Clinic Revenue Manager

San Francisco Community Health Center•San Francisco, CA

55d•Onsite

About The Position

The Clinic Revenue Manager (CRM) is a highly visible role that takes control and forwards the financial flow of patient services at SFCHC, a Federally Qualified Health Center (FQHC). The CRM guarantees that appropriate information is collected, verified, and documented from the initial appointment to the final settlement of charges when bills are fully paid. The CRM is responsible for ensuring that all processes are efficient, adhering with regulatory standards yet removing barriers to person access to whole person care. Importantly, the CRM works to improve cash flow, minimize bad debt, reduce denials and no-shows enhance patient satisfaction and appointments. This position r eports to the Director of Clinical Operations and works full time, on-site at the clinic location.

Requirements

A bachelor's degree in accounting, business administration, or related healthcare is a must
Valid certification in medical/dental billing or coding or related certification
5-10 years of experience in medical billing, coding, eligibility and health insurance
Supervisory experience of 3-5 years
Proficiency of HIPAA, PHI and patient rights
Computer, analytical, and organizational skills

Nice To Haves

Community healthcare or federally qualified health clinic experience is highly desirable
Experience managing claims to Medi-CAL, ECM, Medicare, commercial or private plans
Knowledge of sliding fee discount programs and the 340b drug discount for uninsured self-pay and public health assistance

Responsibilities

Managing the revenue cycle : Leads coding, billing, collections, denial management, and financial reporting
Clean claims are processed : Working with Ochin Billing Services [OBS], a 3rd party billing and collections services and Clinicians that charges are completed, coded correctly, signed off and submitted within 72 hours.
Resolving billing issues : Working to resolve any billing-related issues flagged by OBS with the respective clinicians within 5 days
Managing accounts receivables : Working to effectively manage accounts receivables and reduce over 60 days past dues
Annual master fee schedule : Updates SFCHC master fee schedule and sliding fee discount table for April 1 implementation
Staying apprised of trends : Staying current with coding and revenue trends
Implementing coding changes : Implementing coding changes and providing coding education to staff
Managing the team : Managing and supervising new patient enrollment, appointments, cancellations, insurance verification, eligibility, sliding fee, and works collaboratively with the ESA, ECM and program clients’ support staff
Reporting compliance and analyses: Creates provider productivity and utilization reports, weekly, monthly and year-to-date revenue analysis- charges, payments, adjustments and write-offs
Related fiscal and compliance functions: PIP, risk pool inventive, capitation, wrap-around and credentialing and enrollment of new providers to DHCS-PAVE, CMS-PECOS and health plans
Staff training and collaboration : Creates workflows, on-boarding and training of new staff, cross-functional training with allied services like ECM and programs
Other duties as assigned