM efficiency and effectiveness. Identifies issues and develops resolution strategies
• Use knowledge and experience to analyze detailed data to identify internal revenue cycle or payer trends, underlying root causes, and other related issues in regular reporting to PPSNE Finance and Clinical Services leadership
• Maintains consistent communication with CHN Billing staff
• Develops and assesses processes and procedures for billing and collections at the health centers to ensure accurate, timely, revenue-producing methods are always in place
• Communicates any patient account systems concerns or issues and solicits feedback from the Revenue Cycle team to ensure they are appropriately configured and functioning optimally
• Responds proactively to health center issues and concerns; works with Clinical Services Management Team to implements strategies for center staff education on best practices in billing and posting
• Directs and supports the Regional Directors, HCM and Health Center staff in dealing with billing and collections issues
• Develops and provides training to staff regarding any process changes with billing and collections
• Partners with finance to maintain PPSNE’s Finance manual, ensuring that it is always clear and current
• Work with Director of Finance on month end reporting and annual audit
• Works with provider contracting staff when new/modified reimbursement contracts are needed
• Serves as PPSNE’s AIC - Manages the relationships between finance, information technology, clinical services and CHN RCM and IT teams to ensure that strong partnerships are created and maintained
• Support health center staff in implementing agency priorities and customer requirements regarding billing/collections
• Maintains ongoing and continual feedback with staff members to identify and remove barriers to success and to create useful systems based on their input
• Assures that obstacles to customer service related to billing and collections get prioritized and addressed, and the obstacles outside their sphere of influence are brought to the appropriate forum
• Works to create systems that allow clinic flow and staff members to function at optimum levels
• Proactively investigates, provides input, and offers suggestions on the optimal use of Epic system functionality
• Supports Director of Finance in preparing monthly financial reports
• Supports CFO in preparing data for contract negotiations, annual budgeting and strategic planning
• Continually informs the Finance and Clinical Services teams’ decision-making process by sharing experiences and data
• Participates in agency-wide taskforces to address new initiatives from the perspective of the effect on billing and collections
• Manage the workflow of part time finance assistants for RCM related tasks, including Medicaid FPL follow up, preparation of Good Faith Estimates, third party billing (EDP, Dept. of Corrections)
• Supports and encourages a culture that provides a rich conduit of information and ideas between sites and departments, participates in ongoing feedback with colleagues, customers and processes, incorporates customer satisfaction into all aspects of the work
• Demonstrates self-awareness as it relates to racial and other identities: Aware of multiple group identities and their dynamics, and brings a high level of self-awareness, empathy, and humility to interpersonal interactions
• Builds authentic relationships: Interacts effectively and builds trust with a diversity of people and has demonstrated an ability to effectively work across difference. Communicates clearly and directly, continually able to hear, reflect, and act on feedback related identity and equity with the aim to learn
• Understands Racial Equity: demonstrated understanding of the role that racial inequity plays in our society and its impact on healthcare systems and institutions
• Demonstrates flexibility and teamwork; understands the interaction between this position and others with whom the position works directly and indirectly
• Ensures that interactions incorporate PPSNE values of integrity, partnership, customer focus, communication, and quality
• Supports the agency’s mission and all the reproductive health services offered including family planning services, women’s health screenings, testing and treatment of STI’s, birth control methods and abortion services
• Supports efforts of the agency’s diversity program to provide services that are culturally and linguistically competent; takes the initiative to develop own awareness and knowledge of diversity matters
• Works well with volunteers to achieve the agency’s mission

Qualifications

• Bachelor’s degree or certificate program, study in an area related to RCM or health care technology preferred
• Minimum of 5 years’ experience in healthcare administrative setting
• ICD-10, CPT-4,HL7, HTML, revenue cycle workflow or practice management system experience a plus
• Experience with health care billing and familiarity with electronic medical record systems
• Demonstrated project management skills including excellent follow through for multiple projects at multiple locations and ability to work independently
• Excellent computational and analytical skills
• Ability to create and analyze computer generated reports, utilizing data to inform the decision-making process
• Excellent communication and customer service skills; comfort level dealing with all levels in the agency including management team and external contacts
• Demonstrated skills prioritizing and organizing workload, superb attention to detail
• Must be able to work well independently and as a team member
• Ability to handle discreet, confidential information
• Ability to utilize Windows based word processing, spreadsheets, database, and ad hoc reporting software programs
• Knowledge of specialized practice management systems (like Misys Vision)
• Team centered cooperative work philosophy
• Strong supporter of PPSNE mission and all the reproductive health services offered
• Must be able to work in a stressful, fast paced, high volume environment that requires direct contact with diverse staff, clients, and volunteers
• Ability to routinely travel