About the Role
Responsible for Revenue Cycle management collaborating with the Senior Management Team to identify opportunities for improving cash flow while also developing and executing business plans to maximize revenue cycle performance.
The Manager of Revenue Cycle will be responsible for the development, implementation, and quality assurance of all revenue cycle policies and procedures. This role reports directly to the Executive Director/Vice President Business Strategy and Operations.
This hands-on role of Manager of Revenue Cycle will provide oversight for their team’s staffing, evaluation, training, and continued development. This role will ensure that the supply of resources meets work demand and teams are trained and compliant with standards and best practices. This role will be responsible for revenue cycle initiatives and standardization of new technology and operational functions.
This position is responsible for ensuring that patient billing and processing of payment receipts are consistently completed timely and in accordance with policy. This role will minimize bad debt, improve cash flow and effectively manage accounts receivables. This position will coordinate effective management of revenue cycle activities across the organization to include, but not limited to front desk, out-patient billing, and collections.
Responsibilities
• Manage, lead, and develop the billing and collection’s team to provide operational reporting, cash flow and efficiency analysis, and workflow support
• Develop revenue cycle KPI’s, work cross-functionally to build dynamic reporting, and enact change for a metrics-driven environment
• Lead and develop best-in-class processes
• You and your team will be responsible for identifying, analyzing, and problem-solving revenue cycle issues
• Build scalable processes, define roles clearly, assign responsibilities to team members
• Responsible for revenue cycle processes with focus on receivables, bad debt expense
• Ensure accuracy of deposits, demographic and other information entered into the electronic healthcare records
• Compile and prepare various status reports for management in order to analyze trends and make recommendations
• Participate in preparation of monthly, quarterly and annual financial reports
• Monitor data integrity for the practice management system to include reconciliation of charges and collections
• Provide a monthly summary on the status of outstanding charges greater than 90 days in the Accounts Receivable Aging report
• Provide monthly report on the status of credit balances
• Coordinate cross-functionally to stay current on credentialing issues, especially in the case of new providers, with an emphasis on scheduling self-pay patients and Medicare for the new providers until they are credentialed with third party organizations
• Responsible for ensuring the timeliness of processing and correction of rejected claims
• Work closely with the third-party billing entity, and/or in house billing personnel, to maintain a regular schedule for sending out billing statements in accordance with the Financial Policies and Procedures
• Maintain a regular schedule for writing off bad debts, including a process which documents attempts to collect or resubmit prior to removing the charge from outstanding receivables; Submit Bad Debt Write Off Report to management
• Monitor coding practices among providers to determine potential patterns of under coding or other irregularities
• Keep billing personnel up to date on third party coverage contracts, assuring that current contractual terms are understood and applied correctly
• Establish and maintain a regular process for follow up on patient accounts which are pending approval for third party coverage
• Work with Operations to assure that patients are informed of requirements such as income and/or insurance verification at the time that the appointment is scheduled; confirm that patients who have coverage that is not accepted at our organization are made aware of this fact before appointment is scheduled
• Coordinate with Operations to maintain process for verifying insurance at the time of each billable patient encounter
• Monitor and identify any patterns in remittance advices which would indicate employees are not properly collecting insurance information and correct the problem
• Maintain a process of coverage verification for scheduled patients prior to appointment
Qualifications and Experience
• 8+ years experience at Healthcare, MedTech, Diagnostics, or Pharma companies; must have at least 5 years of progressive experience in medical billing
• Expertise in metrics, analytics, and data synthesis in healthcare revenue cycle management
• Bachelor’s degree in Business or equivalent
• High level of attention to detail, excellent organizational skills and ability to prioritize demands and meet deadlines
• Knowledge of medical terminology associated with coding and billing
• A demonstrated ability to work cross-functionally across the organization to build or enhance processes
• Ability to supervise, coach, mentor, train, and evaluate work results
• Outstanding oral and written communication skills and the ability to work with all levels within an organization
• Self-motivation and desire to continually improve efficiency, accuracy, and timeliness of processes
• Demonstrates skill in use of personal computers, various programs and applications required to competently execute job duties
• Strong analytical and problem-solving skills
• Hands-on, self-starter approach on a daily basis
• Ability to prioritize tasks and to delegate them when appropriate
• Ability to act with integrity, professionalism, and confidentiality
• Proficient with Microsoft Office Suite or related software
• Ability to develop programs and lead process improvement projects
• Participate in strategic planning as requested by management
• Knowledge of laws, rules and regulations; standards and guidelines of certifying and accrediting bodies
• Must be onsite Monday through Friday
Beverly Hills Cancer Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.