Description
The Revenue Cycle Manager plays a crucial role in overseeing and optimizing the financial performance of Siskin Children's Institute by managing all aspects of the revenue cycle process. This includes revenue capture, billing, coding, collections, and reimbursement. The role requires a deep understanding of healthcare regulations, coding systems, and reimbursement methodologies, as well as strong leadership and analytical skills to drive process improvements and maximize revenue.
Requirements
QUALIFICATIONS:
Preferred - bachelor's degree in healthcare administration, Business Administration, Finance, or related field. Open to candidates who have proven revenue cycle experience in lieu of a bachelor's degree.Preferred - Certified Professional Coder (CPC) or Certified Revenue Cycle Professional (CRCP) designation.Minimum of 3 years of progressive experience in healthcare revenue cycle.In-depth knowledge of healthcare billing and coding regulations, payer requirements, and reimbursement methodologies.Strong analytical skills with the ability to interpret financial data, identify trends, and develop actionable insights.Excellent communication, leadership, and interpersonal skills, with the ability to collaborate effectively across departments and disciplines.Proficiency in revenue cycle management software, electronic health records (EHR), and Microsoft Office Suite.Demonstrated ability to lead and motivate teams, drive process improvements, and achieve measurable results in a complex healthcare environment.KEY RESPONSIBILITIES 1. Revenue Cycle Oversight Develop and implement strategies to optimize the revenue cycle process from patient registration to final reimbursement.Monitor and analyze key performance indicators (KPIs) to identify trends, variances, and areas for improvement.Ensure compliance with regulatory requirements, payer guidelines, and industry standards related to revenue cycle management.2. Billing and Coding Management Oversee the billing and coding operations to ensure accuracy, timeliness, and completeness of claims submission.Review coding practices to ensure proper code assignment and documentation integrity, minimizing denials and rejections.Stay abreast of coding updates, reimbursement changes, and industry trends to ensure compliance and maximize revenue capture.3. Claims Processing and Denial Management Manage the claims processing workflow to expedite reimbursement and minimize claim denials.Implement strategies to address claim denials and appeals, including root cause analysis and process improvements.Collaborate with internal stakeholders, payers, and external vendors to resolve billing discrepancies and ensure timely payment.4. Patient Financial Services Oversee patient financial services functions, including patient billing, insurance verification, and financial counseling.Develop policies and procedures to improve patient billing and collection processes, enhancing patient satisfaction and financial outcomes.Provide training and education to staff members on financial policies, insurance coverage, and patient payment options.5. Revenue Integrity and Compliance Conduct regular audits and reviews to ensure revenue integrity and compliance with coding and billing regulations.Identify and address potential compliance risks and revenue leakage opportunities through proactive monitoring and corrective action.Collaborate with compliance officers and auditors to address audit findings and implement corrective measures.6. Performance Analysis and Reporting Prepare regular reports and dashboards to communicate revenue cycle performance metrics, trends, and outcomes to senior leadership.Analyze financial data to identify opportunities for revenue enhancement, cost reduction, and process efficiencies.Present findings and recommendations to executive leadership and participate in strategic planning discussions.
